Reported 5 cases of Crimean-Congo hemorrhagic fever in Fars province in 2011

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Fatemeh Rezaei

2012-09-01

Full Text Available Crimean-Congo Hemorrhagic Fever (CCHF is a viral hemorrhagic disease and a zoonosis disease that has been developed in people who deal with animals such as cattle and butchers. The diagnosis of CCHF is performed by detection of human antibodies (IgG and IgM against CCHF virus. Five Patients with CCHF occurred in Fath Abad’s village (in Fars province in the summer of 2011. All patients were men and aged 25-46 years old. Three patients were farmer and two other ones were butchers. The samples were sent to the National Reference Laboratory for Arboviruses and Viral Haemorrhagic Fevers (Pasteur Institute of Iran in Tehran. The result of laboratory test for all patients was positive. None of the patients had died. Since the CCHF is rare, present study was aimed to assess the causes of the disease’s epidemic and clinical and laboratory symptoms stones.

Report of the first case of Crimean Congo hemorrhagic fever in Qazvin Province (2016

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AR. Nikoonejad

2016-12-01

Full Text Available Crimean Congo hemorrhagic fever is a potentially fatal disease that is reported from Asia, Africa and Europe. In May, 2016 a 42 year-old female is admitted to Buali-Sina hospital with epistaxis and within a few hours got loss of consciousness and shock. The patient was put on supportive care and oral Ribavirin. From the sixth admission day, the general condition of the patient improved and on the eleventh day she was discharged without an important sequela. Consequently, it is necessary to consider this disease in the differential diagnosis of all patients presented with fever and acute bleeding diathesis.

Emergence of viral hemorrhagic fevers: Is recent outbreak of crimean congo hemorrhagic fever in India an indication?

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C Lahariya

2012-01-01

Full Text Available The emerging and re-emerging diseases are posing a great health risk for the last few years. One such category of diseases is viral haemorrhagic fevers (VHFs, which have emerged in the new territories, worldwide. Crimean Congo Hemorrhagic Fever (CCHF cases, for the first time in India, were reported from Gujarat, in January 2011. The emergence of diseases not reported earlier, pose great economic and social challenge, burden health system, and create panic reaction. Nonetheless, with recent experience in control of epidemic diseases, and advances in basic scientific knowledge; the public health community is better prepared for these unexpected events. This review provides information to physicians on CCHF for managing outbreak, and identifies public health measures to prevent emergence and re-emergence of VHFs (including CCHF in future. The authors suggest that though, there are a few challenging and unanswered questions, the public health preparedness still remains the key to control emerging and re-emerging diseases. The countries where virus activities have been reported need to be prepared accordingly.

Brucellosis in Patients with Crimean-Congo Hemorrhagic Fever

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Fazilet Duygu

2017-12-01

Full Text Available Background: Crimean-Congo hemorrhagic fever (CCHF is a fatal zoonotic viral disease caused by infection with a tick-borne virus of the genus Nairovirus. In this study, we investigated the incidence of brucellosis in patients diag­nosed with CCHF.Methods: Overall, 169 patients hospitalized with an initial diagnosis of CCHF were included in 2011 in To­kat/ Turkey. Immunoglobulin M (IgM antibodies and/or PCR results were used in the laboratory diagnosis of CCHF, while plate and standard tube agglutination (STA tests were used to diagnose brucellosis.Results: Overall, 120 patients (79% with positive PCR tests were diagnosed with CCHF. Five (4.16% were also diag­nosed with brucellosis based on the positive plate and STA test results. Four patients (2.36% had negative CCHF PCR and positive STA test results.Conclusion: Brucellosis and CCHF can mimic each other and that all patients with CCHF or brucellosis should be screened for both conditions.

Interim Report on SNP analysis and forensic microarray probe design for South American hemorrhagic fever viruses, tick-borne encephalitis virus, henipaviruses, Old World Arenaviruses, filoviruses, Crimean-Congo hemorrhagic fever viruses, Rift Valley fever

Energy Technology Data Exchange (ETDEWEB)

Jaing, C; Gardner, S

2012-06-05

The goal of this project is to develop forensic genotyping assays for select agent viruses, enhancing the current capabilities for the viral bioforensics and law enforcement community. We used a multipronged approach combining bioinformatics analysis, PCR-enriched samples, microarrays and TaqMan assays to develop high resolution and cost effective genotyping methods for strain level forensic discrimination of viruses. We have leveraged substantial experience and efficiency gained through year 1 on software development, SNP discovery, TaqMan signature design and phylogenetic signature mapping to scale up the development of forensics signatures in year 2. In this report, we have summarized the whole genome wide SNP analysis and microarray probe design for forensics characterization of South American hemorrhagic fever viruses, tick-borne encephalitis viruses and henipaviruses, Old World Arenaviruses, filoviruses, Crimean-Congo hemorrhagic fever virus, Rift Valley fever virus and Japanese encephalitis virus.

Seroepidemiological Studies of Crimean-Congo Hemorrhagic Fever Virus in Domestic and Wild Animals.

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Jessica R Spengler

2016-01-01

Full Text Available Crimean-Congo hemorrhagic fever (CCHF is a widely distributed, tick-borne viral disease. Humans are the only species known to develop illness after CCHF virus (CCHFV infection, characterized by a nonspecific febrile illness that can progress to severe, often fatal, hemorrhagic disease. A variety of animals may serve as asymptomatic reservoirs of CCHFV in an endemic cycle of transmission. Seroepidemiological studies have been instrumental in elucidating CCHFV reservoirs and in determining endemic foci of viral transmission. Herein, we review over 50 years of CCHFV seroepidemiological studies in domestic and wild animals. This review highlights the role of livestock in the maintenance and transmission of CCHFV, and provides a detailed summary of seroepidemiological studies of wild animal species, reflecting their relative roles in CCHFV ecology.

Crimean-Congo Haemorrhagic Fever in Kosova : a fatal case report

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Raka Lul

2006-10-01

Full Text Available Abstract Crimean-Congo haemorrhagic fever (CCHF is an often fatal viral infection described in about 30 countries around the world. The authors report a fatal case of Crimean-Congo hemorrhagic fever (CCHF observed in a patient from Kosova. The diagnosis of CCHF was confirmed by reverse transcription-PCR. Late diagnosis decreased the efficacy of treatment and patient died due to severe complications of infection.

Marburg hemorrhagic fever associated with multiple genetic lineages of virus

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Bausch, D G; Nichol, S T; Muyembe-Tamfum, J J

2006-01-01

Background An outbreak of Marburg hemorrhagic fever was first observed in a gold-mining village in northeastern Democratic Republic of the Congo in October 1998. Methods We investigated the outbreak of Marburg hemorrhagic fever most intensively in May and October 1999. Sporadic cases and short ch...

Hepatitis in Patients with Crimean –Congo Hemorrhagic Fever

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Batool Sharifi-Mood

2014-04-01

Full Text Available Background: Crimean–Congo hemorrhagic fever (CCHF is a viral disease and causing approximately 30% fatality rate. Recent studies have been reported that hepatitis in CCHF patients is with high mortality. The aim of this study was to determine the prevalence of hepatitis in the CCHF cases and also detect the mortality rate among patients with hepatitis. Materials and Methods: The present study was conducted in patients with CCHF who were hospitalized in Boo-Ali hospital in Zahedan between Oct 2009 to Feb 2012. Liver function tests including aminotransferase enzymes and prothrombin time and mortality rate were evaluated. Results: Among 53 patients with CCHF, hepatitis was seen in 19 patients (45%. Nine patients died (21%. All dead patients had a serum aminotransaminase level ≥10 times the upper normal limit. Conclusion: Our study showed that hepatitis is prevalent in CCHF patients and a serum aminotransaminase level ≥5 times the upper normal limit (UNL is a risk factor for severe disease and high mortality.

Mean Platelet Volume and Neutrophil-to-Lymphocyte Ratio in Patients with Crimean–Congo Hemorrhagic Fever

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Derya Koçer

2015-01-01

Full Text Available Objectives: Crimean–Congo hemorrhagic fever (CCHF is a tick-borne zoonotic infection caused by Crimean Congo hemorrhagic fever virus (CCHFV. The aim of the present study was to investigate the association between blood neutrophil-to-lymphocyte ratio (NLR and mean platelet volume (MPV which are simple markers of subclinical inflammation and CCHF. We also investigated the relationship of these markers with coagulation parameters.Methods: Thirty-one suspected CCHF patients, who submitted to Training and Research Hospital, Kayseri, Turkey between 2009 and 2013, were evaluated retrospectively. Among thirty-one patients, nineteen were laboratory confirmed CCHF patients diagnosed by RT-PCR or CCHFV-specific IgM positivity. Alanine aminotransferase (ALT, aspartate aminotransferase (AST, lactate dehydrogenase (LDH, creatinin phosphokinase (CK, coagulation parameters, white blood cell counts (WBCs, and platelet counts of patient group were compared with twenty-five healthy individuals.Results: MPV, AST, ALT, LDH, CK and coagulation parameters were significantly higher in patients with CCHF than the controls, whereas WBCs, neutrophil, lymphocyte, hemoglobin, platelet counts and NLR were significantly lower (p<0.05. We found no significant correlation between MPV, NLR and coagulation parameters.Conclusions: Our study demonstrates that MPV and NLR may be beneficial markers in the diagnosis of CCHF. But these parameters should not be considered stand-alone tests for this use owing to nonspecificity with other diseases.

Ribavirin for Crimean-Congo hemorrhagic fever: systematic review and meta-analysis

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G Gail

2010-07-01

Full Text Available Abstract Background Crimean-Congo hemorrhagic fever epidemics often occur in areas where health services are limited, and result in high case fatality rates. Besides intensive care, ribavirin is often recommended. A solid evidence base for the use of this drug will help justify assuring access to the drug in areas where epidemics are common. Methods We carried out a systematic review of observational and experimental studies of people with suspected or confirmed Crimean-Congo hemorrhagic fever that included comparisons between patients given ribavirin and those not. We extracted data on mortality, hospital stay, and adverse events. Risk of bias was assessed using a standard checklist, and data were presented in meta-analytical graphs, stratified by study design, and GRADE tables presented. The risk of bias was summarised using the GRADE method. Results 21 unique studies, including one randomised controlled trial of ribavirin, were included. Quality of the evidence was very low, with a Down and Black median score of 4 (maximum possible 33. Ribavirin treatment was not shown to be superior to no ribavirin treatment for mortality rate in a single RCT (RR: 1.13, 95%CI: 0.29 to 4.32, 136 participants, GRADE=low quality evidence; but ribavirin was associated with reduced mortality by 44% when compared to no ribavirin treatment in the pooled observational studies (RR: 0.56, 95%CI: 0.35 to 0.90, 955 participants; GRADE=very low quality evidence. Adverse events were more common with the ribavirin patients, but no severe adverse events were reported. No difference in length of hospital stay was reported. Conclusions No clear message of benefit is available from the current data on ribavirin as observational data are heavily confounded, and the one trial carried out has limited power. However, ribavirin could potentially have benefits in this condition and these results clearly indicate a pragmatic, randomised controlled trial in the context of good quality

Crimean-Congo Hemorrhagic Fever Virus Nucleocapsid Protein Augments mRNA Translation.

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Jeeva, Subbiah; Cheng, Erdong; Ganaie, Safder S; Mir, Mohammad A

2017-08-01

Crimean-Congo hemorrhagic fever virus (CCHFV) is a tick-borne Nairovirus of the Bunyaviridae family, causing severe illness with high mortality rates in humans. Here, we demonstrate that CCHFV nucleocapsid protein (CCHFV-NP) augments mRNA translation. CCHFV-NP binds to the viral mRNA 5' untranslated region (UTR) with high affinity. It facilitates the translation of reporter mRNA both in vivo and in vitro with the assistance of the viral mRNA 5' UTR. CCHFV-NP equally favors the translation of both capped and uncapped mRNAs, demonstrating the independence of this translation strategy on the 5' cap. Unlike the canonical host translation machinery, inhibition of eIF4F complex, an amalgam of three initiation factors, eIF4A, eIF4G, and eIF4E, by the chemical inhibitor 4E1RCat did not impact the CCHFV-NP-mediated translation mechanism. However, the proteolytic degradation of eIF4G alone by the human rhinovirus 2A protease abrogated this translation strategy. Our results demonstrate that eIF4F complex formation is not required but eIF4G plays a critical role in this translation mechanism. Our results suggest that CCHFV has adopted a unique translation mechanism to facilitate the translation of viral mRNAs in the host cell cytoplasm where cellular transcripts are competing for the same translation apparatus. IMPORTANCE Crimean-Congo hemorrhagic fever, a highly contagious viral disease endemic to more than 30 countries, has limited treatment options. Our results demonstrate that NP favors the translation of a reporter mRNA harboring the viral mRNA 5' UTR. It is highly likely that CCHFV uses an NP-mediated translation strategy for the rapid synthesis of viral proteins during the course of infection. Shutdown of this translation mechanism might selectively impact viral protein synthesis, suggesting that an NP-mediated translation strategy is a target for therapeutic intervention against this viral disease. Copyright © 2017 American Society for Microbiology.

