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1

&NA;. "Asymptomatic Giardia Infection." Pediatric Infectious Disease Journal 11, no. 3 (March 1992): 248. http://dx.doi.org/10.1097/00006454-199203000-00022.

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2

Jewell, Mary E., and Donna E. Sweet. "Asymptomatic HIV infection." Postgraduate Medicine 92, no. 5 (October 1992): 155–66. http://dx.doi.org/10.1080/00325481.1992.11701490.

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3

Wormser, G. P., R. B. Nadelman, J. Nowakowski, and I. Schwartz. "Asymptomatic Borrelia burgdorferi infection." Medical Hypotheses 57, no. 4 (October 2001): 435–38. http://dx.doi.org/10.1054/mehy.2001.1338.

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4

Williamson, W. Daniel. "Asymptomatic Congenital Cytomegalovirus Infection." American Journal of Diseases of Children 144, no. 12 (December 1, 1990): 1365. http://dx.doi.org/10.1001/archpedi.1990.02150360091031.

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5

Millichap, J. Gordon. "Asymptomatic Aneurysms and HIV Infection." Pediatric Neurology Briefs 7, no. 2 (February 1, 1993): 14. http://dx.doi.org/10.15844/pedneurbriefs-7-2-10.

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6

Simberkoff, Michael S. "Management of Asymptomatic HIV Infection." Disease Management & Health Outcomes 1, no. 2 (February 1997): 105–17. http://dx.doi.org/10.2165/00115677-199701020-00005.

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7

Ooi, Eng Eong, and Jenny G. Low. "Asymptomatic SARS-CoV-2 infection." Lancet Infectious Diseases 20, no. 9 (September 2020): 996–98. http://dx.doi.org/10.1016/s1473-3099(20)30460-6.

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Sulis, Efisio, Paolo Lusso, and Licinio Contu. "Prolonged Asymptomatic HIV-1 Infection." New England Journal of Medicine 342, no. 16 (April 20, 2000): 1221–22. http://dx.doi.org/10.1056/nejm200004203421617.

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9

Brito, M. J., J. M. Garrote, M. C. machado, M. H. Carreiro, M. C. Machado, S. Lopo, P. Palminha, et al. "168 Asymptomatic Congenital Cytomegalovirus Infection." Pediatric Research 56, no. 3 (September 2004): 492. http://dx.doi.org/10.1203/00006450-200409000-00191.

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10

Steere, Allen C., Vijay K. Sikand, Robert T. Schoen, and John Nowakowski. "Asymptomatic Infection with Borrelia burgdorferi." Clinical Infectious Diseases 37, no. 4 (August 2003): 528–32. http://dx.doi.org/10.1086/376914.

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11

TSAPAKOS, MICHAEL J., and BRUCE R. LINE. "Phantom Infection in Asymptomatic Vessels." Clinical Nuclear Medicine 18, no. 12 (December 1993): 1101–2. http://dx.doi.org/10.1097/00003072-199312000-00023.

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12

Sarti, Geralyn M. "Asymptomatic patients with HIV infection." Postgraduate Medicine 87, no. 8 (June 1990): 143–54. http://dx.doi.org/10.1080/00325481.1990.11704679.

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13

Chatchen, Supawat, Arunee Sabchareon, and Chukiat Sirivichayakul. "Serodiagnosis of asymptomatic dengue infection." Asian Pacific Journal of Tropical Medicine 10, no. 1 (January 2017): 11–14. http://dx.doi.org/10.1016/j.apjtm.2016.12.002.

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14

Aliee, Maryam, Matt J. Keeling, and Kat S. Rock. "Modelling to explore the potential impact of asymptomatic human infections on transmission and dynamics of African sleeping sickness." PLOS Computational Biology 17, no. 9 (September 13, 2021): e1009367. http://dx.doi.org/10.1371/journal.pcbi.1009367.

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Gambiense human African trypanosomiasis (gHAT, sleeping sickness) is one of several neglected tropical diseases (NTDs) where there is evidence of asymptomatic human infection but there is uncertainty of the role it plays in transmission and maintenance. To explore possible consequences of asymptomatic infections, particularly in the context of elimination of transmission—a goal set to be achieved by 2030—we propose a novel dynamic transmission model to account for the asymptomatic population. This extends an established framework, basing infection progression on a number of experimental and observation gHAT studies. Asymptomatic gHAT infections include those in people with blood-dwelling trypanosomes, but no discernible symptoms, or those with parasites only detectable in skin. Given current protocols, asymptomatic infection with blood parasites may be diagnosed and treated, based on observable parasitaemia, in contrast to many other diseases for which treatment (and/or diagnosis) may be based on symptomatic infection. We construct a model in which exposed people can either progress to either asymptomatic skin-only parasite infection, which would not be diagnosed through active screening algorithms, or blood-parasite infection, which is likely to be diagnosed if tested. We add extra parameters to the baseline model including different self-cure, recovery, transmission and detection rates for skin-only or blood infections. Performing sensitivity analysis suggests all the new parameters introduced in the asymptomatic model can impact the infection dynamics substantially. Among them, the proportion of exposures resulting in initial skin or blood infection appears the most influential parameter. For some plausible parameterisations, an initial fall in infection prevalence due to interventions could subsequently stagnate even under continued screening due to the formation of a new, lower endemic equilibrium. Excluding this scenario, our results still highlight the possibility for asymptomatic infection to slow down progress towards elimination of transmission. Location-specific model fitting will be needed to determine if and where this could pose a threat.
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15

