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The Nevada reinfection case highlights the lasting mystery of Covid-19. Coronavirus outbreak

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Man Nevada I was infected with Covid-19 in March. He recovered and subsequently tested negative for Covid-19. In a pandemic he had infected millions of people in the United States, if he hadn’t been infected again in less than six weeks, he wouldn’t have been noticeable.

A 25-year-old man from the Southwestern United States appears to be the second published case of Covid-19 reinfection in the scientific literature, alongside the case of reinfection in Hong Kong.

A man, a long-term care home worker in Reno, was quarantined in his family’s home during his illness. Researchers believe he was re-infected in early June when his family, as well as an essential worker, brought home a slightly different strain of coronavirus.

“There was an outbreak in a long-term care facility and they were in a position to work with patients,” said Heather Kirwin, epidemiology program manager in Washoe County, Nevada.

The man had to be hospitalized for Covid-19 in his second match, but eventually recovered. He still suffers from side effects. “They are experiencing some sort of fatigue and some of the residual effects of brain fog,” Kirwin said.

Virgologists mainly expect Reinfection may occur.. But experts said the US reinfection case has highlighted a persistent mystery of the coronavirus. This includes the interaction of the virus with individual biology, how long the immune system of a person after infection protects from the virus. Reinfection cases are also important for assessing vaccine development and its impact. This is because the world medical community is competing for vaccine development.

“If we don’t get a reasonably long period of protection against natural infections, we probably won’t get from it. vaccine“Dr. Arnoldmont, a professor of epidemiology and public health at the University of Michigan School of Public Health, said. “Most of our vaccines are less effective than natural infections in terms of protection.”

Images from the National Institute of Allergy and Infectious Diseases show the transmission of SARS-CoV-2 virus particles isolated from patients.
Images of the National Institute of Allergy and Infectious Diseases show the transmission of Sars-CoV-2 virus particles isolated from patients. Photo: National Institute of Allergy an / AFP / Getty Images

Two cases alone cannot solve these mysteries. Experts said scientists would need population-level research to solve the problem. These case studies mark the very beginning of the task.

Dr. Rajesh T. Gandhi, an infectious disease specialist at Massachusetts General Hospital and a professor of medicine at Harvard Medical School, chairs the HIV Medical Association.

More broadly, the Nevada proceedings also reveal the power that strong testing, contact tracking, and public health expertise can bring when all three are under attack. In the decade since the Great Recession, public laboratories and contact tracking programs have cut funds.

Per capita funding for state health has fallen 16% since 2010 Kaiser Health News.. Many people are currently suffering. Overloaded by Covid-19 outbreaks, allegations, or complete conspiracy theories. Until recently, Kirwin led a team of just two epidemiologists (sometimes called “disease detectives”) who had to track all of the more than 8,000 cases in Washoe County.

“We operate for seven days, so we spend 10, 12, 14 hours a day, 4-6 days a week,” says Carwin.

Washoe County epidemiologists, Nevada Institute for Public Health, and university scientists spend a great deal of time identifying cases in Nevada, ensuring that samples are from the same person. Therefore, we carried out “paternity testing”.

Mark Pandri, head of the Nevada Institute for Public Health and associate professor of pathology at the University of Nevada’s Reno Medical College, said: Pandri was a co-author of a case study.

His lab was warned of the incident by one of Carwin’s epidemiologists who had been in contact with the patient. When the patient began reporting Covid-like symptoms, Kirwin notified the laboratory again.

The lab was able to retest the first sample as the technician planned to look for anomalies at the beginning of the pandemic. They store over 100,000 specimens, which invaded every corner of Nevada except Las Vegas. Those specimens included a 25-year-old specimen from Reno.

When Pandori’s lab found a man positive for Covid-19, Richard Tillet, a bioinformatics analyst at the University of Nevada, Reno, was asked to sequence the genomes of both the old and new samples. It was.

“I started with a cautious alert,” Tillet said. “I was absolutely confident that this was the real thing, and I hoped that others could find it and we weren’t making a mistake,” he said.

Tillett once again ran the panel and asked Joel Sevinsky of Theiagen Consulting LLC to verify the results. Scientists made the same discovery – the same patient, two different infections.

Tillett notified Pandri of the results, and Pandri sent a Washoe County Sheriff to the man’s house to collect DNA samples. This caused the team to perform a “father test” to ensure that the two were not different.

“Both are Covid-19 and both are also present in the dominant North American strain, but they are mutations that occur in the first infection and not in the second infection,” Tillett said. I will. “And the second infection has some unique and characteristic mutations.”

However, this can also lead to doubts. Did Nevada’s lab find needles in haystacks, or could many such cases remain unidentified due to cumbersome public health infrastructure?

According to experts, the case helps explain the constraints that U.S. public health workers are working on and how their work can explore the underlying questions about less-understood viruses. Said.

“National public health refunds are one of the things I’m really worried about,” said Mary Pittman, CEO of Public. health Initiative. Advocate and support global public health initiatives. “This is one of the things we have to recognize and improve, because this will not be our last pandemic.”

A case study of male reinfection Lancet preprint service, Or an unpeer-reviewed publication in late August. The case is currently undergoing peer review for further publication. of First case of reinfection Received peer review Published in Journal Clinical Infectious Diseases By researchers at the University of Hong Kong in August.

Similar to Hong Kong, Nevada researchers sequenced the genomes of two samples from the same person and examined the genetic code differences between the two infectious diseases. This finding points to a mysterious bag that has surrounded the coronavirus from the moment it was identified.

How long does innate immunity last? How often do you get severe during the second infection? Does the individual biology of a person play a role in reinfection?

“It takes a lot of cases to say. People will get sick a second time,” Gandhi said. “I can’t do that in a few cases because I don’t have enough to sink my teeth.”

Importantly, a 33-year-old man in Hong Kong was re-infected but asymptomatic on the second infection. In Reno, a 25-year-old man had a worse outcome and was hospitalized briefly with hypoxia.

According to Monto, the CDC has begun a longitudinal study examining these immunity problems, including the University of Michigan, which has a 300-household program originally planned to evaluate influenza vaccines.

“If you have to work hard to confirm it, I tell you it didn’t happen that often,” he said. “But one thing to note here is that people didn’t have much time to see it since they were first infected.”

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