Investigation of an isolated case of human Crimean–Congo hemorrhagic fever in Central Uganda, 2015

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Stephen Balinandi

2018-03-01

Full Text Available Background: Crimean–Congo hemorrhagic fever (CCHF is the most geographically widespread tick-borne viral infection. Outbreaks of CCHF in sub-Saharan Africa are largely undetected and thus under-reported. On November 9, 2015, the National Viral Hemorrhagic Fever Laboratory at the Uganda Virus Research Institute received an alert for a suspect VHF case in a 33-year-old male who presented with VHF compatible signs and symptoms at Mengo Hospital in Kampala. Methods: A blood sample from the suspect patient was tested by RT-PCR for CCHF and found positive. Serological testing on sequential blood specimens collected from this patient showed increasing anti-CCHFV IgM antibody titers, confirming recent infection. Repeat sampling of the confirmed case post recovery showed high titers for anti-CCHFV-specific IgG. An epidemiological outbreak investigation was initiated following the initial RT-PCR positive detection to identify any additional suspect cases. Results: Only a single acute case of CCHF was detected from this outbreak. No additional acute CCHF cases were identified following field investigations. Environmental investigations collected 53 tick samples, with only 1, a Boophilus decoloratus, having detectable CCHFV RNA by RT-PCR. Full-length genomic sequencing on a viral isolate from the index human case showed the virus to be related to the DRC (Africa 2 lineage. Conclusions: This is the fourth confirmed CCHF outbreak in Uganda within 2 years after more than 50 years of no reported human CCHF cases in this country. Our investigations reaffirm the endemicity of CCHFV in Uganda, and show that exposure to ticks poses a significant risk for human infection. These findings also reflect the importance of having an established national VHF surveillance system and diagnostic capacity in a developing country like Uganda, in order to identify the first cases of VHF outbreaks and rapidly respond to reduce secondary cases. Additional efforts should focus on

Isolation and whole-genome sequencing of a Crimean-Congo hemorrhagic fever virus strain, Greece.

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Papa, Anna; Papadopoulou, Elpida; Tsioka, Katerina; Kontana, Anastasia; Pappa, Styliani; Melidou, Ageliki; Giadinis, Nektarios D

2018-03-01

Crimean-Congo hemorrhagic fever virus (CCHFV) was isolated from a pool of two adult Rhipicephalus bursa ticks removed from a goat in 2015 in Greece. The strain clusters into lineage Europe 2 representing the second available whole-genome sequenced isolate of this lineage. CCHFV IgG antibodies were detected in 8 of 19 goats of the farm. Currently CCHFV is not associated with disease in mammals other than humans. Studies in animal models are needed to investigate the pathogenicity level of lineage Europe 2 and compare it with that of other lineages. Copyright © 2018 Elsevier GmbH. All rights reserved.

Crimean–Congo Hemorrhagic Fever Virus and Borrelia burgdorferi sensu lato in Ticks from Kosovo and Albania

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Kurtesh Sherifi; Agim Rexhepi; Kristaq Berxholi; Blerta Mehmedi; Rreze M. Gecaj; Zamira Hoxha; Anja Joachim; Georg G. Duscher

2018-01-01

Tick-borne diseases pose a serious threat to human health in South-Eastern Europe, including Kosovo. While Crimean–Congo hemorrhagic fever (CCHF) is a well-known emerging infection in this area, there are no accurate data on Lyme borreliosis and tick-borne encephalitis (TBE). Therefore, we sampled and tested 795 ticks. Ixodes ricinus (n = 218), Dermacentor marginatus (n = 98), and Haemaphysalis spp. (n = 24) were collected from the environment by flagging (all from Kosovo), while Hyalomma mar...

Crimean-Congo Hemorrhagic Fever: Tick-Host-Virus Interactions

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Anna Papa

2017-05-01

Full Text Available Crimean-Congo hemorrhagic fever virus (CCHFV is transmitted to humans by bite of infected ticks or by direct contact with blood or tissues of viremic patients or animals. It causes to humans a severe disease with fatality up to 30%. The current knowledge about the vector-host-CCHFV interactions is very limited due to the high-level containment required for CCHFV studies. Among ticks, Hyalomma spp. are considered the most competent virus vectors. CCHFV evades the tick immune response, and following its replication in the lining of the tick's midgut, it is disseminated by the hemolymph in the salivary glands and reproductive organs. The introduction of salivary gland secretions into the host cells is the major route via which CCHFV enters the host. Following an initial amplification at the site of inoculation, the virus is spread to the target organs. Apoptosis is induced via both intrinsic and extrinsic pathways. Genetic factors and immune status of the host may affect the release of cytokines which play a major role in disease progression and outcome. It is expected that the use of new technology of metabolomics, transcriptomics and proteomics will lead to improved understanding of CCHFV-host interactions and identify potential targets for blocking the CCHFV transmission.

[Two Crimean-Congo hemorrhagic fever cases without history of tick contact from Ankara region].

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Kaya Kiliç, Esra; Yilmaz, Umut; Cesur, Salih; Koçak Tufan, Zeliha; Kurtoğlu, Yasemin; Bulut, Cemal; Kinikli, Sami; Irmak, Hasan; Demiröz, Ali Pekcan

2009-10-01

Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral disease presenting with flu-like symptoms, fever, hemorrhage and petechia. The virus (CCHFV) is a member of the Nairovirus genera of Bunyaviridae family and can be transmitted to humans by Hyalomma tick-bite, by exposure to infected blood and fomites of patient with CCHF or contact with animal tissue in viremic phase. In this study we present two cases with CCHF but without history of tick bite or exposure to infected fomites, even not coming from endemic areas. The first case was a 67 years old male patient presented with fever, fatique and shortness of breath. Physical examination revealed rales in right lower segments of lung. Laboratory findings showed elevation of liver enzymes with thrombocytopenia and prolonged prothrombin time. Serological markers for viral hepatitis, cytomegalovirus (CMV) and Epstein-Barr virus (EBV) were negative. The patient was found to be IgM and RNA positive for CCHFV by ELISA and polymerase chain reaction (PCR) methods, respectively. His history indicated a contact with livestock. The second patient was a 60 years old male dealing with husbandry. He had fever, fatique and myalgia. Physical examination revealed petechial rash on legs. Laboratory findings showed elevated liver enzymes, prolonged phrothrombin time and thrombocytopenia. Viral hepatitis markers, CMV-IgM and EBV-IgM were found negative. He was also found to be IgM and RNA positive for CCHFV in the reference laboratory. In conclusion, CCHF should be considered in the differential diagnosis of patients who contact with livestock and present with fever, fatigue, rash, elevated liver enzymes, thrombocytopenia and prolonged prothrombin time eventhough they do not reside in endemic areas for CCHF.

Public Knowledge and Attitude toward Crimean Congo Hemorrhagic Fever in Tokat Turkey

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R Yilmaz

2009-12-01

Full Text Available "nBackground: The World health Organization (WHO declares Crimean Congo hemorrhagic fe­ver (CCHF endemic in Turkey. Despite the magnitude of problem, no documented evi­dence exists in Turkey, which reveals the aware­ness and practices of the country's adult popula­tion regarding CCHF, its spread, symptoms, treatment, and preven­tion. This study was conducted to assess the level of knowledge, attitudes, and practices regarding CCHF in people visit­ing terti­ary care hospital in Tokat, Turkey."nMethods: This questionnaire based cross-sectional survey was conducted among patients' rela­tives or guardians who ad­mitted pediatric outpatient clinics during May-July 2008. The question­naire was composed of 25 questions."nResults: A total of 1034 respondents participated in the survey. Sufficient knowledge about CCHF was not found in 28.9% of the sample. Literate individuals were relatively better informed about CCHF as compared to the illiterate peo­ple. Television and radio were con­sidered as the most important and useful source of information on the disease."nConclusion: We have found insufficient knowledge on CCHF in our population. It is thought to have no chance of suc­cess against a fatal disease such as CCHF, which has serious consequences, without the contribution of commu­nity. It is clear that there are important tasks for health, agri­culture, and media sectors to improve public knowledge and awareness about CCHF. "n Keywords: Crimean Congo hemorrhagic fever, Public knowledge, Survey, Turkey

Molecular Assay on Crimean Congo Hemorrhagic Fever Virus in Ticks (Ixodidae) Collected from Kermanshah Province, Western Iran

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Mohammadian, Maria; Chinikar, Sadegh; Telmadarraiy, Zakkyeh; Vatandoost, Hassan; Oshaghi, Mohammad Ali; Hanafi-Bojd, Ahmad Ali; Sedaghat, Mohammad Mehdi; Noroozi, Mehdi; Faghihi, Faezeh; Jalali, Tahmineh; Khakifirouz, Sahar; Shahhosseini, Nariman; Farhadpour, Firoozeh

2016-01-01

Background: Crimean-Congo Hemorrhagic Fever (CCHF) is a feverous and hemorrhagic disease endemic in some parts of Iran and caused by an arbovirus related to Bunyaviridae family and Nairovirusgenus. The main virus reservoir in the nature is ticks, however small vertebrates and a wide range of domestic and wild animals are regarded as reservoir hosts. This study was conducted to determine the infection rate of CCHF virus in hard ticks of Sarpole-Zahab County, Kermanshah province, west of Iran. Methods: From total number of 851 collected ticks from 8 villages, 131 ticks were selected randomlyand investigated for detection of CCHF virus using RT-PCR. Results: The virus was found in 3.8% of the tested ticks. Hyalommaanatolicum, H. asiaticum and Rhipicephalus sanguineus species were found to have viral infection, with the highest infection rate (11.11%) in Rh. sanguineus. Conclusion: These findings provide epidemiological evidence for planning control strategies of the disease in the study area. PMID:27308296

Molecular Assay on Crimean Congo Hemorrhagic Fever Virus in Ticks (Ixodidae Collected from Kermanshah Province, Western Iran

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Maria Mohammadian

2016-01-01

Full Text Available Background: Crimean-Congo Hemorrhagic Fever (CCHF is a feverous and hemorrhagic disease endemic in some parts of Iran and caused by an arbovirus related to Bunyaviridae family and Nairovirusgenus. The main virus reser­voir in the nature is ticks, however small vertebrates and a wide range of domestic and wild animals are regarded as reservoir hosts. This study was conducted to determine the infection rate of CCHF virus in hard ticks of Sarpole-Zahab County, Kermanshah province, west of Iran.Methods: From total number of 851 collected ticks from 8 villages, 131 ticks were selected randomlyand investi­gated for detection of CCHF virus using RT-PCR.Results: The virus was found in 3.8% of the tested ticks. Hyalommaanatolicum, H.asiaticum and Rhipicephalus sanguineus species were found to have viral infection, with the highest infection rate (11.11% in Rh. sanguineus.Conclusion: These findings provide epidemiological evidence for planning control strategies of the disease in the study area.

HMGB1 Is a Potential Biomarker for Severe Viral Hemorrhagic Fevers.

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Katarina Resman Rus

2016-06-01

Full Text Available Hemorrhagic fever with renal syndrome (HFRS and Crimean-Congo hemorrhagic fever (CCHF are common representatives of viral hemorrhagic fevers still often neglected in some parts of the world. Infection with Dobrava or Puumala virus (HFRS and Crimean-Congo hemorrhagic fever virus (CCHFV can result in a mild, nonspecific febrile illness or as a severe disease with hemorrhaging and high fatality rate. An important factor in optimizing survival rate in patients with VHF is instant recognition of the severe form of the disease for which significant biomarkers need to be elucidated. To determine the prognostic value of High Mobility Group Box 1 (HMGB1 as a biomarker for disease severity, we tested acute serum samples of patients with HFRS or CCHF. Our results showed that HMGB1 levels are increased in patients with CCHFV, DOBV or PUUV infection. Above that, concentration of HMGB1 is higher in patients with severe disease progression when compared to the mild clinical course of the disease. Our results indicate that HMGB1 could be a useful prognostic biomarker for disease severity in PUUV and CCHFV infection, where the difference between the mild and severe patients group was highly significant. Even in patients with severe DOBV infection concentrations of HMGB1 were 2.8-times higher than in the mild group, but the difference was not statistically significant. Our results indicated HMGB1 as a potential biomarker for severe hemorrhagic fevers.

Crimean Congo hemorrhagic fever among the one-humped camel (Camelus dromedaries) in Central Sudan.

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Suliman, Hajer M; Adam, Ibrahim A; Saeed, Shamseldin I; Abdelaziz, Sanaa A; Haroun, Eltahir M; Aradaib, Imadeldin E

2017-08-03

Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral zoonotic disease caused by Crimean-Congo hemorrhagic fever virus (CCHFV), a member of the genus Nairovirus in the family Bunyaviridae. CCHF is typically asymptomatic in animals but can be highly fatal in humans approaching case fatality rate of approximately 30%. In the present investigation, a cross sectional study was conducted to determine the prevalence of CCHF and to identify the potential risk factors associated with CCHFV seropositivity among the one-humped camel (Camelus dromedaries) in Central Sudan. A total of 361 camels selected randomly from six localities were employed in the study. Sera sampled were tested for the presence of CCHFV-specific immunoglobulin G (IgG) antibodies using enzyme-linked immunosorbent assay (ELISA). CCHFV seropositivity was recorded in 77 out of 361 animals accounting for a prevalence rate of 21.3%. Age (OR = 3.6, CI = 1.72-7.79, p-value = 0.026); locality (OR = 5.85, CI = 1.81-18.83, p- value = 0.003), tick number (OR = 4.6, CI = 1.37-9.81, P-value 0.04); tick control (OR = 2.2, CI, 1.11-4.35, P-value = 0.023) and breed (OR = 6.60, CI = 2.38-18.36, P-value = 0.001) were recorded as potential risk factors for contracting CCHF. The prevalence of CCHF is significantly high among camels in Khartoum State, Sudan. Age, breed, locality and tick control are considered as potential risk factors for contracting CCHF. This study would be expected to reduce the impact on the livelihood of pastoral communities and ultimately avoid disease spread in human.