PHILLIPS, G., C. C. TAM, L. C. RODRIGUES, and B. LOPMAN. "Prevalence and characteristics of asymptomatic norovirus infection in the community in England." Epidemiology and Infection 138, no. 10 (March 3, 2010): 1454–58. http://dx.doi.org/10.1017/s0950268810000439.

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SUMMARYNorovirus is a major cause of infectious intestinal disease, and a substantial prevalence of asymptomatic infection has been reported. We describe the prevalence, seasonality and characteristics of asymptomatic norovirus infection in England. Healthy individuals were recruited at random from the general population during the Study of Infectious Intestinal Disease (1993–1996). Norovirus was identified using real-time RT–PCR. The age-adjusted prevalence of asymptomatic norovirus infection was 12%; prevalence was highest in children aged <5 years and showed wintertime seasonality. More work is needed to understand whether asymptomatic infections are important for norovirus transmission leading to sporadic illness and outbreaks.
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16

White, Desirée A., Robert K. Heaton, and Andreas U. Monsch. "Neuropsychological studies of asymptomatic Human Immunodeficiency Virus-Type-1 infected individuals." Journal of the International Neuropsychological Society 1, no. 3 (May 1995): 304–15. http://dx.doi.org/10.1017/s1355617700000308.

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AbstractThe current review was conducted to address the ongoing debate regarding the presence or absence of neuropsychological impairment in asymptomatic HIV-Type 1 (HIV-1) seropositive individuals. Results were summarized from 57 studies that compared the performances of seropositive asymptomatic and seronegative individuals. Overall, the differences observed between median rates of impairment for asymptomatic (35%) and seronegative (12%) groups provided the clearest indication of deficits in asymptomatics. In addition, five variables were examined as possible contributors to inconsistencies found in the literature: mode of infection, test battery type, test battery size, sample size, and method of data analysis. Of these variables, only mode of infection and test battery size appeared to substantially influence the outcome of the studies reviewed with regard to identifying neuropsychological impairment in asymptomatics. (JINS, 1995, I, 304–315.)
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17

De Moraes, Consuelo M., Caroline Wanjiku, Nina M. Stanczyk, Hannier Pulido, James W. Sims, Heike S. Betz, Andrew F. Read, Baldwyn Torto, and Mark C. Mescher. "Volatile biomarkers of symptomatic and asymptomatic malaria infection in humans." Proceedings of the National Academy of Sciences 115, no. 22 (May 14, 2018): 5780–85. http://dx.doi.org/10.1073/pnas.1801512115.

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Malaria remains among the world’s deadliest diseases, and control efforts depend critically on the availability of effective diagnostic tools, particularly for the identification of asymptomatic infections, which play a key role in disease persistence and may account for most instances of transmission but often evade detection by current screening methods. Research on humans and in animal models has shown that infection by malaria parasites elicits changes in host odors that influence vector attraction, suggesting that such changes might yield robust biomarkers of infection status. Here we present findings based on extensive collections of skin volatiles from human populations with high rates of malaria infection in Kenya. We report broad and consistent effects of malaria infection on human volatile profiles, as well as significant divergence in the effects of symptomatic and asymptomatic infections. Furthermore, predictive models based on machine learning algorithms reliably determined infection status based on volatile biomarkers. Critically, our models identified asymptomatic infections with 100% sensitivity, even in the case of low-level infections not detectable by microscopy, far exceeding the performance of currently available rapid diagnostic tests in this regard. We also identified a set of individual compounds that emerged as consistently important predictors of infection status. These findings suggest that volatile biomarkers may have significant potential for the development of a robust, noninvasive screening method for detecting malaria infections under field conditions.
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18

Sim, Insuk, Yun-Jung Kang, and Hye Jeong Kim. "COVID-19 in South Korea: The Need for Preemptive Tests from the Perspective of Asymptomatic Infections." Journal of Pure and Applied Microbiology 15, no. 2 (May 11, 2021): 590–93. http://dx.doi.org/10.22207/jpam.15.2.13.

