Session: 139. Adult Viral 1031. PCR Array Profiling of Antiviral in Human Embryonic Kidney Cells Friday, October 6, 2017: 12:30 PM Expressing Human OC43 Structural and Accessory Proteins Meshal Beidas, MSc and Wassim Chehadeh, PhD; Microbiology, Kuwait University, Background. Human (HCoV) OC43, 229E, NL63 and HKU1 Kuwait, Kuwait commonly cause upper respiratory tract , but can also cause severe lower respiratory tract disease. Increased use of diagnostic assays for respiratory has Session: 139. Adult Viral Infection facilitated detection and, since 2014, voluntary reporting of HCoV to the National Friday, October 6, 2017: 12:30 PM Respiratory and Enteric Surveillance System (NREVSS). Background. Human coronavirus OC43 (HCoV-OC43) causes , Methods. We reviewed weekly aggregate test results for HCoV OC43, 229E, and is associated with severe respiratory symptoms in infants, elderly and immu- NL63 and HKU1 voluntarily reported to NREVSS by U.S. hospital and clinical lab- nocompromised patients. HCoV-OC43 is a member of genus that oratories from July 1, 2014‒April 30, 2017. Laboratories reporting any HCoV result includes also the Severe Acute Respiratory Syndrome (SARS) and the Middle East using PCR were included, and the weekly percentage of positive HCoV tests by type Respiratory Syndrome (MERS) coronaviruses. Both SARS-CoV and MERS-CoV were was calculated. For a subset of HCoV detections reported to NREVSS via the Public shown to express proteins with the potential to evade early innate immune responses. Health laboratory Interoperability Project (PHLIP), which collects individual-level However, the ability of HCoV-OC43 to antagonise the intracellular antiviral defences demographic data, we described age distribution and sex. Age distribution by HCoV has not yet been investigated. The objective of this study was to investigate the role of type was compared using the Kruskal–Wallis test. HCoV-OC43 structural (membrane and nucleocapsid) and accessory (ns5a and ns2a) Results. 154 laboratories, across all 9 U.S. census divisions, reported 834,742 proteins in the modulation of antiviral expression profile in human embryonic tests for HCoV; 18,514 (2.2%) were positive for HCoV-OC43, 8,363 (1.0%) for kidney 293 (HEK-293) cells using PCR array analysis. HCoV-NL63, 6,828 (0.8%) for HCoV-229E, and 5,170 (0.6%) for HCoV-HKU1. The Methods. HCoV-OC43 membrane (M), nucleocapsid (N), ns5a and ns2a mRNA Downloaded from https://academic.oup.com/ofid/article/4/suppl_1/S312/4294378 by guest on 27 September 2021 percentage of tests positive for HCoV generally peaked between December and March were amplified and cloned into the pAcGFP1-N expression vector (Clontech), followed (Figure 1). HCoV-OC43 showed distinct annual peaks with variation in magnitude by transfection in HEK-293 cells. Expression of M, N, ns5a and ns2a proteins were by year. HCoV-HKU1 and NL63 had similar patterns, each with notable peaks during confirmed by indirect immunofluorescence test. Three days post-transfection, the cells winter 2016 compared with 2015 or 2017. HCoV-229E showed a discernable peak in were challenged by Sendai virus. The Human Antiviral Response PCR array system 2017 compared with the previous 2 years. Of 20,533 individuals with HCoV test results (Qiagen) was used to profile the antiviral gene expression in HEK-293 cells, using the reported via PHLIP, 1,589 (7.7%) tested positive for any HCoV; 50% of HCoV-positive fold regulation comparison and the manual normalisation methods. individuals were male, and the median age was 22 (range 0–96) years. Age distribution Results. Around 50–60 genes were downregulated by HCoV-OC43 proteins, the differed between HCoV types P( < 0.01, Figure 2). most prominent genes being those critical for the activation of transcription factors Conclusion. Over approximately 3 seasons, peak positivity for HCoV occurred involved in the antiviral response like interferon regulatory factors (IRFs) and activator during winter months, and annual differences in circulation by HCoV type were protein 1 (AP-1). Among the most important downregulated genes were those coding observed. Continued testing and surveillance for HCoV will allow for further char- for Interferons (IFNs) mitogen-activated protein kinases (MAPKs), pro-apoptotic and acterization of circulation trends over time and by geographic region, and improved pyroptotic proteins (Caspases, cathepsins, tumour necrosis factor), pro-inflammatory understanding of the contribution of HCoV to the winter respiratory virus season. cytokines (Interleukins), pattern recognition receptors (PRRs; toll-like receptors and NOD-like receptors) and their signaling transduction proteins (TICAM1, MAVS). Conclusion. This study shows for the first time that similarly to SARS-CoV and MERS-CoV, HCoV-OC43 has the ability to downregulate the transcription of genes critical for the activation of different antiviral signaling pathways. Disclosures. All authors: No reported disclosures.