A case of Crimean-Congo hemorrhagic fever complicated with acute pancreatitis.

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Bastug, Aliye; Kayaaslan, Bircan; But, Ayse; Aslaner, Halide; Sertcelik, Ahmet; Akinci, Esragul; Onguru, Pinar; Yetkin, Meltem Arzu; Bodur, Hurrem

2014-11-01

Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease characterized by nonspecific symptoms like fever, myalgia, severe headache, nausea, vomiting, diarrhea, and abdominal pain. It can result in various complications during the course of the disease due to the diffuse endothelial injury involved in the pathogenesis of CCHF. Here we present a patient with CCHF complicated by acute pancreatitis, including pleural and intra-abdominal effusions. A 70-year-old patient was referred to our hospital from an endemic area with the suspicion of CCHF. The physical examination of the patient revealed high fever (38°C), somnolence, and petechial eruption. The diagnosis of case was confirmed with positive reverse transcriptase polymerase chain reaction (RT-PCR). The viral load of the patient was 4×10(9) copies/mL. On the fifth day of admission, upper abdominal pain, scleral ichter, and abdominal distention developed. The patient had abdominal tenderness with guarding. The laboratory tests revealed an amylase level of 1740 U/L (28-100), lipase level of 583 U/L (13-60), and total bilirubin level of 3.75 mg/dL (<0.3). The diagnosis of acute pancreatitis was confirmed with radiological findings. Until now, atypical presentations of CCHF have been reported in some case reports, but not acute pancreatitis. To the best of our knowledge, this is the first case of acute pancreatitis in the literature seen in the course of CCHF.

Genomic Characterization of Crimean-Congo Hemorrhagic Fever Virus in Hyalomma Tick from Spain, 2014.

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Cajimat, Maria N B; Rodriguez, Sergio E; Schuster, Isolde U E; Swetnam, Daniele M; Ksiazek, Thomas G; Habela, Miguel A; Negredo, Ana Isabel; Estrada-Peña, Agustín; Barrett, Alan D T; Bente, Dennis A

2017-10-01

Crimean-Congo hemorrhagic fever (CCHF) is a severe tick-borne disease caused by CCHF virus (CCHFV). Ticks in the genus Hyalomma are the main vectors and reservoirs of CCHFV. In Spain, CCHFV was first detected in Hyalomma ticks from Cáceres in 2010. Subsequently, two autochthonous CCHF cases were reported in August 2016. In this study, we describe the characterization of the CCHFV genome directly from Hyalomma lusitanicum collected in Cáceres in 2014. Phylogenetic analyses reveal a close relationship with clade III strains from West Africa, with an estimated divergence time of 50 years. The results of this work suggest that CCHFV has been circulating in Spain for some time, and most likely originated from West Africa.

Molecular (ticks) and serological (humans) study of Crimean-Congo hemorrhagic fever virus in the Iberian Peninsula, 2013-2015.

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Palomar, Ana M; Portillo, Aránzazu; Santibáñez, Sonia; García-Álvarez, Lara; Muñoz-Sanz, Agustín; Márquez, Francisco J; Romero, Lourdes; Eiros, José M; Oteo, José A

Crimean-Congo hemorrhagic fever (CCHF) is a viral disease, mainly transmitted through tick bite, of great importance in Public Health. In Spain, Crimean-Congo hemorrhagic fever virus (CCHFV) was detected for the first time in 2010 in Hyalomma lusitanicum ticks collected from deer in Cáceres. The aim of this study was to investigate the presence of CCHFV in ticks from Cáceres, and from other Spanish areas, and to evaluate the presence of antibodies against the virus in individuals exposed to tick bites. A total of 2053 ticks (1333 Hyalomma marginatum, 680 H. lusitanicum and 40 Rhipicephalus bursa) were analyzed using molecular biology techniques (PCR) for CCHFV detection. The determination of specific IgG antibodies against CCHFV in 228 serum samples from humans with regular contact with ticks (at risk of acquiring the infection) was performed by indirect immunofluorescence assay. The CCHFV was not amplified in ticks, nor were antibodies against the virus found in the serum samples analyzed. The absence of the CCHFV in the ticks studied and the lack of antibodies against the virus in individuals exposed to tick bites would seem to suggest a low risk of acquisition of human infection by CCHFV in Spain. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Molecular epidemiology of Crimean- Congo hemorrhagic fever virus genome isolated from ticks of Hamadan province of Iran

DEFF Research Database (Denmark)

Tahmasebi, F; Ghiasi, Seyed Mojtaba; Mostafavi, E

2010-01-01

BACKGROUND & OBJECTIVES: Crimean-Congo hemorrhagic fever (CCHF) virus is a tick-borne member of the genus Nairovirus, family Bunyaviridae. CCHFV has been isolated from at least 31 different tick species. The virus is transmitted through the bite of an infected tick, or by direct contact with CCHFV...... to each other. Even though they clustered in the same group with the strain circulating in Iran, they had a closer relationship to the Matin strain. INTERPRETATION & CONCLUSION: Vector control programs should be applied for reducing population density of potential tick vectors in this province. Further...

Clinical symptoms and laboratory findings supporting early diagnosis of Crimean-Congo hemorrhagic fever in Iran.

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Mostafavi, Ehsan; Pourhossein, Behzad; Chinikar, Sadegh

2014-07-01

Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic disease, which is usually transmitted to humans by tick bites or contact with blood or other infected tissues of livestock. Patients suffering from CCHF demonstrate an extensive spectrum of clinical symptoms. As it can take considerable time from suspecting the disease in hospital until reaching a definitive diagnosis in the laboratory, understanding the clinical symptoms and laboratory findings of CCHF patients is of paramount importance for clinicians. The data were collected from patients who were referred to the Laboratory of Arboviruses and Viral Hemorrhagic Fevers at the Pasteur institute of Iran with a primary diagnosis of CCHF between 1999 and 2012 and were assessed by molecular and serologic tests. Referred patients were divided into two groups: patients with a CCHF positive result and patients with a CCHF negative result. The laboratory and clinical findings of these two groups were then compared. Two-thousand five hundred thirty-six probable cases of CCHF were referred to the laboratory, of which 871 cases (34.3%) were confirmed to be CCHF. Contact with infected humans and animals increased the CCHF infection risk (P important role in patient survival and the application of the findings of this study can prove helpful as a key for early diagnosis. © 2014 Wiley Periodicals, Inc.

The Co- Infection of Crime Congo Hemorrhagic Fever and Brucellosis: A Case Report

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A Saghafipour

2012-07-01

Full Text Available

Background and Objectives: Crimean-Congo Hemorrhagic fever (CCHF is a viral disease transmitted to ruminants or human by the bite of mature tick vectors. It can be transmitted through contact with the infectious blood or viraemic tissues during slaughter and hospital contacts. 80% of the cases are sub clinical and the rest of them are presenting with an acute febrile and occasionally hemorrhagic disease. The mortality rate of the fulminate form of the disease is equal to 20% to 50%. The hemorrhage is usually in the form of hematoma, melena, nose, conjunctiva, uterine or subcutaneous bleeding. CCHF complications are: encephalitis, optic neuropathy, hepatitis, renal failure and myocardial necrosis.

Case Report: In this article, we’ve discussed a CCHF patient who presented with high fever, myalgia, headache, nausea, vomiting, abdominal pain, diffuse cutaneous and gingival hemorrhage during the course of the disease while the patient was hospitalized. Profound jaundice, petechia and global ecchymosis were considerable. Lab data showed at the beginning of hospitalization that the number of liver enzymes was increased up to 8-10 times. The number of placates were lower than 150000 ml. Moreover, during the first three days there was a decrease in the number of white blood cells and PTT was abnormal. (AST was higher than 100 units per litre. The results of serologic examination of IgM- ELISA virus for CCHF on day 5 and IgG-ELISA on day 10–which were carried out in pasture Institute-were reported to be positive. According to the patient’s history and clinical symptoms, he was also suspicious for Brucellosis and the lab data demonstrated that he is also infected with Brucella. (Wright=1.320, 2ME=1.160 (The patient was a 22 year old man, sheep farmer, residing in the GhalehKamkar area of Qom City.

Plasma oxidative stress and total thiol levels in Crimean-Congo hemorrhagic fever.

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Karadag-Oncel, Eda; Erel, Ozcan; Ozsurekci, Yasemin; Caglayik, Dilek Yagci; Kaya, Ali; Gozel, Mustafa Gokhan; Icagasioglu, Fusun Dilara; Engin, Aynur; Korukluoglu, Gulay; Uyar, Yavuz; Elaldi, Nazif; Ceyhan, Mehmet

2014-01-01

In this study, we investigated the pro- and antioxidant status of patients with a pathogenesis of Crimean-Congo hemorrhagic fever (CCHF) in terms of their role in its pathogenesis. During the study period, 34 children and 41 adults were diagnosed with CCHF. The control group consisted of healthy age- and gender-matched children and adults. Serum levels of the total antioxidant capacity (TAC), total oxidant status (TOS), oxidative stress index (OSI), and plasma total thiol (TTL) were evaluated and compared between groups. The difference in mean TAC values between CCHF patients and healthy controls was not statistically significant (P > 0.05). Mean TOS, OSI, and TTL values were significantly lower in CCHF patients than in healthy controls (P 0.05). Our results suggest that TTL may play a more important role in CCHF pathogenesis than the other parameters investigated. The mean TOS and OSI values were higher in the control group than in CCHF patients.

Various clinical conditions can mimic Crimean-Congo hemorrhagic fever in pediatric patients in endemic regions

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Soner S. Kara

2016-09-01

Full Text Available Summary: Crimean-Congo hemorrhagic fever (CCHF is a tick-borne disease with high mortality. Many disorders can mimic CCHF. It is important to recognize the condition and to perform differential diagnosis in endemic countries. Twenty-one children aged 18 years or less with a preliminary diagnosis of CCHF were retrospectively evaluated. Real-time PCR and a confirmatory indirect immunofluorescence assay for negative results were performed. The diagnoses determined that 9 patients had (42.9% CCHF; 7 patients had (33.3% viral upper respiratory tract infections (URTI; 2 patients had (9.5% brucellosis; 1 patients had (4.7% periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA syndrome episode; 1 patient had (4.7% cerebral palsy, diabetes insipidus, acute gastroenteritis, and hypernatremic dehydration; and 1 patient had (4.7% cellulitis after a tick bite. The mean age of patients with CCHF was greater than that of the other patients (116.1 ± 53.6 vs. 94.1 ± 52.1 months, p = 0.02. Seventeen (81% of the children included had a history of tick bites, 2 (9.5% had a history of contact with a patient with CCHF, and 2 (9.5% had no exposure, but were living in an endemic region. Three patients had an underlying disorder: cerebral palsy and diabetes insipidus, epilepsy, or PFAPA. All of the children experienced fever. Other frequent symptoms were malaise, diarrhea, vomiting, and abdominal pain, but none of these differed statistically between the patient groups. CCHF patients had a longer mean duration of symptoms (10.56 ± 1.42 vs. 6.75 ± 3.62 days, p = 0.008 and a longer mean length of hospitalization (8.00 ± 2.08 vs. 3.58 ± 1.56 days, p < 0.001 than the other patients. At laboratory examination, patients with CCHF had statistically significant lower leukocyte and platelet counts, more prolonged coagulation parameters, and greater AST, ALT, LDH, and CK levels than the other patients. No mortality or complications occurred

Crimean-Congo hemorrhagic fever: Risk factors and control measures for the infection abatement

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ASLAM, SAADIA; LATIF, MUHAMMAD SHAHZAD; DAUD, MUHAMMAD; RAHMAN, ZIA UR; TABASSUM, BUSHRA; RIAZ, MUHAMMAD SOHAIL; KHAN, ANWAR; TARIQ, MUHAMMAD; HUSNAIN, TAYYAB

2016-01-01

Crimean-Congo hemorrhagic fever (CCHF) is a vector-borne viral disease, widely distributed in different regions of the world. The fever is caused by the CCHF virus (CCHFV), which belongs to the Nairovirus genus and Bunyaviridae family. The virus is clustered in seven genotypes, which are Africa-1, Africa-2, Africa-3, Europe-1, Europe-2, Asia-1 and Asia-2. The virus is highly pathogenic in nature, easily transmissible and has a high case fatality rate of 10–40%. The reservoir and vector of CCHFV are the ticks of the Hyalomma genus. Therefore, the circulation of this virus depends upon the distribution of the ticks. The virus can be transmitted from tick to animal, animal to human and human to human. The major symptoms include headache, high fever, abdominal pain, myalgia, hypotension and flushed face. As the disease progresses, severe symptoms start appearing, which include petechiae, ecchymosis, epistaxis, bleeding gums and emesis. Enzyme-linked immunosorbent assay, quantitative polymerase chain reaction, antigen detection, serum neutralization and isolation of the virus by cell culture are the diagnostic techniques used for this viral infection. There is no specific antiviral therapy available thus far. However, ribavirin has been approved by the World Health Organization for the treatment of CCHFV infection. Awareness campaigns regarding the risk factors and control measures can aid in reducing the spread of this disease to a greater extent, particularly in developing countries. PMID:26870327

Serological evaluation of Crimean-Congo hemorrhagic fever in humans with high-risk professions living in enzootic regions of Isfahan province of Iran and genetic analysis of circulating strains

DEFF Research Database (Denmark)

Chinikar, Sadegh; Ghiasi, Seyed Mojtaba; Naddaf, Saeed

2012-01-01

Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic viral disease that is asymptomatic in infected livestock, but causes a serious threat to humans with a mortality rate up to 50%. Although the CCHF virus (CCHFV) is often transmitted by ticks, livestock-to-human and human-to-human transmission a...

