A decreased FEV-1, increasing age, presence of chronic infection (especially pseudomonas), a greater extent of lung involvement, high clinical dyspnea scale ratings, increased hospital admissions, a high number of annual exacerbations, and a BMI less than 18.5 lead to higher scores on both clinical scales and are associated with a poor prognosis in bronchiectasis; including increased mortality. Epidemiology
The prevalence and incidence of bronchiectasis is unclear as the symptoms are variable. The disease affects between 1 per 1000 and 1 per 250,000 adults. The disease is more common in women and in the elderly. In a Medicare cohort study in the United States, consisting of adults 65 years and older, the prevalence of bronchiectasis was 701 per 100,000 persons. A similar prevalence rate of bronchiectasis has been reported in other countries including China, Germany, the United Kingdom, Spain and Singapore. Those with a dual COPD and bronchiectasis diagnosis are more likely to be cigarette smokers and more likely to be hospitalized as compared to those with bronchiectasis without COPD. It became less common since the 1950s, with the introduction of antibiotics. It is more common among certain ethnic groups such as indigenous people.An estimated 350,000 to 500,000 adults have bronchiectasis in the United States. Specifically, children of the indigenous populations of Australia, Alaska, Canada and New Zealand have significantly higher rates than other populations. Overall, a shortage of data exists concerning the epidemiology of bronchiectasis in Asia, Africa, and South America.The prevalence and incidence of bronchiectasis has increased greatly in the 21st century.
The VSIV M protein is encoded by an mRNA that is 831 nucleotides long and translates to a 229 amino acid-protein. The predicted M protein sequence does not contain any long hydrophobic or nonpolar domains that might promote membrane association. The protein is rich in basic amino acids and contains a highly basic amino terminal domain. The VSV N protein is required to initiate genome synthesis. Vesicular stomatitis
Clinical signs and diagnosis
The main sign in animals is oral disease appearing as mucosal vesicles and ulcers in the mouth, but also on the udder and around the coronary band. Animals may show systemic signs such as anorexia, lethargy and pyrexia (fever). Disease usually resolves within two weeks, and animals usually recover completely.Cases of human infection with vesicular stomatitis virus have been described. Most of these cases have been among laboratory workers, veterinarians, and livestock handlers. In most cases, VSV infection has resulted in a short 3 to 5 day illness characterized by fever, headache, myalgia, weakness and occasionally vesicular lesions of the mouth. Serological testing is most commonly performed with an ELISA or complement fixation, and viral isolation can also be attempted. Treatment and control
No specific treatment is available, but some animals may require supportive fluids or antibiotics for secondary infections.Control relies on biosecurity protocols, quarantine, isolation and disinfection to ensure the viral disease does not enter a country or herd. Medical applications
Oncolytic therapy
In healthy human cells the virus cannot reproduce, likely because of the interferon response, which allows the cells to adequately respond to viral infection.