1032. Human Coronavirus (HCoV) Infection Among Adults in Cleveland, Ohio: An Increasingly Recognized Respiratory Pathogen Anubhav Kanwar, MD1; Suresh Selvaraju, PhD2 and Frank Esper, MD3; 1Medicine, Division of Infectious Diseases and HIV Medicine, Case Western Reserve University School of Medicine/UH Cleveland Medical Center, Cleveland, Ohio, 2Microbiology, Metrohealth Medical Center, Cleveland, Ohio, 3Rainbow Babies and Children’s Hospital, Cleveland, Ohio Session: 139. Adult Viral Infection Friday, October 6, 2017: 12:30 PM Background. Human Coronaviruses (CoV) have been long recognized as a com- mon cause of respiratory tract disease including severe respiratory tract illness, yet there are few recent studies characterizing disease among adults in the United States. Here, we describe CoV infections and clinical characteristics among adults (>18 years) presenting with respiratory illness in Cleveland, Ohio. Methods. Between February 1, 2016 and April 30, 2017, 2949 nasopharyngeal swab specimens were analyzed by NxTAG Respiratory Pathogen Panel in adults pre- senting with respiratory illness at MetroHealth Medical Center. Clinical data were collected on adults whose samples screened positive for CoV-HKU1, CoV-OC43, CoV-229E or CoV-NL63. Results. Coronaviruses were detected in 192 (6.5%) adults including 105 (3.5%) OC43, 67 (2.3%) 229E, 13 (0.4%) HKU1 and 7 (0.2%) NL63. The majority of adults with coronavirus infection were females (66.2%) with a median age of 53 years. Common comorbidities included smoking (40.0%), asthma (38.0%), COPD (35.4%), and inhaled corticosteroid use (28.6%). Eighty-five (46.4%) required admission to the hospital. Common presenting symptoms included shortness of breath (42.7%) and cough (31.0%) whereas fever was uncommon (12.5%). Gastrointestinal symptoms were more common in HKU1 and NL63 infected adults. Seventy-three percent of coronavirus disease occurred between the months of January and March. Despite the recognition of coronavirus infection, 70 (36.5%) received antibiotics for their disease. Conclusion. This study provides needed insight into clinical characteristics and severity associated with coronavirus infection in adults. Coronavirus infection should be considered in differential diagnosis of respiratory tract illness in adults including those that require hospitalization, have a history of smoking and have pulmonary comorbidities. Disclosures. All authors: No reported disclosures.

1033. Evaluation of Serum TNF-alpha, IL-6, IL-10, and IFN-gamma Levels in Patients with Crimean–Congo Hemorrhagic Fever Hülya Yilmaz, MD1; Gürdal Yilmaz, Professor2; Ugur Kostakoglu, Assistant profes- sor3; Mustafa Arslan, MD4; Süleyman Caner Karahan, Professor5 and Iftihar Koksal, Professor2; 1Department of Medical Biochemistry, Health Sciences University, Kanuni Training and Research Hospital, Trabzon, Turkey, 2Department of Infectious Diseases Disclosures. All authors: No reported disclosures. and Clinical Microbiology, Karadeniz Technical University, Medical Faculty, Trabzon,

S312 • OFID 2017:4 (Suppl 1) • Poster Abstracts Turkey, 3Department of Infectious Diseases and Clinical Microbiology, Recep Tayyip Results. EV RNA was detected in 103 (17.6%) of 586 stool specimens by real-time Erdogan University, Rize, Turkey, 4Department of Infectious Diseases and Clinical RT-PCR targeting the highly conserved 5’ UTR region. Out of them, 71 (12.11%) were Microbiology, Amasya University Sabuncuoglu Serefeddin Training and Research NPEV, partially sequenced by VP1 which revealed the prevalence of echovirus (ECV) Hospital, Amasya, Turkey, 5Department of Medical Biochemistry,, Karadeniz 19 (n = 6), ECV 11 (n = 7), ECV 18 (n = 4), ECV 33 (n = 5), ECV 29 (n = 1), ECV 25 Technical University, Faculty of Medicine, Trabzon, Turkey (n = 2), ECV 24 (n = 3), ECV 3 (n = 3), ECV 14 (n = 2), ECV 13 (n = 1), ECV 2 (n = 1), ECV 20 (n = 2), ECV 27 (n = 4), ECV 6 (n = 2), CV A10 (n = 2), CV A9 (n = 1), CV Session: 139. Adult Viral Infection A6 (n = 2), CV B4 (n = 1), CV B5 (n = 3), CV B6 (n = 3), EV 80 (n = 1), EV 83 (n = 1), Friday, October 6, 2017: 12:30 PM EV 97 (n = 2). Background. Crimean–Congo hemorrhagic fever (CCHF) is a potentially fatal Total 63 (10.75%) HBoVs were detected by real-time PCR which were further disease caused by a tick-borne virus from the Bunyaviridae family. Cytokines plays an sequenced by VP1, consists