TRAINING PROGRAM FOR NURSING STAFF REGARDING VIRAL HEMORRHAGIC FEVERS IN A MILITARY HOSPITAL.

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El-Bahnasawy, Mamdouh M; Megahed, Laila Abdel-Mawla; Saleh, Halla Ahmed Abdullah; Abdelfattah, Magda Abdelhamid; Morsy, Tosson Aly

2015-08-01

Viral hemorrhagic fevers (VHFs) refer to a group of illnesses caused by several distinct families of viruses. In general, the term "viral hemorrhagic fever" is used to describe a severe multisystem syndrome (multisystem in that multiple organ systems in the bpdy are affected). Characteristically, the overall vascular system is damaged, and the body's ability to regulate itself is impaired. These symptoms are often accompanied by hemorrhage (bleeding); however, the bleeding is it rarely life-threatening. While some types of hemorrhagic fever viruses can cause relatively mild illnesses, many of these viruses cause severe, life-threatening disease. The selected disaster diseases for this study included: 1-Crimean-Congo hemorrhagic Fever, 2-Dengue Fever, 3-Ebola Fever, 4-Hem-orrhagic Fever with renal syndrome (HFRS), 5-Hantavirus Pulmonary Syndrome, 6-Lassa Fever, 7-Marburg Fever, 8-Rift Valley Fever and 9-Yellow Fever. The educational training program was given over ten sessions to a group of Staff Nurses. The results showed that the program succeeded in enhancing nurse' knowledge, awareness, responsibility, and obligations toward patients with the Viral Hemorrhagic Fevers The results showed a significant impact of training sessions illuminated in the follow-up test on the knowledge score of nurses in all types of diseases except for the Congo hemorrhagic fever, while, statistical significance varied in some diseases in the study when it comes to the comparison between pretest and post-test. All results confirmed on the positive impact of the training program in enhancing the knowledge of nurses toward VHFs patients and their relevant. There was a significant positive impact of the training sessions on changing the attitude of nurses toward patients with VHFs. This result was confirmed on the collective level since the total scores on tests revealed significant positive impact of the study on changing the attitude of nurses toward relevant patients. The relationship

Structural Analysis of a Viral Ovarian Tumor Domain Protease from the Crimean-Congo Hemorrhagic Fever Virus in Complex with Covalently Bonded Ubiquitin

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Capodagli, Glenn C.; McKercher, Marissa A.; Baker, Erica A.; Masters, Emily M.; Brunzelle, Joseph S.; Pegan, Scott D. (Denver); (NWU)

2014-10-02

Crimean-Congo hemorrhagic fever (CCHF) virus is a tick-borne, negative-sense, single-stranded RNA [ssRNA(-)] nairovirus that produces fever, prostration, and severe hemorrhages in humans. With fatality rates for CCHF ranging up to 70% based on several factors, CCHF is considered a dangerous emerging disease. Originally identified in the former Soviet Union and the Congo, CCHF has rapidly spread across large sections of Europe, Asia, and Africa. Recent reports have identified a viral homologue of the ovarian tumor protease superfamily (vOTU) within its L protein. This protease has subsequently been implicated in downregulation of the type I interferon immune response through cleavage of posttranslational modifying proteins ubiquitin (Ub) and the Ub-like interferon-simulated gene 15 (ISG15). Additionally, homologues of vOTU have been suggested to perform similar roles in the positive-sense, single-stranded RNA [ssRNA(+)] arteriviruses. By utilizing X-ray crystallographic techniques, the structure of vOTU covalently bound to ubiquitin propylamine, a suicide substrate of the enzyme, was elucidated to 1.7 {angstrom}, revealing unique structural elements that define this new subclass of the OTU superfamily. In addition, kinetic studies were carried out with aminomethylcoumarin (AMC) conjugates of monomeric Ub, ISG15, and NEDD8 (neural precursor cell expressed, developmentally downregulated 8) substrates in order to provide quantitative insights into vOTU's preference for Ub and Ub-like substrates.

Crimean–Congo Hemorrhagic Fever Virus and Borrelia burgdorferi sensu lato in Ticks from Kosovo and Albania

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Sherifi, Kurtesh; Rexhepi, Agim; Berxholi, Kristaq; Mehmedi, Blerta; Gecaj, Rreze M.; Hoxha, Zamira; Joachim, Anja; Duscher, Georg G.

2018-01-01

Tick-borne diseases pose a serious threat to human health in South-Eastern Europe, including Kosovo. While Crimean–Congo hemorrhagic fever (CCHF) is a well-known emerging infection in this area, there are no accurate data on Lyme borreliosis and tick-borne encephalitis (TBE). Therefore, we sampled and tested 795 ticks. Ixodes ricinus (n = 218), Dermacentor marginatus (n = 98), and Haemaphysalis spp. (n = 24) were collected from the environment by flagging (all from Kosovo), while Hyalomma marginatum (n = 199 from Kosovo, all from Kosovo) and Rhipicephalus bursa (n = 130, 126 from Albania) could be collected only by removal from animal pasture and domestic ruminants. Ticks were collected in the years 2014/2015 and tested for viral RNA of CCHF and TBE viruses, as well as for DNA of Borrelia burgdorferi sensu lato by real-time PCR. In Kosovo, nine ticks were positive for RNA of Crimean–Congo hemorrhagic fever virus and seven for DNA of B. burgdorferi s. l. None of the ticks tested positive for TBEV. CCHF virus was detected in one H. marginatum male specimen collected while feeding on grazing cattle from the Prizren region and in eight R. bursa specimens (five females and three males collected while feeding on grazing sheep and cattle) from the Prishtina region (Kosovo). B. burgdorferi s. l. was detected in seven questing ticks (four male and one female D. marginatus, two I. ricinus one female and one male) from the Mitrovica region (Kosovo). Our study confirmed that CCHF virus is circulating in Kosovo mainly in H. marginatum and R. bursa in the central areas of the country. B. burgdorferi s. l. was found in its major European host tick, I. ricinus, but also in D. marginatus, in the north of the Kosovo. In order to prevent the spread of these diseases and better control of the tick-borne infections, an improved vector surveillance and testing of ticks for the presence of pathogens needs to be established. PMID:29560357

Crimean–Congo Hemorrhagic Fever Virus and Borrelia burgdorferi sensu lato in Ticks from Kosovo and Albania

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Kurtesh Sherifi

2018-03-01

Full Text Available Tick-borne diseases pose a serious threat to human health in South-Eastern Europe, including Kosovo. While Crimean–Congo hemorrhagic fever (CCHF is a well-known emerging infection in this area, there are no accurate data on Lyme borreliosis and tick-borne encephalitis (TBE. Therefore, we sampled and tested 795 ticks. Ixodes ricinus (n = 218, Dermacentor marginatus (n = 98, and Haemaphysalis spp. (n = 24 were collected from the environment by flagging (all from Kosovo, while Hyalomma marginatum (n = 199 from Kosovo, all from Kosovo and Rhipicephalus bursa (n = 130, 126 from Albania could be collected only by removal from animal pasture and domestic ruminants. Ticks were collected in the years 2014/2015 and tested for viral RNA of CCHF and TBE viruses, as well as for DNA of Borrelia burgdorferi sensu lato by real-time PCR. In Kosovo, nine ticks were positive for RNA of Crimean–Congo hemorrhagic fever virus and seven for DNA of B. burgdorferi s. l. None of the ticks tested positive for TBEV. CCHF virus was detected in one H. marginatum male specimen collected while feeding on grazing cattle from the Prizren region and in eight R. bursa specimens (five females and three males collected while feeding on grazing sheep and cattle from the Prishtina region (Kosovo. B. burgdorferi s. l. was detected in seven questing ticks (four male and one female D. marginatus, two I. ricinus one female and one male from the Mitrovica region (Kosovo. Our study confirmed that CCHF virus is circulating in Kosovo mainly in H. marginatum and R. bursa in the central areas of the country. B. burgdorferi s. l. was found in its major European host tick, I. ricinus, but also in D. marginatus, in the north of the Kosovo. In order to prevent the spread of these diseases and better control of the tick-borne infections, an improved vector surveillance and testing of ticks for the presence of pathogens needs to be established.

Crimean-Congo Hemorrhagic Fever Virus and Borrelia burgdorferi sensu lato in Ticks from Kosovo and Albania.

Science.gov (United States)

Sherifi, Kurtesh; Rexhepi, Agim; Berxholi, Kristaq; Mehmedi, Blerta; Gecaj, Rreze M; Hoxha, Zamira; Joachim, Anja; Duscher, Georg G

2018-01-01

Tick-borne diseases pose a serious threat to human health in South-Eastern Europe, including Kosovo. While Crimean-Congo hemorrhagic fever (CCHF) is a well-known emerging infection in this area, there are no accurate data on Lyme borreliosis and tick-borne encephalitis (TBE). Therefore, we sampled and tested 795 ticks. Ixodes ricinus ( n  = 218), Dermacentor marginatus ( n  = 98), and Haemaphysalis spp. ( n  = 24) were collected from the environment by flagging (all from Kosovo), while Hyalomma marginatum ( n  = 199 from Kosovo, all from Kosovo) and Rhipicephalus bursa ( n  = 130, 126 from Albania) could be collected only by removal from animal pasture and domestic ruminants. Ticks were collected in the years 2014/2015 and tested for viral RNA of CCHF and TBE viruses, as well as for DNA of Borrelia burgdorferi sensu lato by real-time PCR. In Kosovo, nine ticks were positive for RNA of Crimean-Congo hemorrhagic fever virus and seven for DNA of B. burgdorferi s. l. None of the ticks tested positive for TBEV. CCHF virus was detected in one H. marginatum male specimen collected while feeding on grazing cattle from the Prizren region and in eight R. bursa specimens (five females and three males collected while feeding on grazing sheep and cattle) from the Prishtina region (Kosovo). B. burgdorferi s. l. was detected in seven questing ticks (four male and one female D. marginatus , two I. ricinus one female and one male) from the Mitrovica region (Kosovo). Our study confirmed that CCHF virus is circulating in Kosovo mainly in H. marginatum and R. bursa in the central areas of the country. B. burgdorferi s. l. was found in its major European host tick, I. ricinus , but also in D. marginatus , in the north of the Kosovo. In order to prevent the spread of these diseases and better control of the tick-borne infections, an improved vector surveillance and testing of ticks for the presence of pathogens needs to be established.

Spatial cluster analysis of human cases of Crimean Congo hemorrhagic fever reported in Pakistan.

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Abbas, Tariq; Younus, Muhammad; Muhammad, Sayyad Aun

2015-01-01

Crimean Congo hemorrhagic fever (CCHF) is a tick-borne viral zoonotic disease that has been reported in almost all geographic regions in Pakistan. The aim of this study was to identify spatial clusters of human cases of CCHF reported in country. Kulldorff's spatial scan statisitc, Anselin's Local Moran's I and Getis Ord Gi* tests were applied on data (i.e. number of laboratory confirmed cases reported from each district during year 2013). The analyses revealed a large multi-district cluster of high CCHF incidence in the uplands of Balochistan province near it border with Afghanistan. The cluster comprised the following districts: Qilla Abdullah; Qilla Saifullah; Loralai, Quetta, Sibi, Chagai, and Mastung. Another cluster was detected in Punjab and included Rawalpindi district and a part of Islamabad. We provide empirical evidence of spatial clustering of human CCHF cases in the country. The districts in the clusters should be given priority in surveillance, control programs, and further research.

Vectors of Crimean Congo Hemorrhagic Fever Virus in Iran

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Zakkyeh Telmadarraiy

2015-10-01

Full Text Available Background: Ticks are important vectors and reservoirs of Crimean Congo Hemorrhagic Fever (CCHF virus. Human beings may be infected whenever the normal life cycle of the infected ticks on non- human vertebrate hosts is interrupted by the undesirable presence of humans in the cycle. A total of 26 species of Argasid and Ixodid ticks have been recorded in Iran; including nine Hyalomma, two Rhipicephalus, two Dermacentor, five Haemaphysalis, two Boophilus, one Ixodes and two Argas as well as three Ornithodoros species as blood sucking ectoparasites of livestock and poultries. The present paper reviews tick vectors of CCHF virus in Iran, focusing on the role of ticks in different provinces of Iran using reverse transcription polymerase chain reaction (RT-PCR assay.Methods: During ten years study, 1054 tick specimens; including two species of Argasidae and 17 species of Ixodidae were examined for their infection to CCHF virus genome. The output of all studies as well as related publications were discussed in the current paper.Results: The results show that Rhipicephalus sanguineus, Hyalomma marginatum, H. anatolicum, H. asiaticum and H. dromedarii were known as the most frequent species which were positive for CCHF virus.Conclusion: The status of ticks which were positive for CCHF virus revealed that unlike the most common idea that Hyalomma species are the most important vectors of CCHF virus, other ticks including Rhipicephalus,Haemaphysalis and Dermacentor can be reservoir of this virus; thus, considering geographical distribution, type of host and environmental conditions, different tick control measurements should be carried out in areas with high incidence of CCHF disease.