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The first case of coronavirus disease reported in South Korea was a person infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), who entered South Korea from China on January 20, 2020. In the Capital, the Korean government applied the social distancing policy at level 2.5 for 8 days from August 30 to September 6, 2020. The Central Disease Relief Center explained that the reason the number of newly confirmed cases per day did not fall below 100 was because the infection spread nationwide through sporadic mass infections or asymptomatic patients. Asymptomatic infection with SARS-CoV-2 is a subject of constant controversies, as asymptomatic patients can infect other people while not showing any symptoms themselves. Their atypical clinical characteristics in the early stages of the disease make prevention more difficult. Additional studies on the infecting power of SARS-CoV-2 in asymptomatic cases are needed. Nonetheless, such probabilities should be taken into consideration and we should remain vigilant.
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19

Grant, Rebecca, Mamunur Rahman Malik, Amgad Elkholy, and Maria D. Van Kerkhove. "A Review of Asymptomatic and Subclinical Middle East Respiratory Syndrome Coronavirus Infections." Epidemiologic Reviews 41, no. 1 (2019): 69–81. http://dx.doi.org/10.1093/epirev/mxz009.

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Abstract The epidemiology of Middle East respiratory syndrome coronavirus (MERS-CoV) since 2012 has been largely characterized by recurrent zoonotic spillover from dromedary camels followed by limited human-to-human transmission, predominantly in health-care settings. The full extent of infection of MERS-CoV is not clear, nor is the extent and/or role of asymptomatic infections in transmission. We conducted a review of molecular and serological investigations through PubMed and EMBASE from September 2012 to November 15, 2018, to measure subclinical or asymptomatic MERS-CoV infection within and outside of health-care settings. We performed retrospective analysis of laboratory-confirmed MERS-CoV infections reported to the World Health Organization to November 27, 2018, to summarize what is known about asymptomatic infections identified through national surveillance systems. We identified 23 studies reporting evidence of MERS-CoV infection outside of health-care settings, mainly of camel workers, with seroprevalence ranges of 0%–67% depending on the study location. We identified 20 studies in health-care settings of health-care worker (HCW) and family contacts, of which 11 documented molecular evidence of MERS-CoV infection among asymptomatic contacts. Since 2012, 298 laboratory-confirmed cases were reported as asymptomatic to the World Health Organization, 164 of whom were HCWs. The potential to transmit MERS-CoV to others has been demonstrated in viral-shedding studies of asymptomatic MERS infections. Our results highlight the possibility for onward transmission of MERS-CoV from asymptomatic individuals. Screening of HCW contacts of patients with confirmed MERS-CoV is currently recommended, but systematic screening of non-HCW contacts outside of health-care facilities should be encouraged.
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20

Ferreira, Victor H., Andrzej Chruscinski, Vathany Kulasingam, Trevor J. Pugh, Tamara Dus, Brad Wouters, Amit Oza, et al. "Prospective observational study and serosurvey of SARS-CoV-2 infection in asymptomatic healthcare workers at a Canadian tertiary care center." PLOS ONE 16, no. 2 (February 16, 2021): e0247258. http://dx.doi.org/10.1371/journal.pone.0247258.

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Health care workers (HCWs) are at higher risk for SARS-CoV-2 infection and may play a role in transmitting the infection to vulnerable patients and members of the community. This is particularly worrisome in the context of asymptomatic infection. We performed a cross-sectional study looking at asymptomatic SARS-CoV-2 infection in HCWs. We screened asymptomatic HCWs for SARS-CoV-2 via PCR. Complementary viral genome sequencing was performed on positive swab specimens. A seroprevalence analysis was also performed using multiple assays. Asymptomatic health care worker cohorts had a combined swab positivity rate of 29/5776 (0.50%, 95%CI 0.32–0.75) relative to a comparative cohort of symptomatic HCWs, where 54/1597 (3.4%) tested positive for SARS-CoV-2 (ratio of symptomatic to asymptomatic 6.8:1). SARS-CoV-2 seroprevalence among 996 asymptomatic HCWs with no prior known exposure to SARS-CoV-2 was 1.4–3.4%, depending on assay. A novel in-house Coronavirus protein microarray showed differing SARS-CoV-2 protein reactivities and helped define likely true positives vs. suspected false positives. Our study demonstrates the utility of routine screening of asymptomatic HCWs, which may help to identify a significant proportion of infections.
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21

Henry, Keith. "Risky behaviors with asymptomatic HIV infection?" Postgraduate Medicine 109, no. 2 (February 2001): 124. http://dx.doi.org/10.3810/pgm.2001.02.865.

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22

Fitzgibbon, Marian L., David F. Cella, Gary Humfleet, Eugene Griffin, and Kathleen Sheridan. "Motor Slowing in Asymptomatic HIV Infection." Perceptual and Motor Skills 68, no. 3_suppl (June 1989): 1331–38. http://dx.doi.org/10.2466/pms.1989.68.3c.1331.