of HBoV-1 (n = 8), HBoV-2 (n = 15), HBoV-3 (n = 9) important role in the pathogenesis of viral, bacterial, and immunologic diseases. This and HBoV-4 (n = 5). Out of them 9 (1.5%) were detected as co infection with NPEVs. study aimed to investigate the role of TNF-alpha, IL-6, IL-10, and IFN-gamma levels in Phylogenetic analysis showed 0.9 - 5.6% divergence at nucleotide level among HBoVs. the severity of infection and clinical outcome of patients with CCHF. Total 9 (1.5%) saffold viruses was detected and characterized by VP1 sequencing. Methods. Patients with confirmed CCHF were divided into two groups (severe Conclusion. ECV and HBoV were found the main etiologic agent in children sus- cases: Patients who exhibited hemorrhage during their hospital stay, and mild/ pected with AFP. Molecular typing of these viruses is useful for characterizing emerg- moderate cases: Patients who displayed no hemorrhage during their hospital stay). ing serotypes and their epidemiological investigation. Demographic characteristics, laboratory tests on admission of all patients with CCHF Disclosures. All authors: No reported disclosures. were investigated, and serum TNF-alpha, IL-6, IL-10, and IFN-gamma levels were measured. Downloaded from https://academic.oup.com/ofid/article/4/suppl_1/S312/4294378 by guest on 27 September 2021 Results. A total of 154 patients with confirmed CCHF were investigated. Forty- 1035. Frequency of Epstein–Barr Virus Genotypes in Pakistani Trangender six (29.9%) of these patients were in the severe group. In patients with severe CCHF, SexWorkers significantly higher serum levels of TNF-alpha (68.2 ± 23.5; P = 0.008) and IL-6 Sadia Salahud Din, Master; Biological Sciences, Gomal University, Dera Islamail (73.1 ± 41.6; P = 0.003) were detected, compared with cytokine levels in patients who Khan, Pakistan mild/moderate CCHF (Table 1). No differences in serum IL-10 and IFN-gamma lev- Session: 139. Adult Viral Infection els between patients who severe CCHF and those who mild/moderate CCHF were Friday, October 6, 2017: 12:30 PM detected (P > 0.05). Background. Transgender community large association with sex work has put them at a greater risk of contracting sexually transmitted infections (STIs).The aim of Table 1: Cytokine levels, demographic and laboratory characteristics in patients with severe and this study was to investigate the prevalence of Epstein–Barr Virus (EBV) genotypes in mild/moderate cases with CCHF. transgender sex workers (TSWs) of twin-cities of Pakistan. The high prevalence of EBV-2 genotype in sex workers has been previously reported. EBV genotypes were investigated Severe cases Mild/moderate cases in transgender sex workers to find out EBV-2 occurrence in Pakistani population. Features n = 46 n = 108 P-value Methods. A total of 86 transgender (Hijras) sex workers were randomly included Age 50.6 ± 20.3 49.8 ± 21.0 0.682 in this study. Demographics, including age, the number of sex partners, sexual hab- Female gender, 31 (67.4) 63 (58,3) 0.291 its, and awareness about protective methods were obtained. Blood was collected from n (%) all subjects and The presence of Human Virus, and C TNF- 68.2 ± 23.5 41.3 ± 17.4 0.008 virus were determined by antibody strip testing. EBV detection and genotyping were IL-6 73.1 ± 41.6 38.0 ± 19.5 0.003 performed by extracting genomic DNA from all whole blood samples. Β-globin and IL-10 6.32 ± 1.3 6.21 ± 1.4 0.753 EBNA-1 were amplified to assess the quality and presence of EBV DNA. Analysis of IFN-gamma 145 ± 96 126 ± 92 0.664 EBNA-2 genotyping was done by nested PCR. WBC 3286 ± 5,602 2,275 ± 1,286 0.280 Results. HIV was the most prevalent infection in 40 transgender sex workers PLT 53,564 ± 36,520 98,065 ± 42,768 0.001 (46.51%) followed by HCV in 15 (17.44%). Among HIV-seropositive TSW’s, EBV gen- CRP 3.2 ± 2.6 1.1 ± 1.4 0.005 ALT 521 ± 482 208 ± 320 0.044 otype determination was only achievable in 60% of cases, where 62.5% were EBV-1, AST 869 ± 1.182 256 ± 215 0.016 29.16% of EBV-2 and co-infection was found in 8% samples. Among HIV-negative CPK 1,138 ± 970 676 ± 835 0.007 individuals, 78% were EBV-1, whereas EBV-2 genotype and co-infections were absent. LDH 1,800 ± 1,254 589 ± 271 0.002 All non-typable samples were amplifiable for the EBNA-1 gene in both populations, confirming EBV genome in the samples. Conclusion. EBV-1 was the most common genotype of EBV in HIV seropositive