Vectors of Crimean Congo Hemorrhagic Fever Virus in Iran

Science.gov (United States)

Telmadarraiy, Zakkyeh; Chinikar, Sadegh; Vatandoost, Hassan; Faghihi, Faezeh; Hosseini-Chegeni, Asadollah

2015-01-01

Background: Ticks are important vectors and reservoirs of Crimean Congo Hemorrhagic Fever (CCHF) virus. Human beings may be infected whenever the normal life cycle of the infected ticks on non-human vertebrate hosts is interrupted by the undesirable presence of humans in the cycle. A total of 26 species of Argasid and Ixodid ticks have been recorded in Iran; including nine Hyalomma, two Rhipicephalus, two Dermacentor, five Haemaphysalis, two Boophilus, one Ixodes and two Argas as well as three Ornithodoros species as blood sucking ectoparasites of livestock and poultries. The present paper reviews tick vectors of CCHF virus in Iran, focusing on the role of ticks in different provinces of Iran using reverse transcription polymerase chain reaction (RT-PCR) assay. Methods: During ten years study, 1054 tick specimens; including two species of Argasidae and 17 species of Ixodidae were examined for their infection to CCHF virus genome. The output of all studies as well as related publications were discussed in the current paper. Results: The results show that Rhipicephalus sanguineus, Hyalomma marginatum, H. anatolicum, H. asiaticum and H. dromedarii were known as the most frequent species which were positive for CCHF virus. Conclusion: The status of ticks which were positive for CCHF virus revealed that unlike the most common idea that Hyalomma species are the most important vectors of CCHF virus, other ticks including Rhipicephalus, Haemaphysalis and Dermacentor can be reservoir of this virus; thus, considering geographical distribution, type of host and environmental conditions, different tick control measurements should be carried out in areas with high incidence of CCHF disease. PMID:26623426

Molecular detection of Crimean-Congo hemorrhagic fever virus in ticks, Greece, 2012-2014.

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Papa, Anna; Kontana, Anastasia; Tsioka, Katerina; Chaligiannis, Ilias; Sotiraki, Smaragda

2017-11-01

Crimean-Congo hemorrhagic fever virus (CCHFV) is transmitted to humans mainly through the bite of infected ticks. In Greece, only one clinical case has been observed, in 2008, but the seroprevalence in humans is relatively high (4.2%). To have a first insight into the circulation of CCHFV in Greece, 2000 ticks collected from livestock during 2012-2014 were tested. CCHFV was detected in 36 of the 1290 (2.8%) tick pools (1-5 ticks per pool). Two genetic lineages were identified: Europe 1 and Europe 2. Most Europe 1 sequences were obtained from Rhipicephalus sanguineus sensu lato ticks, while most Europe 2 sequences were recovered from Rhipicephalus bursa ticks. The number of collected Hyalomma marginatum ticks (the principal vector of CCHFV) was low (0.5% of ticks) and all were CCHFV negative. Since it is not known how efficient ticks of the Rhipicephalus genus are as vectors of the virus, laboratory studies will be required to explore the role of Rhipicephalus spp. ticks in CCHFV maintenance and transmission.

Evaluation of knowledge about protection against Crimean-Congo hemorrhagic fever.

Science.gov (United States)

Gungormus, Z; Kiyak, E

2011-05-01

This study was conducted in order to evaluate individuals' knowledge about protection against Crimean Congo hemorrhagic fever (CCHF). This descriptive study was carried out among 478 persons, to whom a Family Health Center located within boundaries of Erzurum Metropolitan Municipality, provides health service. A questionnaire form developed by the researchers was used for collecting data. Seventy-one point eight percent of individuals who participated in the study stated they had knowledge about CCHF, 25.9% stated that region was risky in terms of being bitten by ticks, 61.3% stated they could recognize ticks and 56.1% stated that not all tick bites cause the disease. Seventy-seven point eight percent stated CCHF is a virulent disease, 33.1% stated it can be transmitted from human to human and 30.3% stated it can be transmitted from animals to humans. In terms of protection from tick bites, 45, 15.3 and 11.3% of individuals stated wearing clothes to cover the whole body, carefully inspecting the body, and not touching ticks with bare hands, respectively, were good methods. Ninety-two point one percent stated it is necessary to go to a healthcare organization immediately in case of tick bite, whereas 18% of individuals stated it is necessary to remove the tick with tweezers or forceps. The results of this study show most individuals are not well informed about methods for protecting against CCHF, for removing ticks and what precautions to take to protect against tick bites.

Molecular epidemiology of Crimean-Congo hemorrhagic fever virus in Kosovo.

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Luka Fajs

Full Text Available Crimean-Congo hemorrhagic fever virus (CCHFV is a zoonotic agent that causes severe, life-threatening disease, with a case fatality rate of 10-50%. It is the most widespread tick-borne virus in the world, with cases reported in Africa, Asia and Eastern Europe. CCHFV is a genetically diverse virus. Its genetic diversity is often correlated to its geographical origin. Genetic variability of CCHFV was determined within few endemic areas, however limited data is available for Kosovo. Furthermore, there is little information about the spatiotemporal genetic changes of CCHFV in endemic areas. Kosovo is an important endemic area for CCHFV. Cases were reported each year and the case-fatality rate is significantly higher compared to nearby regions. In this study, we wanted to examine the genetic variability of CCHFV obtained directly from CCHF-confirmed patients, hospitalized in Kosovo from 1991 to 2013. We sequenced partial S segment CCHFV nucleotide sequences from 89 patients. Our results show that several viral variants are present in Kosovo and that the genetic diversity is high in relation to the studied area. We also show that variants are mostly uniformly distributed throughout Kosovo and that limited evolutionary changes have occurred in 22 years. Our results also suggest the presence of a new distinct lineage within the European CCHF phylogenetic clade. Our study provide the largest number of CCHFV nucleotide sequences from patients in 22 year span in one endemic area.

Mice orally immunized with a transgenic plant expressing the glycoprotein of Crimean-Congo hemorrhagic fever virus

DEFF Research Database (Denmark)

Ghiasi, Seyed Mojtaba; Salmanian, A H; Chinikar, S

2011-01-01

in their serum and feces, respectively. The mice in the fed/boosted group showed a significant rise in specific IgG antibodies after a single boost. Our results imply that oral immunization of animals with edible materials from transgenic plants is feasible, and further assessments are under way. In addition......While Crimean-Congo hemorrhagic fever (CCHF) has a high mortality rate in humans, the associated virus (CCHFV) does not induce clinical symptoms in animals, but animals play an important role in disease transmission to humans. Our aim in this study was to examine the immunogenicity of the CCHFV...... glycoprotein when expressed in the root and leaf of transgenic plants via hairy roots and stable transformation of tobacco plants, respectively. After confirmatory analyses of transgenic plant lines and quantification of the expressed glycoprotein, mice were either fed with the transgenic leaves or roots, fed...

Two cases of Hantavirus infection in Crimean-Congo Haemorrhagic Fever endemic region

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Mustafa Sünbül

2012-09-01

Full Text Available Crimean-Congo Hemorrhagic Fever (CCHF and Leptospirosis are endemic in our region. Hantavirus infections may beconfused with similar clinical picture zoonotic infections. Two patients with fever, malaise, cough, phlegm, nausea, vomiting,thrombocytopenia, renal failure, elevated transaminases, and a history of mouse contact were hospitalized in ourclinic with a presumptive diagnosis of leptospirosis, pneumonia, CCHF and Hantavirus infections. Empirical antibiotictreatment was initiated and CCHF and leptospirosis was ruled out with laboratory tests. Hantavirus immunoglobulin(Ig-G and Ig-M antibodies were detected positive by immunofluorescent antibody (IFA method in both cases but,Dobrova virus was detected in only one patient with immunoblotting methods. Both patients were discharged aftertreatment. Hantavirus infections may be misdiagnosed as zoonotic infections since they have similar clinical picture. Itshould be considered in the differential diagnosis of patients with a history of contact with mouse. J Microbiol Infect Dis2012; 2(3: 117-120Key words: Hantavirus, hemorrhagic fever, renal syndrome, pulmonary syndrome

Hard ticks (Ixodidae and Crimean-Congo hemorrhagic fever virus in south west of Iran.

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Narges Sharifinia

2015-03-01

Full Text Available Ticks are vectors of some important arthropod-borne diseases in both fields of veterinary and medicine, such as Lyme, tularemia, Rocky Mountain spotted fever, and some types of encephalitis as well as Crimean Congo hemorrhagic fever (CCHF. Iran is known as one of the main foci of CCHF in west of Asia. This study was conducted in DarrehShahr County because of the development of animal husbandry in this area to detect the fauna and viral infection of the hard ticks of livestock. A cross-sectional survey was conducted during 2011-2012 with random sampling in four villages. A sample of ticks was subjected to RT-PCR method for detection of viral infection. During the study period, 592 Ixodidae ticks were collected and identified as seven species of Hyalomma asiaticum, Hy. marginatum, Hy. anatolicum, Hy. dromedarii, Hy. detritum, Rhipicephalus bursa and Rh. sanguineus. More than 20% of these ticks were examined to detect the genome of CCHF virus while 6.6% were positive. All species of Hyalomma were found to be positive. A high rate of livestock was found to be infected with hard ticks, which can act as the vectors of the CCHF disease. Regarding infection of all five Hyalomma species captured in this area, this genus should be considered as the main vector of CCHF. Planning control program can be performed based on the obtained data on seasonal activity of Ixodidae to prevent animal infestation as well as to reduce the risk of CCHF transmission.

Crimean-Congo Hemorrhagic Fever Virus Suppresses Innate Immune Responses via a Ubiquitin and ISG15 Specific Protease

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Florine E.M. Scholte

2017-09-01

Full Text Available Antiviral responses are regulated by conjugation of ubiquitin (Ub and interferon-stimulated gene 15 (ISG15 to proteins. Certain classes of viruses encode Ub- or ISG15-specific proteases belonging to the ovarian tumor (OTU superfamily. Their activity is thought to suppress cellular immune responses, but studies demonstrating the function of viral OTU proteases during infection are lacking. Crimean-Congo hemorrhagic fever virus (CCHFV, family Nairoviridae is a highly pathogenic human virus that encodes an OTU with both deubiquitinase and deISGylase activity as part of the viral RNA polymerase. We investigated CCHFV OTU function by inactivating protease catalytic activity or by selectively disrupting its deubiquitinase and deISGylase activity using reverse genetics. CCHFV OTU inactivation blocked viral replication independently of its RNA polymerase activity, while deubiquitinase activity proved critical for suppressing the interferon responses. Our findings provide insights into viral OTU functions and support the development of therapeutics and vaccines.

HEMORRHAGIC-FEVER VIRUS-INFECTIONS IN AN ISOLATED RAIN-FOREST AREA OF CENTRAL LIBERIA - LIMITATIONS OF THE INDIRECT IMMUNOFLUORESCENCE SLIDE TEST FOR ANTIBODY SCREENING IN AFRICA

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van der Waals, F. W.; Pomeroy, K. L.; Goudsmit, J.; Asher, D. M.; Gajdusek, D. C.

1986-01-01

Serum samples from 119 healthy individuals and 106 epilepsy patients inhabiting Grand Bassa County, Liberia, were tested for antibodies to hemorrhagic fever viruses (HFV) by indirect immunofluorescence. E6 Vero cells infected with Lassa fever virus (LAS), Rift Valley Fever virus (RVF), Congo

A Q fever case mimicking crimean-congo haemorrhagic fever

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O Karabay

2011-01-01

Full Text Available Coxiella burnetii is the bacterium that causes Q fever. Human infection is mainly transmitted from cattle, goats and sheep. The disease is usually self-limited. Pneumonia and hepatitis are the most common clinical manifestations. In this study, we present a case of Q fever from the western part of Turkey mimicking Crimean-Congo haemorrhagic fever (CCHF in terms of clinical and laboratory findings.

Genetic Diversity of Crimean Congo Hemorrhagic Fever Virus Strains from Iran

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Sadegh Chinikar

2016-01-01

Full Text Available Background: Crimean Congo hemorrhagic fever virus (CCHFV is a member of the Bunyaviridae family and Nairovirus genus. It has a negative-sense, single stranded RNA genome approximately 19.2 kb, containing the Small, Medium, and Large segments. CCHFVs are relatively divergent in their genome sequence and grouped in seven distinct clades based on S-segment sequence analysis and six clades based on M-segment sequences. Our aim was to obtain new insights into the molecular epidemiology of CCHFV in Iran.Methods: We analyzed partial and complete nucleotide sequences of the S and M segments derived from 50 Iranian patients. The extracted RNA was amplified using one-step RT-PCR and then sequenced. The sequences were ana­lyzed using Mega5 software.Results: Phylogenetic analysis of partial S segment sequences demonstrated that clade IV-(Asia 1, clade IV-(Asia 2 and clade V-(Europe accounted for 80 %, 4 % and 14 % of the circulating genomic variants of CCHFV in Iran respectively. However, one of the Iranian strains (Iran-Kerman/22 was associated with none of other sequences and formed a new clade (VII. The phylogenetic analysis of complete S-segment nucleotide sequences from selected Ira­nian CCHFV strains complemented with representative strains from GenBank revealed similar topology as partial sequences with eight major clusters. A partial M segment phylogeny positioned the Iranian strains in either associa­tion with clade III (Asia-Africa or clade V (Europe.Conclusion: The phylogenetic analysis revealed subtle links between distant geographic locations, which we pro­pose might originate either from international livestock trade or from long-distance carriage of CCHFV by infected ticks via bird migration.