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To examine neuropsychological deficits associated with the human immunodeficiency virus (HIV), 25 asymptomatic homosexual men and sexual partners of intravenous drug users and 25 seronegative homosexual men and nonhigh-risk heterosexuals were assessed on measures of fine motor control, visual scanning, attention, depression, and global psychological functioning. Analysis suggested that HIV infection is associated with reduced fine motor control. Seropositivity is associated with elevated depression and global psychological maladjustment. When depression and global adjustment were analyzed as covariates, motor slowing was evident in the seropositive group. These findings suggest an association between motor slowing and HIV infection in asymptomatic subjects and point to the necessity of measuring affect at least as a control variable. Further study is needed to determine whether the fine motor deficit evident in this sample is limited to distinct subgrouping of the over-all sample.
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23

Kerkar, Shilpa C., Shashank Latta, Vinita Salvi, and Jayanti Mania-Pramanik. "Human Papillomavirus infection in asymptomatic population." Sexual & Reproductive Healthcare 2, no. 1 (January 2011): 7–11. http://dx.doi.org/10.1016/j.srhc.2010.11.001.

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24

Garcia, C., H. L. DuPont, K. Z. Long, J. I. Santos, and G. Ko. "Asymptomatic Norovirus Infection in Mexican Children." Journal of Clinical Microbiology 44, no. 8 (August 1, 2006): 2997–3000. http://dx.doi.org/10.1128/jcm.00065-06.

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25

Hammerschlag, Margaret R. "Asymptomatic Respiratory Infection With Chlamydia pneumoniae." Chest 119, no. 5 (May 2001): 1303–5. http://dx.doi.org/10.1378/chest.119.5.1303-a.

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26

LaMontagne, D. Scott, David N. Fine, and Jeanne M. Marrazzo. "Chlamydia trachomatis infection in asymptomatic men." American Journal of Preventive Medicine 24, no. 1 (January 2003): 36–42. http://dx.doi.org/10.1016/s0749-3797(02)00573-1.

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27

Seymour, C. A. "Asymptomatic infection with hepatitis C virus." BMJ 308, no. 6930 (March 12, 1994): 670–71. http://dx.doi.org/10.1136/bmj.308.6930.670.

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28

&NA;. "Zidovudine effective in asymptomatic HIV infection." Inpharma Weekly &NA;, no. 824 (February 1992): 17. http://dx.doi.org/10.2165/00128413-199208240-00035.

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29

Damos, D. L., R. S. John, E. S. Parker, and A. M. Levine. "Cognitive Function in Asymptomatic HIV Infection." Archives of Neurology 54, no. 2 (February 1, 1997): 179–85. http://dx.doi.org/10.1001/archneur.1997.00550140051012.

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30

Sharpstone, Daniel R., Claire P. Murray, Hazel M. Ross, Margaret R. Hancock, Margaret S. Phelan, Roger C. Crane, Ian S. Menzies, et al. "Energy balance in asymptomatic HIV infection." AIDS 10, no. 12 (October 1996): 1377–84. http://dx.doi.org/10.1097/00002030-199610000-00010.

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31

Jamrozik, Euzebiusz, and Michael J. Selgelid. "Invisible epidemics: ethics and asymptomatic infection." Monash Bioethics Review 38, S1 (December 2020): 1–16. http://dx.doi.org/10.1007/s40592-020-00123-z.

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AbstractInteractions between microbes and human hosts can lead to a wide variety of possible outcomes including benefits to the host, asymptomatic infection, disease (which can be more or less severe), and/or death. Whether or not they themselves eventually develop disease, asymptomatic carriers can often transmit disease-causing pathogens to others. This phenomenon has a range of ethical implications for clinical medicine, public health, and infectious disease research. The implications of asymptomatic infection are especially significant in situations where, and/or to the extent that, the microbe in question is transmissible, potentially harmful, and/or untreatable. This article reviews the history and concept of asymptomatic infection, and relevant ethical issues associated with this phenomenon. It illustrates the role and ethical significance of asymptomatic infection in outbreaks, epidemics, and pandemics–including recent crises involving drug resistance, Zika, and Covid19. Serving as the Introduction to this Special Issue of Monash Bioethics Review, it also provides brief summaries of the other articles comprising this collection.
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32

FRIEDEN, ILONA J. "Tinea capitis: asymptomatic carriage of infection." Pediatric Infectious Disease Journal 18, no. 2 (February 1999): 186–90. http://dx.doi.org/10.1097/00006454-199902000-00026.

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33

Weller, Ian V. D. "The treatment of asymptomatic HIV infection." Aids 3, Supplement (January 1989): S215–220. http://dx.doi.org/10.1097/00002030-198901001-00031.

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34

ELLICKALPUTHENPURA, BENA E., and HARRYS A. TORRES. "HISTOPLASMOSIS: An asymptomatic to lifethreatening infection." Journal of the American Academy of Physician Assistants 25, no. 12 (December 2012): 18. http://dx.doi.org/10.1097/01720610-201212000-00005.

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35

Nebigil, I., and N. Tümer. "Asymptomatic urinary tract infection in childhood." European Journal of Pediatrics 151, no. 4 (April 1992): 308–9. http://dx.doi.org/10.1007/bf02072236.

