Publications by authors named "Arne Broch Brantsaeter"

22 Publications

  • Page 1 of 1

Dispersion of SARS-CoV-2 in air surrounding COVID-19-infected individuals with mild symptoms.

Indoor Air 2022 02;32(2):e13001

Norwegian Defence Research Establishment, Kjeller, Norway.

Since the beginning of the pandemic, the transmission modes of SARS-CoV-2-particularly the role of aerosol transmission-have been much debated. Accumulating evidence suggests that SARS-CoV-2 can be transmitted by aerosols, and not only via larger respiratory droplets. In this study, we quantified SARS-CoV-2 in air surrounding 14 test subjects in a controlled setting. All subjects had SARS-CoV-2 infection confirmed by a recent positive PCR test and had mild symptoms when included in the study. RT-PCR and cell culture analyses were performed on air samples collected at distances of one, two, and four meters from test subjects. Oronasopharyngeal samples were taken from consenting test subjects and analyzed by RT-PCR. Additionally, total aerosol particles were quantified during air sampling trials. Air viral concentrations at one-meter distance were significantly correlated with both viral loads in the upper airways, mild coughing, and fever. One sample collected at four-meter distance was RT-PCR positive. No samples were successfully cultured. The results reported here have potential application for SARS-CoV-2 detection and monitoring schemes, and for increasing our understanding of SARS-CoV-2 transmission dynamics. Practical implications. In this study, quantification of SARS-CoV-2 in air was performed around infected persons with mild symptoms. Such persons may go longer before they are diagnosed and may thus be a disproportionately important epidemiological group. By correlating viral concentrations in air with behavior and symptoms, we identify potential risk factors for viral dissemination in indoor environments. We also show that quantification of total aerosol particles is not a useful strategy for monitoring SARS-CoV-2 in indoor environments.
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http://dx.doi.org/10.1111/ina.13001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9111593PMC
February 2022

Best practices of highly infectious decedent management: Consensus recommendations from an international expert workshop.

J Occup Environ Hyg 2022 03 16;19(3):129-138. Epub 2022 Feb 16.

Department of Environmental, Agricultural and Occupational Health, University of Nebraska Medical Center College of Public Health, Omaha, Nebraska.

With the increasing number of highly infectious disease incidents, outbreaks, and pandemics in our society (e.g., Ebola virus disease, Lassa fever, coronavirus diseases), the need for consensus and best practices on highly infectious decedent management is critical. In January 2020, a workshop of subject matter experts from across the world convened to discuss highly infectious live patient transport and highly infectious decedent management best practices. This commentary focuses on the highly infectious decedent management component of the workshop. The absence of guidance or disparate guidance on highly infectious decedent management can increase occupational safety and health risks for death care sector workers. To address this issue, the authorship presents these consensus recommendations on best practices in highly infectious decedent management, including discussion of what is considered a highly infectious decedent; scalability and storage for casualty events; integration of key stakeholders; infection control and facility considerations; transport; care and autopsy; psychological, ethical, and cultural considerations as well as multi-national care perspectives. These consensus recommendations are not intended to be exhaustive but rather to underscore this overlooked area and serve as a starting point for much-needed conversations.
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http://dx.doi.org/10.1080/15459624.2022.2027427DOI Listing
March 2022

Achievements and Challenges in the Prevention of Mother-to-Child Transmission of HIV-A Retrospective Cohort Study from a Rural Hospital in Northern Tanzania.

Int J Environ Res Public Health 2021 03 9;18(5). Epub 2021 Mar 9.

Department of Infectious Diseases, Ullevål Hospital, Oslo University Hospital, P.O. Box 4956, Nydalen, 0424 Oslo, Norway.

Despite the goal of eliminating new human immunodeficiency virus (HIV) infections in children, mother-to-child transmission is still common in resource-poor countries. The aims of this study were to assess the occurrence of mother-to-child transmission of HIV (MTCT) by age 18 months, risk factors for transmission, and the implementation of the national prevention of MTCT (PMTCT) program in a rural hospital in Tanzania. Data were collated from various medical registers and records. We included 172 children and 167 HIV-infected mothers. Among 88 children (51%) with adequate information, 9 (10.2%) were infected. Increased risk of MTCT was associated with late testing of the child (>2 months) [OR = 9.5 (95% CI: 1.8-49.4)], absence of antiretroviral therapy during pregnancy [OR = 9.7 (95% CI: 2.1-46.1)], and maternal CD4 cell count <200 cells/mm [OR = 15.3 (95% CI: 2.1-111)]. We were unable to determine the occurrence of MTCT transmission in 84 children (49%). The results from this study highlight that there is an urgent need for enhanced efforts to improve follow-up of HIV-exposed children, to improve documentation in registries and records, and to facilitate ease of linkage between these.
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http://dx.doi.org/10.3390/ijerph18052751DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7967482PMC
March 2021

The story of an extraordinary year: Challenges and opportunities in responding to Covid-19.