Treating viral hemorrhagic fever.

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Mairuhu, A.T.; Brandjes, D.P.; Gorp, E. van

2003-01-01

Viral hemorrhagic fevers are illnesses associated with a number of geographically restricted, mostly tropical areas. Over recent decades a number of new hemorrhagic fever viruses have emerged. Advances in our understanding of the pathophysiology of these diseases have improved our initial supportive

Protective role of host aquaporin 6 against Hazara virus, a model for Crimean-Congo hemorrhagic fever virus infection.

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Molinas, Andrea; Mirazimi, Ali; Holm, Angelika; Loitto, Vesa M; Magnusson, Karl-Eric; Vikström, Elena

2016-04-01

Crimean-Congo hemorrhagic fever virus (CCHFV) is an arthropod-borne pathogen that causes infectious disease with severe hemorrhagic manifestations in vascular system in humans. The proper function of the cells in the vascular system is critically regulated by aquaporins (AQP), water channels that facilitate fluxes of water and small solutes across membranes. With Hazara virus as a model for CCHFV, we investigated the effects of viruses on AQP6 and the impact of AQP6 on virus infectivity in host cells, using transiently expressed GFP-AQP6 cells, immunofluorescent assay for virus detection, epifluorescent imaging of living cells and confocal microscopy. In GFP-AQP6 expressing cells, Hazara virus reduced both the cellular and perinuclear AQP6 distribution and changed the cell area. Infection of human cell with CCHFV strain IbAR 10200 downregulated AQP6 expression at mRNA level. Interestingly, the overexpression of AQP6 in host cells decreased the infectivity of Hazara virus, speaking for a protective role of AQP6. We suggest the possibility for AQP6 being a novel player in the virus-host interactions, which may lead to less severe outcomes of an infection. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A crimean - congo hemorrhagic fever outbreak in northern balochistan

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Nadeem, M.; Ali, N.

2007-01-01

To describe the clinical characteristics, epidemiology, predictors of fatal outcome (PFO), and management effects of Crimean-Congo haemorrhagic fever (CCHF) patients during an outbreak in Northern Balochistan. Patients presenting with a fever of less than 2 weeks duration and bleeding manifestations were included. Clinical history was recorded and patients were placed on oral ribavirin, and hematological support. Diagnosis was established by PCR for CCHF or detection of CCHF specific IgM and IgG. Eighty-four patients were received, 34 (40.5%) were suspected of suffering from classical CCHF. All 34 (100%) patients presented with a history of fever and bleeding (epistaxis, gum bleeding, melena or haematuria). Mean platelet count was 30 x 109/L and mean ALT (alanine transferase) was 288 U/L. Among fatal cases, the mean platelet count was 18.4 x 10 9/L and ALT was 781 units/L. PCR for CCHF viral RNA performed on 10 patients was positive in 3 (30%) patients. CCHF specific IgM and IgG was positive in 17.6% (6/34). Four patients were brought in moribund condition and expired before treatment could be started, 4 patients expired during treatment and 76.5% (26/34) were cured. The overall mortality was 23.5% (8/34). Main predictors of fatal outcome were ALT z 150 units/L, activated partial thromboplastin time(aPT) z 60 seconds, prothrombin time (PT) z 34 seconds, aspartate transferase (AST) z 200 units/L, platelets o 20 x 109/L, and fibrinogen o 110 mg/dL. In this series of CCHF occurring in Northern parts of Balochistan, gastrointestinal tract bleeding was the worst prognostic factor associated with fatal outcome. Providing education to healthcare workers and at risk populations, hematological support, antiviral drugs, and barrier nursing may help reduce mortality. (author)

[Ebola hemorrhagic fever: its extension reflects the African sanitary disaster].

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Bourée, Patrice

2014-09-01

Ebola virus, described in 1976 in Zaire, causes severe hemorrhagic fever with a high mortality rate in humans and nonhuman primates. Epidemics occurred since this time to nowadays in Sudan, Gabon, Congo and currently in Guinea, Liberia, Sierra-Leone, Nigeria and Senegal. Specific treatment and vaccine are not available. So, to prevent the virus transmission with live and dead patients, we must use strict individual and collective measures which are not always understood by local populations and make contact tracing; it is the only way to curb the epidemic.

Consensus report: Preventive measures for Crimean-Congo Hemorrhagic Fever during Eid-al-Adha festival.

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Leblebicioglu, Hakan; Sunbul, Mustafa; Memish, Ziad A; Al-Tawfiq, Jaffar A; Bodur, Hurrem; Ozkul, Aykut; Gucukoglu, Ali; Chinikar, Sadegh; Hasan, Zahra

2015-09-01

Crimean-Congo hemorrhagic fever (CCHF) is endemic in Eurasian countries such as, Turkey, Pakistan, Afghanistan and Iran. CCHF virus is spread by the Hyalomma tick, which is found mainly on cattle and sheep. Muslim countries, in which these animals are sacrificed during Eid-Al-Adha, are among the countries where CCHF is endemic, and it has been observed that CCHF is associated with practices surrounding the Eid-ad-Adha festival. The dates for Eid-Al-Adha drift 10 days earlier in each year according to Georgian calendar. In previous years Eid-al-Adha occurred in autumn-winter months however in the next 10-15 years it will be take place in the summer months when CCHF is more prevalent. This may lead to a rise in the number of cases due to increased dissemination of CCHF virus with uncontrolled animal movements in and between countries. This consensus report focuses on the variable practices regarding animal handling in different regions and possible preventative measures to reduce the incidence of CCHF. Environmental hygiene and personal protection are essential parts of prevention. There is a need for international collaborative preparedness and response plans for prevention and management of CCHF during Eid-Al-Adha in countries where the disease is prevalent. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Biosafety standards for working with Crimean-Congo hemorrhagic fever virus.

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Weidmann, Manfred; Avsic-Zupanc, Tatjana; Bino, Silvia; Bouloy, Michelle; Burt, Felicity; Chinikar, Sadegh; Christova, Iva; Dedushaj, Isuf; El-Sanousi, Ahmed; Elaldi, Nazif; Hewson, Roger; Hufert, Frank T; Humolli, Isme; Jansen van Vuren, Petrus; Koçak Tufan, Zeliha; Korukluoglu, Gülay; Lyssen, Pieter; Mirazimi, Ali; Neyts, Johan; Niedrig, Matthias; Ozkul, Aykut; Papa, Anna; Paweska, Janusz; Sall, Amadou A; Schmaljohn, Connie S; Swanepoel, Robert; Uyar, Yavuz; Weber, Friedemann; Zeller, Herve

2016-11-01

In countries from which Crimean-Congo haemorrhagic fever (CCHF) is absent, the causative virus, CCHF virus (CCHFV), is classified as a hazard group 4 agent and handled in containment level (CL)-4. In contrast, most endemic countries out of necessity have had to perform diagnostic tests under biosafety level (BSL)-2 or -3 conditions. In particular, Turkey and several of the Balkan countries have safely processed more than 100 000 samples over many years in BSL-2 laboratories. It is therefore advocated that biosafety requirements for CCHF diagnostic procedures should be revised, to allow the tests required to be performed under enhanced BSL-2 conditions with appropriate biosafety laboratory equipment and personal protective equipment used according to standardized protocols in the countries affected. Downgrading of CCHFV research work from CL-4, BSL-4 to CL-3, BSL-3 should also be considered.

Crimean-Congo hemorrhagic fever in pregnancy: A systematic review and case series from Russia, Kazakhstan and Turkey.

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Pshenichnaya, Natalia Yurievna; Leblebicioglu, Hakan; Bozkurt, Ilkay; Sannikova, Irina Viktorovna; Abuova, Gulzhan Narkenovna; Zhuravlev, Andrey Sergeevich; Barut, Sener; Shermetova, Mutabar Bekovna; Fletcher, Tom E

2017-05-01

Crimean-Congo hemorrhagic fever (CCHF) is acute viral infection and a major emerging infectious diseases threat, affecting a large geographical area. There is no proven antiviral therapy and it has a case fatality rate of 4-30%. The natural history of disease and outcomes of CCHF in pregnant women is poorly understood. To systematically review the characteristics of CCHF in pregnancy, and report a case series of 8 CCHF cases in pregnant women from Russia, Kazakhstan and Turkey. A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement protocol. PubMed, SCOPUS, Science Citation Index (SCI) were searched for reports published between January 1960 and June 2016. Two independent reviewers selected and reviewed studies and extracted data. Thirty-four cases of CCHF in pregnancy were identified, and combined with the case series data, 42 cases were analyzed. The majority of cases originated in Turkey (14), Iran (10) and Russia (6). There was a maternal mortality of 14/41(34%) and fetal/neonatal mortality of in 24/41 cases (58.5%). Hemorrhage was associated with maternal (p=0.009) and fetal/neonatal death (p<0.0001). There was nosocomial transmission to 38 cases from 6/37 index pregnant cases. Cases of CCHF in pregnancy are rare, but associated with high rates of maternal and fetal mortality, and nosocomial transmission. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Crimean-Congo hemorrhagic fever virus in ticks collected from livestock in Albania.

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Papa, Anna; Velo, Enkeleda; Kadiaj, Perparim; Tsioka, Katerina; Kontana, Anastasia; Kota, Majlinda; Bino, Silvia

2017-10-01

Albania is a Balkan country endemic for Crimean-Congo hemorrhagic fever (CCHF). It was shown previously that CCHF virus (CCHFV) sequences from Albanian patients cluster into Europe 1 clade. Aim of the present study was to test for CCHFV ticks collected in several regions of Albania, and to determine the genetic lineage(s) of the CCHFV strains in relation with their geographic distribution. A total of 726 ticks (366 Hyalomma marginatum, 349 Rhipicephalus bursa and 11 Rhipicephalus sanguineus) collected from livestock during 2007-2014 were included in the study. Thirty of 215 (13.9%) tick pools were positive for CCHFV. Lineage Europe 1 was detected in H. marginatum ticks collected in the endemic region of Albania, while lineage Europe 2 was detected mainly in R. bursa ticks in various regions of the country. Both genetic lineages were detected in the CCHF endemic area (northeastern Albania), while only Europe 2 lineage was detected in the south of the country. A higher genetic diversity was seen among Europe 2 than Europe 1 Albanian sequences (mean distance 3.7% versus 1%), suggesting a longer evolution of AP92-like strains (Europe 2) in their tick hosts. The present study shows that besides CCHFV lineage Europe 1, lineage Europe 2 is also present in Albania. Combined with results from recent studies, it is concluded that lineage Europe 2 is widely spread in the Balkans and Turkey, and is associated mainly with R. bursa ticks (at least in this region). Its pathogenicity and impact to the public health remain to be elucidated. Copyright © 2017 Elsevier B.V. All rights reserved.

Epidemiological survey of Crimean Congo hemorrhagic fever virus in cattle in East Darfur State, Sudan.

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Ibrahim, Alaa M; Adam, Ibrahim A; Osman, Badreldin T; Aradaib, Imadeldin E

2015-06-01

Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease caused by CCHF virus (CCHFV) of the genus Nairovirus in the family Bunyaviridae. CCHFV causes subclinical infection in domestic livestock and an often fatal hemorrhagic illness in humans, with approximately 30% mortality rates. In the present study, a cross-sectional serosurvey was conducted in a total of 282 randomly selected cattle from five localities in East Darfur State, Sudan. The exposure status to CCHF was determined using enzyme-linked immunosorbent assay (ELISA) for detection of CCHFV-specific IgG antibodies in cattle serum samples. The CCHFV-specific IgG antibodies were detected in 54 out of 282 animals, accounting for a 19.14% prevalence rate. Older cattle (>2 years of age) were approximately five times more likely to be infected with the virus (OR=4.90, CI=1.28-18.98, p-value=0.02). Heavily tick-infested cattle (ticks all over the body) were at 11 times higher at risk compared to tick-free animals (OR=11.11, CI=2.86-43.25, p-value=0.01). Grazing system is another factor affecting CCHF, where cattle grazing on open system were 27 times more at risk compared to other grazing systems (OR=27.22, CI=7.46-99.24, p-value=0.001). There was an association between localities and CCHF cattle (OR=0.24, CI=0.07-0.83, p-value=0.02). This study confirms the exposure of cattle to CCHF in East Darfur and identifies potential risk factors associated with the disease. Further epidemiological studies and improved surveillance are urgently needed to prevent a possible outbreak of CCHF among humans in the Darfur region of Sudan. Copyright © 2015 Elsevier GmbH. All rights reserved.

[Ebola and Marburg hemorrhagic fever viruses: update on filoviruses].

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Leroy, E; Baize, S; Gonzalez, J P

2011-04-01

The Ebola and Marburg viruses are the sole members of the Filoviridae family of viruses. They are characterized by a long filamentous form that is unique in the viral world. Filoviruses are among the most virulent pathogens currently known to infect humans. They cause fulminating disease characterized by acute fever followed by generalized hemorrhagic syndrome that is associated with 90% mortality in the most severe forms. Epidemic outbreaks of Marburg and Ebola viruses have taken a heavy toll on human life in Central Africa and devastated large ape populations in Gabon and Republic of Congo. Since their discovery in 1967 (Marburg) and 1976 (Ebola), more than 2,300 cases and 1,670 deaths have been reported. These numbers pale in comparison with the burden caused by malnutrition or other infectious disease scourges in Africa such as malaria, cholera, AIDS, dengue or tuberculosis. However, due to their extremely high lethality, association with multifocal hemorrhaging and specificity to the African continent, these hemorrhagic fever viruses have given rise to great interest on the part not only of the international scientific community but also of the general public because of their perceived potential as biological weapons. Much research has been performed on these viruses and major progress has been made in knowledge of their ecology, epidemiology and physiopathology and in development of vaccine candidates and therapeutic schemes. The purpose of this review is to present the main developments in these particular fields in the last decade.