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36

Hart, Gavin. "The Epidemiology of Genital Chlamydial Infection in South Australia." International Journal of STD & AIDS 4, no. 4 (July 1993): 204–10. http://dx.doi.org/10.1177/095646249300400405.

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All laboratory tests performed and medical reports received in South Australia in 1990–1991 and screening results for Chlamydia trachomatis at the central STD clinic from 1988–1991 were analysed to clarify the epidemiology of genital chlamydial infection. From 70494 laboratory tests in 1990–1991, 2449 (3.5%) infections were detected of which 2431 (99%) were also reported by clinicians. Infections were detected in 1335 (6.4%) of 21004 patients (71% of 29 401 attendees) screened at the central STD clinic from 1988 to 1991. STD clinic yields suggest a male: female ratio of 1.08:1 (95% confidence intervals = 1.05:1–1.11:1), with 46% of infections in males and 67% of infections in females being asymptomatic. For both males and females, infection rates were highest in 15–19-year-olds and decreased with increasing age, but were not independently related to marital status. The statewide epidemiological pattern was probably distorted in medical reports because of selection biases in testing (89% of tests performed by non-STD clinicians were on females) which resulted in decreased detection in asymptomatic females, symptomatic and asymptomatic males, married persons and unmarried young persons (15–19-year-old females and 15–24-year-old males) by private practitioners. A cost-effective method for increased detection of chlamydial infection in undertested groups (particularly of asymptomatic unmarried males aged 15–24) will be required to control transmission of chlamydial infection in South Australia. Increased detection in young married persons is also desirable.
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37

Gomolin, Irving H. "When Asymptomatic Bacteriuria is not Asymptomatic or “Pseudo-Urinary Tract Infection”." Journal of the American Geriatrics Society 66, no. 11 (October 5, 2018): 2223. http://dx.doi.org/10.1111/jgs.15529.

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38

Zarubinsky, V. Ya, M. N. Gapon, and O. V. Akelina. "ASYMPTOMATIC ROTAVIRAL INFECTION: SPREAD AND EPIDEMIOLOGICAL IMPORTANCE." Epidemiology and Infectious Diseases 22, no. 2 (December 15, 2017): 101–5. http://dx.doi.org/10.17816/eid42635.

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There were age and seasonal features of the spread of submanifest forms of rotaviral infection with the aim of the assessment of their importance in epidemiology. In 2011-2015 2608 residents of Rostov-on-Don at the age from of 2 weeks to 90 years were examined by ELISA methods for the isolation of group A rotaviruses. The widespread of asymptomatic rotaviral infection was established in the population. Rotavirus was detected in 63.3% of patients aged of 0-1 year, 24.7% -from 2 to 14 years, and 12.5% - 15-90 years. There was revealed an active circulation of rotaviruses in all seasons of the year. In June and July, the infestation of adults is not reduced, children from 1 year to 14 years - 17.5% seems to be higher than in periods of seasonal rises of the morbidity rate. The high level of asymptomatic infection in summer, may indicate to a decline in circulation of epidemic strains and the predominance of avirulent variants of rotavirus. The heterogeneity of the viral populations increases, which creates conditions for the formation of a large number of new reassortants and genetic variants of the pathogen. Thus, asymptomatic infections prevailing among the population both serve as a major reservoir of viral gene pool, the source of new variants of the virus and play a major role in the immune selection of epidemic strains. There was substantiated the assumption that the cause a winter-spring seasonality of infection is the advantage in the spread of virulent strains of rotavirus over avirulent ones, which is realized at low temperatures that increase pathogen survival. Early summer-autumn surges in the incidence rate in the South of Russia can cause a skid by millions of tourists of new genotypes of rotavirus to the territory with favorable social conditions for their active circulation.
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Alene, Muluneh, Leltework Yismaw, Moges Agazhe Assemie, Daniel Bekele Ketema, Belayneh Mengist, Bekalu Kassie, and Tilahun Yemanu Birhan. "Magnitude of asymptomatic COVID-19 cases throughout the course of infection: A systematic review and meta-analysis." PLOS ONE 16, no. 3 (March 23, 2021): e0249090. http://dx.doi.org/10.1371/journal.pone.0249090.

