• Estimation of age-specific rates of reactivation and immune boosting of the varicella zoster virus.

      Marinelli, Isabella; van Lier, Alies; de Melker, Hester; Pugliese, Andrea; van Boven, Michiel (2017)
      Studies into the impact of vaccination against the varicella zoster virus (VZV) have increasingly focused on herpes zoster (HZ), which is believed to be increasing in vaccinated populations with decreasing infection pressure. This idea can be traced back to Hope-Simpson's hypothesis, in which a person's immune status determines the likelihood that he/she will develop HZ. Immunity decreases over time, and can be boosted by contact with a person experiencing varicella (exogenous boosting) or by a reactivation attempt of the virus (endogenous boosting). Here we use transmission models to estimate age-specific rates of reactivation and immune boosting, exogenous as well as endogenous, using zoster incidence data from the Netherlands (2002-2011, n=7026). The boosting and reactivation rates are estimated with splines, enabling these quantities to be optimally informed by the data. The analyses show that models with high levels of exogenous boosting and estimated or zero endogenous boosting, constant rate of loss of immunity, and reactivation rate increasing with age (to more than 5% per year in the elderly) give the best fit to the data. Estimates of the rates of immune boosting and reactivation are strongly correlated. This has important implications as these parameters determine the fraction of the population with waned immunity. We conclude that independent evidence on rates of immune boosting and reactivation in persons with waned immunity are needed to robustly predict the impact of varicella vaccination on the incidence of HZ.
    • Natural outdoor environments and mental health: Stress as a possible mechanism.

      Triguero-Mas, Margarita; Donaire-Gonzalez, David; Seto, Edmund; Valentín, Antònia; Martínez, David; Smith, Graham; Hurst, Gemma; Carrasco-Turigas, Glòria; Masterson, Daniel; van den Berg, Magdalena; Ambròs, Albert; Martínez-Íñiguez, Tania; Dedele, Audrius; Ellis, Naomi; Grazulevicius, Tomas; Voorsmit, Martin; Cirach, Marta; Cirac-Claveras, Judith; Swart, Wim; Clasquin, Eddy; Ruijsbroek, Annemarie; Maas, Jolanda; Jerret, Michael; Gražulevičienė, Regina; Kruize, Hanneke; Gidlow, Christopher J; Nieuwenhuijsen, Mark J (2017-10)
      Better mental health has been associated with exposure to natural outdoor environments (NOE). However, comprehensive studies including several indicators of exposure and outcomes, potential effect modifiers and mediators are scarce.
    • Pubertal Timing and Cardiometabolic Markers at Age 16 Years.

      Berentzen, Nina E; Wijga, Alet H; van Rossem, Lenie; Postma, Dirkje S; Gehring, Ulrike; Smit, Henriëtte A (2017-08)
      To examine the association between pubertal timing and cardiometabolic markers among adolescents.
    • The safety of medical devices containing DEHP plasticized PVC or other plasticizers on neonates and other groups possibly at risk (2015 update).

      Testai, Emanuela; Hartemann, Philippe; Rastogi, Suresh Chandra; Bernauer, Ulrike; Piersma, Aldert; De Jong, Wim; Gulliksson, Hans; Sharpe, Richard; Schubert, Dirk; Rodríguez-Farre, Eduardo (2016-04)
    • The sample of choice for detecting Middle East respiratory syndrome coronavirus in asymptomatic dromedary camels using real-time reversetranscription polymerase chain reaction.

      Mohran, K A; Farag, E A B; Reusken, C B E; Raj, V S; Lamers, M M; Pas, S D; Voermans, J; Smits, S L; Alhajri, M M; Alhajri, F; Al-Romaihi, H E; Ghobashy, H; El-Maghraby, M M; Al Dhahiry, S H S; Al-Mawlawi, N; El-Sayed, A M; Al-Thani, M; Al-Marri, S A; Haagmans, B L; Koopmans, M P G (2016-12)
      The newly identified Middle East respiratory syndrome coronavirus (MERS-CoV), which causes severe respiratory disease, particularly in people with comorbidities, requires further investigation. Studies in Qatar and elsewhere have provided evidence that dromedary camels are a reservoir for the virus, but the exact modes of transmission of MERS-CoV to humans remain unclear. In February 2014, an assessment was made of the suitability and sensitivity of different types of sample for the detection of MERSCoV by real-time reverse-transcription polymerase chain reaction (RT-PCR) for three gene targets: UpE (upstream of the E gene), the N (nucleocapsid) gene and open reading frame (ORF) 1a. Fifty-three animals presented for slaughter were sampled. A high percentage of the sampled camels (79% [95% confidence interval 66.9-91.5%, standard error 0.0625]; 42 out of 53) were shown to be shedding MERS-CoV at the time of slaughter, yet all the animals were apparently healthy. Among the virus-positive animals, nasal swabs were most often positive (97.6%). Oral swabs were the second most frequently positive (35.7%), followed by rectal swabs (28.5%). In addition, the highest viral load, expressed as a cycle threshold (Ct) value of 11.27, was obtained from a nasal swab. These findings lead to the conclusion that nasal swabs are the candidate sample of choice for detecting MERS-CoV using RT-PCR technology in apparently healthy camels.