A comparison of clinical diagnosis and serological diagnosis in an epidemic of Crimean-Congo Hemorrhagic Fever

International Nuclear Information System (INIS)

Nadeem, M.; Ali, N.; Anwar, M.

2003-01-01

Crimean Congo Hemorrhagic Fever (CCHF) is the life-threatening disease caused by Nairovirus of genus Bunya virus caused by tick bite of Hayalomma species or by direct contact of the blood/sera of the patient and animals suffering from this disease. Epidemics have been occurring in Balochistan province of Pakistan and neighboring Afghanistan and Iran from time to time with this mortality. Aim: In the absence of facilities for detection of serological markers of CCHF (IgM Et IgG antibodies and PCR for viral RNA), a study was designed to diagnose and treat cases of CCHF reporting to a specialist unit hospital situated at Quetta, Pakistan. The aim was to compare the clinical features, complications and outcome of both groups of patients: one detecting the disease clinically only and the other depending upon serological tests for the diagnosis. Methods: Thirty-four patients having fever of less than two weeks of duration with features of bleeding from the skin and various orifices were included in this study from June 2001 to September 2001 after hospitalization. Index case and some of the consecutive cases were subjected to detection of serological markers. Rest of the cases were diagnosed on clinical ground and baseline laboratory investigations only. Difference in both the group was noted carefully. All the patients were given Ribavirin and blood products as and when required. Results: Statistically there was no obvious difference in clinical manifestations (fever, body aches, purpuric spots, ecchymosis, epistaxis, gum bleed etc. ) and laboratory findings (blood picture, serum ALT, serum urea and electrolytes, PT, APTT, etc). There was also no difference in mortality of the two groups studied. Conclusion: In an on ongoing outbreak of CCHF, history, clinical findings and supportive baseline, laboratory investigations may be sufficient for early detection and treatment of CCHF cases. However for documentation of start of epidemic, serological markers should be done

Simultaneous detection of IgG antibodies associated with viral hemorrhagic fever by a multiplexed Luminex-based immunoassay.

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Wu, Wei; Zhang, Shuo; Qu, Jing; Zhang, Quanfu; Li, Chuan; Li, Jiandong; Jin, Cong; Liang, Mifang; Li, Dexin

2014-07-17

Viral hemorrhagic fevers (VHFs) are worldwide diseases caused by several kinds of viruses. With the emergence of new viruses, advanced diagnostic methods are urgently needed for identification of VHFs. Based on Luminex xMAP technology, a rapid, sensitive, multi-pathogen and high-throughput method which could simultaneously detect hemorrhagic fever viruses (HFVs) specific IgG antibodies was developed. Recombinant antigens of nine HFVs including Hantaan virus (HTNV), Seoul virus (SEOV), Puumala virus (PUUV), Andes virus (ANDV), Sin Nombre virus (SNV), Crimean-Congo hemorrhagic fever virus (CCHFV), Rift Valley fever virus (RVFV), Severe fever with thrombocytopenia syndrome bunyavirus (SFTSV) and dengue virus (DENV) were produced and purified from a prokaryotic expression system and the influence of the coupling amount was investigated. Cross-reactions among antigens and their rabbit immune sera were evaluated. Serum samples collected from 51 laboratory confirmed hemorrhagic fever with renal syndrome (HFRS) patients, 43 confirmed SFTS patients and 88 healthy donors were analyzed. Results showed that recombinant nucleocapsid protein of the five viruses belonging to the genus Hantavirus, had serological cross-reactivity with their corresponding rabbit immune sera, but not apparent with immune sera of other four viruses. Evaluation of this new method with clinical serum samples showed 98.04% diagnostic sensitivity for HFRS, 90.70% for SFTS detection and the specificity was ranging from 66.67% to 100.00%. The multiplexed Luminex-based immunoassay has firstly been established in our study, which provides a potentially reliable diagnostic tool for IgG antibody detection of VHFs. Copyright © 2014 Elsevier B.V. All rights reserved.

Ebola Hemorrhagic Fever as a Public Health Emergency of International Concern; a Review Article.

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Safari, Saeed; Baratloo, Alireza; Rouhipour, Alaleh; Ghelichkhani, Parisa; Yousefifard, Mahmood

2015-01-01

Ebola hemorrhagic fever (EHF) was first reported in 1976 with two concurrent outbreaks of acute viral hemorrhagic fever centered in Yambuku (near the Ebola river), Democratic Republic of Congo, and in Nzara, Sudan. The current outbreak of the Ebola virus was started by reporting the first case in March 2014 in the forest regions of southeastern Guinea. Due to infection rates raising over 13,000% within a 6-month period, Ebola is now considered as a global public health emergency and on August 8(th), 2014 the World Health Organization (WHO) declared the epidemic to be a Public Health Emergency of International Concern. With more than 5000 involved cases and nearly 3000 deaths, this event has turned into the largest and most dangerous Ebola virus outbreak in the world. Based on the above-mentioned, the present article aimed to review the virologic characteristics, transmission, clinical manifestation, diagnosis, treatment, and prevention of Ebola virus disease.

Increased Levels of VEGF-A and HIF-1α in Turkish Children with Crimean-Congo Hemorrhagic Fever

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Murat Sefikogullari

2017-04-01

Full Text Available Background: Crimean-Congo Hemorrhagic Fever (CCHF is a disease characterized by serious course, including acute viral fever, ecchymosis, thrombocytopenia, liver dysfunction and high rate of mortality. Hypoxia Inducible Factor-1α (HIF-1α and Vascular Endothelial Growth Factor-A (VEGF-A play an important role both in the inflamma­tory process and plasma leakage. The aim of this study was to define HIF-1α and VEGF-A serum levels obtained from CCHF patients and control group and to investigate whether these factors were correlated with the pathogenesis of this disease.Methods: Thirty cases younger than 17 yr confirmed by RT-PCR and/or ELISA for CCHF were included in this study. Thirty age and sex matched healthy peoples were enrolled as controls. Blood samples collected from the pa­tient and control groups. Serum levels of HIF-1α and VEGF-A were measured with ELISA.Results: Levels of HIF-1α and VEGF-A were statistically significantly increased in CCHF patients compared to the control group (P< 0.05.  A significant positive correlation was found between the levels of HIF-1α and VEGF-A in the patient group (P< 0.01. The levels of ALT, AST, CK, aPTT, WBC and Thrombocyte count were significantly higher in the patients than in the control group (P< 0.001. A positive correlation was found among the levels of AST and CK from biochemical parame­ters and VEGF and HIF-1α in the patient group (P< 0.05Conclusion: HIF-1α and VEGF-A might play an important role in CCHF pathogenesis.

[A case of brucellosis and Crimean-Congo hemorrhagic fever coinfection in an endemic area].

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Karakeçili, Faruk; Çıkman, Aytekin; Akın, Hicran; Gülhan, Barış; Özçiçek, Adalet

2016-04-01

Brucellosis, a zoonotic disease which is especially seen in developing countries is still an important public health problem worldwide. Crimean-Congo hemorrhagic fever (CCHF) is another zoonotic disease that transmits to humans by infected tick bites as well as exposure to blood or tissue from infected animals. Both of the diseases are common among persons who live in rural areas and deal with animal husbandry. Since brucellosis usually presents with non-specific clinical symptoms and may easily be confused with many other diseases, the diagnosis of those infections could be delayed or misdiagnosed. In this report, a case of coinfection of brucellosis and CCHF has been presented to emphasize the possibility of association of these infections. A 70-year-old female patient with a history of dealing with animal husbandry in a rural area admitted to our hospital with the complaints of fever, malaise, generalized body and joint pains, and headache. Her complaints had progressed within the past two days. She also reported nausea, vomiting, abdominal pain and bloody diarrhea. She denied any history of tick bites. Her physical examination was significant for the presence of 38.8°C fever, increased bowel sounds and splenomegaly. Laboratory analysis revealed leukopenia, thrombocytopenia and high levels of liver enzymes. The patient was admitted to our service with the prediagnosis of CCHF. Serum sample was sent to the Department of Microbiology Reference Laboratory at Public Health Agency of Turkey for CCHF testing. During patient's hospitalization in service, more detailed history was confronted and it was learned that she had fatigue, loss of appetite, sweating, joint pain, and intermittent fever complaints were continuing within a month and received various antibiotic treatments. The tests for brucellosis were conducted and positive results for Brucella Rose Bengal test, tube agglutination (1/160 titers) and immune capture test with Coombs (1/320 titers) were determined

Therapeutic management of Crimean-Congo haemorrhagic fever.

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de la Calle-Prieto, Fernando; Martín-Quirós, Alejandro; Trigo, Elena; Mora-Rillo, Marta; Arsuaga, Marta; Díaz-Menéndez, Marta; Arribas, José Ramón

2017-06-29

Crimean-Congo haemorrhagic fever has been reported in more than 30 countries in Africa, Asia, the Middle East and Eastern Europe, with an increasing incidence in recent years, especially in Europe. Because no specific treatments have demonstrated efficacy, supportive treatment is essential, as well as the provision of a centre with the appropriate means to guarantee the safety of its healthcare professionals. Laboratory monitoring of thrombocytopenia, severe coagulopathy or liver failure is of critical importance. Patients with Crimean-Congo haemorrhagic fever should be admitted to High Level Isolation Units where appropriate biocontainment procedures can prevent nosocomial transmission through infected fluids or accidents with contaminated material. In case of high-risk exposures, early administration of ribavirin should be considered. Copyright © 2017. Publicado por Elsevier España, S.L.U.

A Study of Renogram in Korean Hemorrhagic Fever

International Nuclear Information System (INIS)

Choi, Tae Kyu; Lee, Jung Sang; Koh, Chang Soon; Lee, Mun Ho

1974-01-01

The patterns of renogram in patients with Korean hemorrhagic fever were evaluated with clinical course and renal hemodynamic changes in various clinical stages. The renal plasma flow was measured by hippuran blood clearance using 131 I-ortho-iodohippurate and hippuran renogram was analysed means of quantitative and qualitative methods in 26 patients of Korean hemorrhagic fever. The results obtained with this study were as follows;1) During the oliguric phase of Korean hemorrhagic fever, the renogram showed non-functioning (flat) or obstructive pattern. The group of patients with non-functioning pattern of renogram had more severe impairment of renal function and grave prognosis than the group with obstructive pattern of renogram. 2) During the diuretic phase, the renogram showed obstructive or dysfunction ar normal pattern, which was related with the recovery of renal function. Obstruction pattern of renogram was observed till the 2nd week of diuretic phase. Normal pattern of renogram began to appear by the 2nd week of diuretic phase. 3) During the convalescent phase of Korean hemorrhagic fever, 40% of patients showed dysfunction pattern of renogram, and the recovery of abnormal renogram in Korean hemorrhagic fever was more delayed than the recovery of clinical features and laboratory findings. 4) The renogram showed normal pattern 6 months after onset of Korean hemorrhagic fever in all cases. 5) There was significant correlationship between the pattern of renogram and the decrease of renal plasma flow in the patients with Korean hemorrhagic fever. The decrease of renal plasma flow was marked in the patients with non-functioning pattern of renogram and was least in the patients with dysfunction pattern of renogram. All above results suggested that the renogram reflects the effective renal plasma flow and degree of renal impairment, and the renogram may be one of the important indexes which could give us a more precise prognosis in Korean hemorrhagic fever.

Inherent dynamics within the Crimean-Congo Hemorrhagic fever virus protease are localized to the same region as substrate interactions

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Eisenmesser, Elan Z.; Capodagli, Glenn; Armstrong, Geoffrey S.; Holliday, Michael; Isern, Nancy G.; Zhang, Fengli; Pegan, Scott D.

2015-05-01

Crimean-Congo Hemorrhagic fever virus (CCHFV) is one of several lethal viruses that encodes for a viral ovarian tumor domain (vOTU), which serves to cleave and remove multiple proteins involved in cellular signaling such as ubiquitin (Ub) and interferon stimulated gene produce 15 (ISG15). Such manipulation of the host cell machinery serves to downregulate the host response and, therefore, complete characterization of these proteases is important. While several structures of the CCHFV vOTU protease have been solved, both free and bound to Ub and ISG15, few structural differences have been found and little insight has been gained as to the dynamic plasticity of this protease. Therefore, we have used NMR relaxation experiments to probe the dynamics of CCHV vOTU, both alone and in complex with Ub, thereby discovering a highly dynamic protease that exhibits conformational exchange within the same regions found to engage its Ub substrate. These experiments reveal a structural plasticity around the N-terminal regions of CCHV vOTU, which are unique to vOTUs, and provide a rationale for engaging multiple substrates with the same binding site.