Transfus Apher Sci 2021 Apr 16;60(2):103092. Epub 2021 Feb 16.

Department of Infectious Medicine, Oslo University Hospital, Oslo, Norway.

Little more than a year after the first reports of a new coronavirus in Wuhan, China, the world is in the middle of a pandemic that has brought dramatic changes in societies all over the world. This is our story, as seen from the Department of Immunology and Transfusion at Oslo University Hospital (OUH).
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http://dx.doi.org/10.1016/j.transci.2021.103092DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7885672PMC
April 2021

Investigational treatment of COVID-19.

Tidsskr Nor Laegeforen 2020 09 24;140(12). Epub 2020 Aug 24.

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http://dx.doi.org/10.4045/tidsskr.20.0653DOI Listing
September 2020

The burden of herpes zoster disease in Norway.

Vaccine 2020 04 13;38(18):3501-3507. Epub 2019 Dec 13.

Department of Infectious Diseases Epidemiology and Modeling, Infection Control and Environmental Health, Norwegian Institute of Public Health, PO Box 222 Skøyen, N-0213 Oslo, Norway; MSD Norway, Associate Director Medical Affairs Vaccines. Electronic address:

Background: No national vaccination program against herpes zoster (HZ) is currently in place in Norway. We aimed to quantify the burden of medically attended HZ to assess the need for a vaccination program.

Methods: We linked data from several health registries to identify medically attended HZ cases during 2008-2014 and HZ-associated deaths during1996-2012 in the entire population of Norway. We calculated HZ incidences for primary and hospital care by age, sex, type of health encounter, vaccination status, and co-morbidities among hospital patients. We also estimated HZ-associated mortality and case-fatality.

Results: The study included 82,064 HZ patients, of whom none were reported as vaccinated against HZ. The crude annual incidence of HZ was 227.1 cases per 100,000 in primary healthcare and 24.8 cases per 100,000 in hospitals. Incidence rates were higher in adults aged ≥50 years (461 per 100,000 in primary care and 57 per 100,000 in hospitals), and women than in men both in primary healthcare (267 vs 188 per 100,000), and hospitals (28 vs 22 per 100,000). Among hospital patients, 47% had complicated zoster and 25% had comorbidities, according to the Charlson comorbidity index. The duration of hospital stay (median 4 days) increased with the severity of comorbidities. The estimated mortality rate was 0.18 per 100,000; and in-hospital case-fatality rate was 1.04%.

Conclusions: Medically attended HZ poses a substantial burden in the Norwegian healthcare sector. The majority of the zoster cases occurred among adults aged ≥50 years - the group eligible for zoster vaccination - and increased use of zoster vaccination may be warranted, especially among persons with co-morbidities.
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http://dx.doi.org/10.1016/j.vaccine.2019.11.054DOI Listing
April 2020

Non-tuberculous mycobacterial pulmonary infections.

Tidsskr Nor Laegeforen 2018 11 26;138(19). Epub 2018 Nov 26.

Bakgrunn: Lungeinfeksjoner med ikke-tuberkuløse mykobakterier påvises jevnlig i klinisk praksis. Diagnostikk og behandling er utfordrende, og internasjonale retningslinjer bygger i stor grad på erfaring og kasuistikker. Temaet er kort og generelt omtalt i Tuberkuloseveilederen, utover det finnes ingen nasjonal behandlingsveileder om temaet. Denne artikkelen sammenfatter den nyeste kunnskapen om emnet, med hovedvekt på diagnostikk og behandling.

Kunnskapsgrunnlag: Vi søkte i PubMed, Embase og Cochrane etter alle oversiktsartikler og systematiske oversiktsartikler i tidsrommet 2007-17 om ikke-tuberkuløse mykobakterier som årsak til lungesykdom.

Resultater: Ved diagnostikk og behandling av lungeinfeksjoner med ikke-tuberkuløse mykobakterier må både kliniske, radiologiske og mikrobiologiske funn vurderes før man beslutter om det er behandlingsindikasjon. Identifikasjon av art og eventuell underart av påvist mykobakterie og resistensmønster er av stor betydning. Behandlingen består av en kombinasjon av flere medikamenter over lang tid som ofte har mange bivirkninger og interaksjoner.