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Background Asymptomatic SARS-CoV-2 infections are responsible for potentially significant transmission of COVID-19. Worldwide, a number of studies were conducted to estimate the magnitude of asymptomatic COVID-19 cases. However, there is a need for more robust and well-designed studies to have a relevant public health intervention. Synthesis of the available studies significantly strengthens the quality of evidences for public health practice. Thus, this systematic review and meta-analysis aimed to determine the overall magnitude of asymptomatic COVID-19 cases throughout the course of infection using available evidences. Methods We followed the PRISMA checklist to present this study. Two experienced review authors (MA and DBK) were systematically searched international electronic databases for studies. We performed meta-analysis using R statistical software. The overall weighted proportion of asymptomatic COVID-19 cases throughout the course infection was computed. The pooled estimates with 95% confidence intervals were presented using forest plot. Egger’s tests were used to assess publication bias, and primary estimates were pooled using a random effects model. Furthermore, a sensitivity analysis was conducted to assure the robustness of the result. Results A total of 28 studies that satisfied the eligibility criteria were included in this systematic review and meta-analysis. Consequently, in the meta-analysis, a total of 6,071 COVID-19 cases were included. The proportion of asymptomatic infections among the included studies ranged from 1.4% to 78.3%. The findings of this meta-analysis showed that the weighted pooled proportion of asymptomatic COVID-19 cases throughout the course of infection was 25% (95%CI: 16–38). The leave-one out result also revealed that the weighted pooled average of asymptomatic SARS-CoV-2 infection was between 28% and 31.4%. Conclusions In conclusion, one-fourth of SARS-CoV-2 infections are remained asymptomatic throughout the course infection. Scale-up of testing, which targeting high risk populations is recommended to tackle the pandemic.
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40

Mbala, Placide, Marc Baguelin, Ipos Ngay, Alicia Rosello, Prime Mulembakani, Nikolaos Demiris, W. John Edmunds, and Jean-Jacques Muyembe. "Evaluating the frequency of asymptomatic Ebola virus infection." Philosophical Transactions of the Royal Society B: Biological Sciences 372, no. 1721 (April 10, 2017): 20160303. http://dx.doi.org/10.1098/rstb.2016.0303.

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The potential for asymptomatic infection from Ebola viruses has long been questioned. Knowing the proportion of infections that are asymptomatic substantially changes the predictions made by mathematical models and alters the corresponding decisions based upon these models. To assess the degree of asymptomatic infection occurring during an Ebola virus disease (EVD) outbreak, we carried out a serological survey in the Djera district of the Equateur province of the Democratic Republic of the Congo affected by an Ebola outbreak in 2014. We sampled all asymptomatic residents ( n = 182) of 48 households where at least one case of EVD was detected. To control for potential background seroprevalence of Ebola antibodies in the population, we also sampled 188 individuals from 92 households in an unaffected area with a similar demographic background. We tested the sera collected for anti-Ebola IgG and IgM antibodies at four different dilutions. We then developed a mixture model to estimate the likely number of asymptomatic patients who developed IgM and IgG responses to Ebola antigens in both groups. While we detected an association between medium to high titres and age, we did not detect any evidence of increased asymptomatic infection in the individuals who resided in the same household as cases. This article is part of the themed issue ‘The 2013–2016 West African Ebola epidemic: data, decision-making and disease control’.
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41

Rodulfo, Hectorina, Marcos de Donato, Isaurea Quijada, and Ada Peña. "High prevalence of malaria infection in Amazonas state, Venezuela." Revista do Instituto de Medicina Tropical de São Paulo 49, no. 2 (April 2007): 79–85. http://dx.doi.org/10.1590/s0036-46652007000200003.

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This study was carried out to determine the incidence of malaria in an endemic region of Amazonas State, Venezuela. For this, 200 random samples were collected from symptomatic and asymptomatic individuals from San Fernando de Atabapo and Santa Barbara. Epidemiological factors were related to malaria infection, which was diagnosed by microscopy observation and amplification of the 18S rDNA sequence by PCR. Malaria prevalence in these populations was 28.5%, whilst P. vivax and P. falciparum prevalences were 12 and 17%, respectively. No infection by P. malariae was found. A mixed infection was found on an asymptomatic individual. Prevalence patterns differed between age groups depending on the Plasmodium species. We found that 34.8% of the P. vivax and 15.2% of the P. falciparum infections were asymptomatic. The use of nets was helpful to prevent P. vivax infection, but did not protect against P. falciparum infection. The results suggest the presence of more than one mosquito vector in the area, displaying a differential pattern of infection for each Plasmodium species. There appear to be risk factors associated with malaria infections in some individuals. The population based approach and PCR diagnosis improved the accuracy of the statistical analysis in the study.
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42

Quilter, Laura A. S., Eve Obondi, Colin Kunzweiler, Duncan Okall, Robert C. Bailey, Gaston Djomand, Boaz Otieno-Nyunya, Fredrick Otieno, and Susan M. Graham. "Prevalence and correlates of and a risk score to identify asymptomatic anorectal gonorrhoea and chlamydia infection among men who have sex with men in Kisumu, Kenya." Sexually Transmitted Infections 95, no. 3 (September 21, 2018): 201–11. http://dx.doi.org/10.1136/sextrans-2018-053613.