Conclusion. Cytokines, chemokines, and other inflammatory mediators function and seronegative TSW’s but the high occurrence of EBV-2 and co-infection of both in a manner, acting on many different cell types to regulate the host’s immune response. types was observed only in HIV seropositive individuals. This is the first report of fre- When cytokines present in high concentrations, they might toxic or even lethal effects. quency of EBV infections in the HIV-positive transgender community of Pakistan. In accordance with this view, we have detected increased serum TNF-alpha, IL-6 levels Disclosures. All authors: No reported disclosures. in the patients with severe CCHF. Disclosures. All authors: No reported disclosures. 1036. Risk Factors for Herpes Zoster: a Systematic Review and Meta-Analysis Kosuke Kawai, ScD1 and Barbara P. Yawn, MD, MSc, MSPH, FAAFP2; 1Boston 1034. Etiologic Involvement of Enterovirus and Human Bocavirus in Acute Children’s Hospital and Harvard Medical School, Boston, Massachusetts, Flaccid Paralysis Cases in India 2Department of Research, Olmsted Medical Center, Rochester, Minnesota; University Manjari Baluni, Ph.D(Pursuing)1; Dharamveer Singh, Ph.D(Pursuing)1; of Minnesota, Minneapolis, Minnesota Sneha Ghildiyal, PhD Pursuing2; Tanzeem Fatima, Ph.D (Pursuing)3; Amreen Zia, 3 1 1 Session: 139. Adult Viral Infection Ph.D(Pursuing) and Tapan Dhole, MD ; Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India, 2Sanjay Gandhi Postgraduate Institute of Medical Friday, October 6, 2017: 12:30 PM 3 Sciences, Lucknow, India, Microbiology, Sanjay Gandhi Post Graduate Institute of Background. Well-recognized risk factors for herpes zoster (HZ), commonly Medical Sciences, Lucknow, India known as shingles, are age and immunosuppression. Numerous studies have investi- Session: 139. Adult Viral Infection gated other various risk factors for HZ in recent years. The objective of our study is to Friday, October 6, 2017: 12:30 PM systematically review studies examining risk factors for HZ and discuss implications based on the updated evidence. Background. Acute flaccid paralysis (AFP), characterized by the rapid onset of Methods. We performed a literature search using PubMed, Embase, and Web of asymmetric paralysis, can be caused by a variety of viral infections or coinfections. Science and included studies that examined risk factors for HZ. Random effects model Besides wild-type and revertant vaccine strains of , several nonpolio was used to summarize the risk ratio (RR) or odds ratio (OR) and 95% confidence enteroviruses, have also been associated with AFP. Enteroviruses (EVs) are RNA interval (CI). viruses in the family Picornaviridae comprising more than 100 serotypes that are Results. Of the 3450 studies screened, we included 84 studies in the systematic divided into four species, human enteroviruses A to D. The clinical manifestations review and conducted meta-analysis in 62 studies. Women are at increased risk of of EVs range from conjunctivitis, respiratory tract infection, , menin- HZ compared with men (pooled adjusted RR = 1.31; 95% CI: 1.27, 1.34). Black indi- gitis, encephalitis, and neonatal sepsis, like illness. Human Bocavirus (HBoV), a viduals have almost half the risk of HZ than White individuals (pooled RR = 0.54; newly classified member of theParvoviridae family, has been detected frequently 95% CI: 0.47, 0.63). Family history was found to be a risk factor for HZ (pooled in feces of diarrhoeic children suggesting its possible etiological involvement in the OR = 3.59; 95% CI: 2.39, 5.40). Autoimmune diseases, including rheumatoid arthritis disease. (pooled RR = 1.67; 95% CI: 1.41, 1.98) and systemic lupus erythematous (RR = 2.10; Methods. Total 586 stool specimens were collected in 2016 from children sus- 95% CI: 1.40, 3.15), were associated with an elevated risk of HZ. Other comorbidities pected for AFP. Molecular method for targeting 5’ untranslated region (UTR) and were associated with an increased risk of HZ, with the pooled RRs ranging from 1.25 VP1 region was used for detection of human enteroviruses (HEV), human boca (95% CI: 1.13, 1.39) for asthma to 1.30 (1.17, 1.45) for diabetes mellitus, and 1.31 viruses (HBoV) and saffold viruses in direct clinical specimen. (95% CI: 1.22, 1.41) for chronic obstructive pulmonary disease. Statin use was also

Poster Abstracts • OFID 2017:4 (Suppl 1) • S313