Fortolkning: Behandlingsresultatene for lungeinfeksjoner med ikke-tuberkuløse mykobakterier er varierende. Det er viktig å ta stilling til om nytten av behandlingen forventes å oppveie ulempene den kan medføre. For mange pasienter vil optimalisering av øvrig behandling for den underliggende lungesykdommen være viktigst. Pasientene må følges opp regelmessig med ekspektoratprøver og monitorering av bivirkninger.
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http://dx.doi.org/10.4045/tidsskr.18.0077DOI Listing
November 2018

Stratification by interferon-γ release assay level predicts risk of incident TB.

Thorax 2018 Apr 5. Epub 2018 Apr 5.

Department of Microbiology, Oslo University Hospital, Oslo, Norway.

Introduction: Targeted testing and treatment of latent TB infection (LTBI) are priorities on the global health agenda, but LTBI management remains challenging. We aimed to evaluate the prognostic value of the QuantiFERON TB-Gold (QFT) test for incident TB, focusing on the interferon (IFN)-γ level, when applied in routine practice in a low TB incidence setting.

Methods: In this large population-based prospective cohort, we linked QFT results in Norway (1 January 2009-30 June 2014) with national registry data (Norwegian Surveillance System for Infectious Diseases, Norwegian Prescription Database, Norwegian Patient Registry and Statistics Norway) to assess the prognostic value of QFT for incident TB. Participants were followed until 30 June 2016. We used restricted cubic splines to model non-linear relationships between IFN-γ levels and TB, and applied these findings to a competing risk model.

Results: The prospective analyses included 50 389 QFT results from 44 875 individuals, of whom 257 developed TB. Overall, 22% (n=9878) of QFT results were positive. TB risk increased with the IFN-γ level until a plateau level, above which further increase was not associated with additional prognostic information. The HRs for TB were 8.8 (95% CI 4.7 to 16.5), 19.2 (95% CI 11.6 to 31.6) and 31.3 (95% CI 19.8 to 49.5) times higher with IFN-γ levels of 0.35 to <1.00, 1.00 to <4.00 and >4.00 IU/mL, respectively, compared with negative tests (<0.35 IU/mL).

Conclusions: Consistently, QFT demonstrates increased risk of incident TB with rising IFN-γ concentrations, indicating that IFN-γ levels may be used to guide targeted treatment of LTBI.
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http://dx.doi.org/10.1136/thoraxjnl-2017-211147DOI Listing
April 2018

[Tattooed norwegian tourist with fever and rashes].

Tidsskr Nor Laegeforen 2017 02 7;137(3):205-207. Epub 2017 Feb 7.

Infeksjonsmedisinsk avdeling Oslo universitetssykehus, Ullevål og Nasjonal behandlingstjeneste for CBRNE-medisin Oslo universitetssykehus.

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http://dx.doi.org/10.4045/tidsskr.16.0710DOI Listing
February 2017

Hepatitis E - a neglected disease in Norway.

Tidsskr Nor Laegeforen 2016 Oct 25;136(19):1604. Epub 2016 Oct 25.

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http://dx.doi.org/10.4045/tidsskr.16.0675DOI Listing
October 2016

Human cytomegalovirus (CMV) in Africa: a neglected but important pathogen.

J Virus Erad 2016 Jul 1;2(3):136-42. Epub 2016 Jul 1.

Department of Infectious Diseases and Department of Acute Medicine , Oslo University Hospital Ullevål , Oslo , Norway.

In Africa, human cytomegalovirus (CMV) is an important pathogen in a diverse range of patient groups. Congenital CMV infection is common, and most children undergo primary infection during the first year of life. Preliminary studies suggest that these early primary CMV infections could have population-wide effects on growth and development. In most studies of adults, CMV seroprevalence is close to 100%, but some studies have found that significant minorities of adults are seronegative. CMV is a common cause of pneumonia and meningitis in hospitalised immunosuppressed patient groups, and CMV DNAemia may be an important marker of rapid progression and poor outcomes of HIV infection, despite roll-out of antiretroviral therapy (ART). Diagnosis and treatment of CMV-related disease is broadly neglected in Africa, and no randomised clinical trials of anti-CMV drugs have been conducted to date. Autopsy is rarely performed in Africa, but identifies CMV as a frequent pathogen when it is carried out. Here we review the available literature on CMV in Africa, primarily in adult patients, and discuss this in the context of contemporary understanding of CMV as a human pathogen.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4967964PMC
July 2016

Personal protective equipment management and policies: European Network for Highly Infectious Diseases data from 48 isolation facilities in 16 European countries.

Infect Control Hosp Epidemiol 2012 Oct 27;33(10):1008-16. Epub 2012 Aug 27.