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ObjectivesIn settings where laboratory capacity is limited, the WHO recommends presumptive treatment for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) in asymptomatic men who have sex with men (MSM) at high risk for these infections. However, little is known about how best to target this intervention. We aimed to identify correlates of anorectal NG/CT infection in Kenyan MSM with and without anorectal symptoms and evaluate the performance of an empirical, model-based risk score to identify cases in asymptomatic men.MethodsAnorectal NG/CT infections were diagnosed by the Abbott RealTime NG/CT nucleic acid amplification testamong 698 MSM at enrolment into the Anza Mapema study. Multivariable logistic regression was used to identify correlates of anorectal NG/CT infection in men with and without anorectal symptoms. Using coefficients from the final multivariable model for asymptomatic men, we calculated a risk score for each participant. Risk score performance was determined by calculating the sensitivity, specificity and number needed to treat (NNT) to identify one NG/CT infection.ResultsOverall anorectal NG/CT infection prevalence was 5.2% (n=36), of which 58.3% (n=21) were asymptomatic. Factors associated with anorectal NG/CT infection in asymptomatic men were aged 18–24 years (aOR=7.6; 95% CI: 1.7 to 33.2), HIV positive serostatus (aOR=6.9; 95% CI: 2.2 to 21.6) and unprotected anal sex in the past 3 months (aOR=3.8; 95% CI: 1.2 to 11.9). Sensitivity and specificity were optimal (81.0% and 66.1%, respectively) at a model-derived risk score cut-point ≥3, and the NNT was 12.ConclusionsA model-derived risk score based on correlates of anorectal NG/CT infection in asymptomatic participants would be sensitive and efficient (i.e, low NNT) for targeting presumptive treatment. If validated in other settings, this risk score could improve on the WHO algorithm and help reduce the burden of asymptomatic anorectal NG/CT infections among MSM in settings where diagnostic testing is not available.
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43

QUILLIAM, R. S., P. CROSS, A. PRYSOR WILLIAMS, G. EDWARDS-JONES, R. L. SALMON, D. RIGBY, R. M. CHALMERS, D. Rh THOMAS, and D. L. JONES. "Subclinical infection and asymptomatic carriage of gastrointestinal zoonoses: occupational exposure, environmental pathways, and the anonymous spread of disease." Epidemiology and Infection 141, no. 10 (May 10, 2013): 2011–21. http://dx.doi.org/10.1017/s0950268813001131.

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SUMMARYAsymptomatic carriage of gastrointestinal zoonoses is more common in people whose profession involves them working directly with domesticated animals. Subclinical infections (defined as an infection in which symptoms are either asymptomatic or sufficiently mild to escape diagnosis) are important within a community as unknowing (asymptomatic) carriers of pathogens do not change their behaviour to prevent the spread of disease; therefore the public health significance of asymptomatic human excretion of zoonoses should not be underestimated. However, optimal strategies for managing diseases where asymptomatic carriage instigates further infection remain unresolved, and the impact on disease management is unclear. In this review we consider the environmental pathways associated with prolonged antigenic exposure and critically assess the significance of asymptomatic carriage in disease outbreaks Although screening high-risk groups for occupationally acquired diseases would be logistically problematical, there may be an economic case for identifying and treating asymptomatic carriage if the costs of screening and treatment are less than the costs of identifying and treating those individuals infected by asymptomatic hosts.
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44

Turner, Lucien H., Jeremy M. Kinder, Adrienne Wilburn, Rahul J. D’Mello, Makayla R. Braunlin, Tony T. Jiang, Giang Pham, and Sing Sing Way. "Preconceptual Zika virus asymptomatic infection protects against secondary prenatal infection." PLOS Pathogens 13, no. 11 (November 16, 2017): e1006684. http://dx.doi.org/10.1371/journal.ppat.1006684.

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45

Ngwe Tun, Mya Myat, Saw Wut Hmone, Aung Min Soe, Elizabeth Luvai, Khine Mya Nwe, Shingo Inoue, Corazon C. Buerano, Kyaw Zin Thant, and Kouichi Morita. "Zika virus infection in asymptomatic persons in Myanmar, 2018." Transactions of The Royal Society of Tropical Medicine and Hygiene 114, no. 6 (February 11, 2020): 440–47. http://dx.doi.org/10.1093/trstmh/trz134.

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Abstract Background Zika virus (ZIKV) is a mosquito-borne flavivirus. Outbreaks of ZIKV infection have occurred in Africa, Southeast Asia, the Pacific Islands, the Americas and the Caribbean. Although most ZIKV infections are asymptomatic, cases of neurological manifestations have been described. The aim of the present study was to identify the prevalence of ZIKV infection among the asymptomatic persons in Myanmar in 2018. Methods A total of 284 serum samples from apparently healthy persons were collected from Yangon, Myanmar in 2018. They were analysed for ZIKV infection by immunoglobulin M (IgM) capture enzyme-linked immunosorbent assay (ELISA), IgG indirect ELISA, 50% focus reduction neutralization test, real-time reverse transcription polymerase chain reaction (RT-PCR) and conventional RT-PCR. Results Of the 284 apparently healthy persons, 31.3% were positive for the presence of IgM against ZIKV and 94.3% were positive for anti-flavivirus IgG. Among the ZIKV IgM-positive samples, we confirmed ZIKV infection in 15.8% of asymptomatic persons by neutralization test and real-time RT-PCR. Conclusions We conclude that ZIKV infection was increasing among asymptomatic persons in the same area in Myanmar during 2018 compared with 2017. It is highly recommended to strengthen the surveillance system for ZIKV to prevent possible outbreaks.
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Faro, Sebastian. "Infection and Infertility." Infectious Diseases in Obstetrics and Gynecology 1, no. 1 (1993): 51–57. http://dx.doi.org/10.1155/s1064744993000134.

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47

Charest, Louise, Judith Fafard, and Zoë R. Greenwald. "Asymptomatic urethral lymphogranuloma venereum: a case report." International Journal of STD & AIDS 29, no. 8 (January 19, 2018): 828–30. http://dx.doi.org/10.1177/0956462417751813.

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Since 2003, there has been a resurgence of lymphogranuloma venereum (LGV), a variant of Chlamydia trachomatis (CT), among men who have sex with men (MSM) in several urban areas of Europe and North America. LGV infection occurs most often at anal sites causing proctitis. Urethral and oropharyngeal infections are rare. In Quebec, LGV incidence has been increasing exponentially in recent years and the current guidelines support systematic LGV genotype testing among anorectal CT-positive samples only. This case report describes a patient with a urethral LGV infection, remarkable due to its prolonged asymptomatic development prior to the manifestation of an inguinal bubo. Physicians should be vigilant of potential cases of LGV and forward CT-positive samples occurring among individuals with LGV risk factors for genotype testing.
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Cai, Tommaso, Sandra Mazzoli, Nicola Mondaini, Gianni Malossini, and Riccardo Bartoletti. "Chlamydia trachomatis infection: a challenge for the urologist." Microbiology Research 2, no. 1 (December 12, 2011): 14. http://dx.doi.org/10.4081/mr.2011.e14.

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<p>The role of <em>Chlamydia trachomatis</em> (Ct) in everyday clinical practice is now on the increase because Ct infections are the most prevalent sexually transmitted bacterial infections worldwide. Ct can cause urethritis, cervicitis, pharyngitis, or epididymitis, although asymptomatic infections are quite common. Ct infection remains asymptomatic in approximately 50% of infected men and 70% of infected women, with risk for reproductive tract sequelae both in women and men. A proper early diagnosis and treatment is essential in order to prevent persistent consequences. An accurate comprehension of the pathology, diagnosis and treatment of this entity is essential for the urologist. We review the literature about the new findings in diagnosis and treatment of Ct infection in sexually active young men.</p>
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Wikström, A., C. Popescu, and O. Forslund. "Asymptomatic Penile HPV Infection: A Prospective Study." International Journal of STD & AIDS 11, no. 2 (February 2000): 80–84. http://dx.doi.org/10.1177/095646240001100203.

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The occurrence of human papillomavirus (HPV) among males was analysed with the polymerase chain reaction (PCR) method. Penile brush samples were taken once from 147 males attending for a control or for HPV non-related reasons, and consecutive samples were collected from 88 males re-attending the clinic. Of the males attending once, 13% (19/147) were HPV DNA positive and among the re-attenders 14% (12/88) were initially positive as compared with 33% (29/88) who were positive at least at one visit. Totally, 22 different HPV types were detected of which HPV 16 was most common, found in 6.4% (15/235), followed by HPV 42 found in 3.8% (9/235). Among 14 HPV-positive males with at least one follow-up, 7 had persistent infections with at least one HPV type, and transient HPV types were observed in 9; but in 5 of them new types appeared at follow-up. Among sexually-active males subclinical/latent HPV infection is common and repeated sampling increases its prevalence.
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PHILLIPS, G., C. C. TAM, L. C. RODRIGUES, and B. LOPMAN. "Risk factors for symptomatic and asymptomatic norovirus infection in the community." Epidemiology and Infection 139, no. 11 (December 17, 2010): 1676–86. http://dx.doi.org/10.1017/s0950268810002839.

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SUMMARYThe objective of this study was to investigate risk factors for norovirus-associated infectious intestinal disease (IID) and asymptomatic norovirus infection. Individuals with IID and healthy controls were recruited in a community-based study in England (1993–1996). This is the first risk-factor study to use viral load measurements, generated by real-time RT–PCR, to identify cases of norovirus-associated IID and asymptomatic infections. Using multivariable logistic regression the main risk factor identified for norovirus-associated IID was contact with a person with IID symptoms. Infectious contacts accounted for 54% of norovirus cases in young children and 39% of norovirus cases in older children and adults. For young children, contacts outside the household presented the highest risk; for older children and adults, the highest risk was associated with child contacts inside the household. Foreign travel and consumption of shellfish increased the risk of norovirus-associated IID. Lifestyle and dietary factors were associated with a decreased risk of both norovirus-associated IID and asymptomatic infection. No risk factors were identified for asymptomatic norovirus infection.
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