National Institute for Infectious Diseases L. Spallanzani, Rome, Italy.

Objective: To collect data about personal protective equipment (PPE) management and to provide indications for improving PPE policies in Europe.

Design: Descriptive, cross-sectional survey.

Setting And Participants: Data were collected in 48 isolation facilities in 16 European countries nominated by National Health Authorities for the management of highly infectious diseases (HIDs).

Methods: Data were collected through standardized checklists at on-site visits during February-November 2009. Indications for adequate PPE policies were developed on the basis of a literature review, partners' expert opinions, and the collected data.

Results: All facilities have procedures for the selection of PPE in case of HID, and 44 have procedures for the removal of PPE. In 40 facilities, different levels of PPE are used according to a risk assessment process, and in 8 facilities, high-level PPE (e.g., positive-pressure complete suits or Trexler units) is always used. A fit test is performed at 25 of the 40 facilities at which it is applicable, a seal check is recommended at 25, and both procedures are used at 17. Strategies for promoting and monitoring the correct use of PPE are available at 42 facilities. In case of a sudden increase in demand, 44 facilities have procedures for rapid supply of PPE, whereas 14 facilities have procedures for decontamination and reuse of some PPE.

Conclusions: Most isolation facilities devote an acceptable level of attention to PPE selection and removal, strategies for the promotion of the correct use of PPE, and ensuring adequate supplies of PPE. Fit test and seal check procedures are still not widely practiced. Moreover, policies vary widely between and within European countries, and the development of common practice procedures is advisable.
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http://dx.doi.org/10.1086/667729DOI Listing
October 2012

[Malaria treatment--herbal therapy in new clothes].

Tidsskr Nor Laegeforen 2012 Mar;132(6):614

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http://dx.doi.org/10.4045/tidsskr.12.0238DOI Listing
March 2012

[Did vaccines and hygiene recommendations affect the pandemic?].

Tidsskr Nor Laegeforen 2011 Apr;131(7):662

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http://dx.doi.org/10.4045/tidsskr.11.0318DOI Listing
April 2011

[An underestimated throat bacteria].

Tidsskr Nor Laegeforen 2009 Sep;129(17):1756

Infeksjonsmedisinsk avdeling og NBC-senteret, Oslo universitetssykehus, Ullevål 0407 Oslo, Norway.

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http://dx.doi.org/10.4045/tidsskr.09.0788DOI Listing
September 2009

[Action against tuberculosis--all has its time].

Tidsskr Nor Laegeforen 2008 Dec;128(24):2817

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December 2008

[Acute hepatitis E].

Tidsskr Nor Laegeforen 2007 Aug;127(15):1966-8

Medisinsk Avdeling Sykehuset Asker og Baerum, Postboks 83, 1309 Rud.

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August 2007

Outbreak of community-acquired legionnaires disease in southeast Norway, May 2005.

Euro Surveill 2005 May 26;10(5):E050526.1. Epub 2005 May 26.

Nasjonalt folkehelseinstitutt (Norwegian Institute of Public Health), Oslo, Norway.

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May 2005

[Tularemia].

Tidsskr Nor Laegeforen 2006 Apr;126(8):1034

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April 2006

CMV disease in AIDS patients: incidence of CMV disease and relation to survival in a population-based study from Oslo.

Scand J Infect Dis 2002 ;34(1):50-5

Department of Infectious Diseases, Ullevål University Hospital, Oslo, Norway.

CMV disease is an important cause of morbidity and mortality in patients with AIDS. The purpose of this study was to investigate the incidence of CMV disease in a well-defined population of AIDS patients with a high rate of autopsy. No such study has previously been published from Scandinavia. A total of 248 patients who developed clinical AIDS in Oslo during the period 1 January, 1983 to 31 December, 1995 were included. Autopsy was performed in 152 of 213 deaths (71.3%). CMV disease was diagnosed in 95 patients. In the autopsy group, 73 patients (48%) had CMV disease, and in 52 of these patients CMV disease was first detected at autopsy. Retinitis was the most frequent manifestation, followed by adrenalitis, pneumonitis, encephalitis and gastrointestinal disease. No intravenous drug users (IVDUs) were diagnosed alive with CMV disease. All patients diagnosed with CMV disease before death had evidence of CMV disease at autopsy despite anti-CMV treatment. CMV disease was associated with increased risk of death. We conclude that CMV disease was frequent in patients with AIDS during the study period, was associated with increased mortality and was often diagnosed too late for the administration of appropriate therapy.
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http://dx.doi.org/10.1080/00365540110076976DOI Listing
September 2002
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