Combination of RT-PCR and proteomics for the identification of Crimean-Congo hemorrhagic fever virus in ticks

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Isabel G. Fernández de Mera

2017-07-01

Full Text Available Crimean-Congo hemorrhagic fever (CCHF is an emerging tick-borne zoonotic disease caused by the CCHF virus (CCHFV. In this study, an experimental approach combining RT-PCR and proteomics was used for the identification and characterization of CCHFV in 106 ticks from 7 species that were collected from small ruminants in Greece. The methodological approach included an initial screening for CCHFV by RT-PCR followed by proteomics analysis of positive and control negative tick samples. This novel approach allowed the identification of CCHFV-positive ticks and provided additional information to corroborate the RT-PCR findings using a different approach. Two ticks, Dermacentor marginatus and Haemaphysalis parva collected from a goat and a sheep, respectively were positive for CCHFV. The sequences for CCHFV RNA segments S and L were characterized by RT-PCR and proteomics analysis of tick samples, respectively. These results showed the possibility of combining analyses at the RNA and protein levels using RT-PCR and proteomics for the characterization of CCHFV in ticks. The results supported that the CCHFV identified in ticks are genetic variants of the AP92 strain. Although the AP92-like strains probably do not represent a high risk of CCHF to the population, the circulation of genetically diverse CCHFV strains could potentially result in the appearance of novel viral genotypes with increased pathogenicity and fitness.

Ebola hemorrhagic Fever.

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Burnett, Mark W

2014-01-01

Ebola hemorrhagic fever is an often-fatal disease caused by a virus of the Filoviridae family, genus Ebolavirus. Initial signs and symptoms of the disease are nonspecific, often progressing on to a severe hemorrhagic illness. Special Operations Forces Medical Providers should be aware of this disease, which occurs in sporadic outbreaks throughout Africa. Treatment at the present time is mainly supportive. Special care should be taken to prevent contact with bodily fluids of those infected, which can transmit the virus to caregivers. 2014.

Spontaneous muscle hematomas in a patient with Dengue hemorrhagic fever

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Jency Maria Koshy

2014-01-01

Full Text Available Dengue hemorrhagic fever (DHF and Dengue shock syndrome manifest in various forms, ranging from petechial skin hemorrhage to life threatening cerebral, pulmonary, gastrointestinal and genitourinary hemorrhages. However it is very rare to have muscle hematomas in DHF. We report a rare case of spontaneous Iliopsoas hematoma complicating Dengue hemorrhagic fever.

[Marburg and Ebola hemorrhagic fevers--pathogens, epidemiology and therapy].

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Stock, Ingo

2014-09-01

Marburg and Ebola hemorrhagic fevers are severe, systemic viral diseases affecting humans and non-human primates. They are characterized by multiple symptoms such as hemorrhages, fever, headache, muscle and abdominal pain, chills, sore throat, nausea, vomiting and diarrhea. Elevated liver-associated enzyme levels and coagulopathy are also associated with these diseases. Marburg and Ebola hemorrhagic fevers are caused by (Lake victoria) Marburg virus and different species of Ebola viruses, respectively. They are enveloped, single-stranded RNA viruses and belong to the family of filoviridae. Case fatality rates of filovirus disease outbreaks are among the highest reported for any human pathogen, ranging from 25 to 90% or more. Outbreaks of Marburg and Ebola hemorrhagic fever occur in certain regions of equatorial Africa at irregular intervals. Since 2000, the number of outbreaks has increased. In 2014, the biggest outbreak of a filovirus-induced hemorrhagic fever that has been documented so far occurred from March to July 2014 in Guinea, Sierra Leone, Liberia and Nigeria. The outbreak was caused by a new variant of Zaire Ebola-Virus, affected more than 2600 people (stated 20 August) and was associated with case-fatality rates of up to 67% (Guinea). Treatment of Marburg and Ebola hemorrhagic fevers is symptomatic and supportive, licensed antiviral agents are currently not available. Recently, BCX4430, a promising synthetic adenosine analogue with high in vitro and in vivo activity against filoviruses and other RNA viruses, has been described. BCX4430 inhibits viral RNA polymerase activity and protects cynomolgus macaques from Marburg virus infection when administered as late as 48 hours after infection. Nucleic acid-based products, recombinant vaccines and antibodies appear to be less suitable for the treatment of Marburg and Ebola hemorrhagic fevers.

Co-circulation of Crimean-Congo Hemorrhagic Fever virus strains Asia 1 and 2 between the border of Iran and Pakistan.

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Shahhosseini, Nariman; Jafarbekloo, Ahmad; Telmadarraiy, Zakkyeh; Chinikar, Sadegh; Haeri, Ali; Nowotny, Norbert; Groschup, Martin H; Fooks, Anthony R; Faghihi, Faezeh

2017-11-01

Crimean-Congo Hemorrhagic Fever (CCHF) is a tick-borne viral disease that is transmitted by numerous species of ticks, which serve both as a reservoir and vector of CCHF virus (CCHFV). Molecular and serological tests were undertaken on hard ticks (Ixodidae spp.) and samples from livestock were collected in 2015 from Chabahar County in Southeast Iran. Using RT-PCR, the ticks were tested for the presence of CCHFV. In addition, seven livestock were serologically tested for the presence of IgG antibodies using an ELISA test. IgG antibodies against CCHFV were detected in one of 7 of the livestock that were tested. In total, 49 ticks including five species: Rhipicephalus sanguineus, Hyalomma anatolicum , Hy. asiaticum, Hy. dromedarii and Hy. marginatum with a prevalence of 46.9%, 32.7%, 4.1%, 4.1% and 2.1% respectively were identified. CCHFV was detected in three ticks among 49 collected ticks. The ticks infected with CCHFV belonged to the genus Hyalomma and Rhipicephalus. Phylogenetic analysis demonstrated that two sequences clustered in clade IV (Asia-1) and one sequence was located within clade IV (Asia-2). Most of the animal and human CCHF cases of the country are reported from Sistan and Baluchistan provinces. Regular monitoring programs in the tick population and livestock are needed in the future.

Experimental transmission of Crimean-Congo hemorrhagic fever virus by west African wild ground-feeding birds to Hyalomma marginatum rufipes ticks.

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Zeller, H G; Cornet, J P; Camicas, J L

1994-06-01

Hyalomma (H.) marginatum rufipes ticks commonly infest birds and are potential vectors of Crimean-Congo hemorrhagic fever (CCHF) virus in west Africa. An experimental model for investigating the role of birds in the CCHF virus transmission cycle was developed. Following CCHF virus inoculation, antibodies were detected by enzyme-linked immunosorbent assay in one red-beaked hornbill and one glossy starling, but not in two laughing doves and six domestic chickens. None of the birds showed a detectable viremia. Hyalomma marginatum rufipes larvae were placed on three red-beaked hornbills and one glossy starling. These birds were then inoculated with CCHF virus (10(1.5) 50% mouse intracerebral lethal doses). Virus transmission to larvae or nymphs was obtained and seroconversions in birds were recorded. Virus was also detected in 90% of the individually tested nymphs, as well as in adults. The virus was then successfully transmitted by adult ticks to rabbits and the engorged females were allowed to oviposit. Progeny larvae were placed on another group of birds and one of three birds showed seroconversion. The cycle of transmission of virus between ticks and aviremic ground-feeding birds represent a potential reservoir and amplification mechanism of CCHF virus in west Africa.

Seroepidemiology and risk factors of Crimean-Congo Hemorrhagic Fever among butchers and slaughterhouse workers in southeastern Iran

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Ehsan Mostafavi

2017-11-01

Full Text Available Objective: Crimean-Congo Haemorrhagic Fever (CCHF is a viral zoonotic disease. Butchers and slaughterhouse workers are considered to be high risk occupational groups for the disease. Sistan and Baluchistan province is an area in southeastern Iran which is endemic for CCHF, and the most confirmed cases of the disease are reported from this province. The aim of this study was to investigate the seroprevalence of CCHF and risk factors for seropositivity among them in Sistan and Baluchistan province in 2011. Methods: Questionnaire data and blood sample collection were carried out for each participant and the sera samples were sent to the national reference laboratory for ELISA IgG testing. Results: In this study, the seroprevalence of CCHF among 190 butchers and slaughterhouse workers from 11 counties was 16.49%. 79% of participants were aware that they were at risk of zoonosis and 39.7% did not use any personal protective equipment during their work. Of 31 CCHF IgG positive individuals in this study, eleven individuals had a previous record of CCHF infection in 57 months prior to the study. Conclusions: High seroprevalence of CCHF among butchers and slaughterhouse workers and minimal use of personal protective equipment’s during daily work indicates the need for training courses, for these groups to increase their knowledge, attitude and practice with respect to zoonosis. Keywords: Seroepidemiology, Crimean-Congo Haemorrhagic Fever, Butchers, Slaughterhouse Workers, Iran

Lassa fever or lassa hemorrhagic fever risk to humans from rodent-borne zoonoses.

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El-Bahnasawy, Mamdouh M; Megahed, Laila Abdel-Mawla; Abdalla Saleh, Hala Ahmed; Morsy, Tosson A

2015-04-01

Viral hemorrhagic fevers (VHFs) typically manifest as rapidly progressing acute febrile syndromes with profound hemorrhagic manifestations and very high fatality rates. Lassa fever, an acute hemorrhagic fever characterized by fever, muscle aches, sore throat, nausea, vomiting, diarrhea and chest and abdominal pain. Rodents are important reservoirs of rodent-borne zoonosis worldwide. Transmission rodents to humans occur by aerosol spread, either from the genus Mastomys rodents' excreta (multimammate rat) or through the close contact with infected patients (nosocomial infection). Other rodents of the genera Rattus, Mus, Lemniscomys, and Praomys are incriminated rodents hosts. Now one may ask do the rodents' ectoparasites play a role in Lassa virus zoonotic transmission. This paper summarized the update knowledge on LHV; hopping it might be useful to the clinicians, nursing staff, laboratories' personals as well as those concerned zoonoses from rodents and rodent control.

Impaired fibrinolysis in the pathogenesis of dengue hemorrhagic fever.

NARCIS (Netherlands)

Gorp, E. van; Setiati, T.E.; Mairuhu, A.T.; Suharti, C.; Cate, H.H.; Dolmans, W.M.V.; Meer, J.W.M. van der; Hack, C.E.; Brandjes, D.P.

2002-01-01

The mechanisms contributing to bleeding complications in dengue hemorrhagic fever were studied by investigating the pattern of activation of the coagulation and fibrinolytic systems in 50 children with severe dengue hemorrhagic fever. Thirteen patients (26%) died, and activation of coagulation was

Impaired fibrinolysis in the pathogenesis of dengue hemorrhagic fever

NARCIS (Netherlands)

van Gorp, Eric C. M.; Setiati, Tatty E.; Mairuhu, Albert T. A.; Suharti, Catharina; Cate Ht, Hugo ten; Dolmans, Wil M. V.; van der Meer, Jos W. M.; Hack, C. Erik; Brandjes, Dees P. M.

2002-01-01

The mechanisms contributing to bleeding complications in dengue hemorrhagic fever were studied by investigating the pattern of activation of the coagulation and fibrinolytic systems in 50 children with severe dengue hemorrhagic fever. Thirteen patients (26%) died, and activation of coagulation was

Clinical features and patient management of Lujo hemorrhagic fever.

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Nivesh H Sewlall

Full Text Available In 2008 a nosocomial outbreak of five cases of viral hemorrhagic fever due to a novel arenavirus, Lujo virus, occurred in Johannesburg, South Africa. Lujo virus is only the second pathogenic arenavirus, after Lassa virus, to be recognized in Africa and the first in over 40 years. Because of the remote, resource-poor, and often politically unstable regions where Lassa fever and other viral hemorrhagic fevers typically occur, there have been few opportunities to undertake in-depth study of their clinical manifestations, transmission dynamics, pathogenesis, or response to treatment options typically available in industrialized countries.We describe the clinical features of five cases of Lujo hemorrhagic fever and summarize their clinical management, as well as providing additional epidemiologic detail regarding the 2008 outbreak. Illness typically began with the abrupt onset of fever, malaise, headache, and myalgias followed successively by sore throat, chest pain, gastrointestinal symptoms, rash, minor hemorrhage, subconjunctival injection, and neck and facial swelling over the first week of illness. No major hemorrhage was noted. Neurological signs were sometimes seen in the late stages. Shock and multi-organ system failure, often with evidence of disseminated intravascular coagulopathy, ensued in the second week, with death in four of the five cases. Distinctive treatment components of the one surviving patient included rapid commencement of the antiviral drug ribavirin and administration of HMG-CoA reductase inhibitors (statins, N-acetylcysteine, and recombinant factor VIIa.Lujo virus causes a clinical syndrome remarkably similar to Lassa fever. Considering the high case-fatality and significant logistical impediments to controlled treatment efficacy trials for viral hemorrhagic fever, it is both logical and ethical to explore the use of the various compounds used in the treatment of the surviving case reported here in future outbreaks

Dengue hemorrhagic fever and acute hepatitis: a case report

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Maria Paula Gomes Mourão

Full Text Available Dengue fever is the world's most important viral hemorrhagic fever disease, the most geographically wide-spread of the arthropod-born viruses, and it causes a wide clinical spectrum of disease. We report a case of dengue hemorrhagic fever complicated by acute hepatitis. The initial picture of classical dengue fever was followed by painful liver enlargement, vomiting, hematemesis, epistaxis and diarrhea. Severe liver injury was detected by laboratory investigation, according to a syndromic surveillance protocol, expressed in a self-limiting pattern and the patient had a complete recovery. The serological tests for hepatitis and yellow fever viruses were negative. MAC-ELISA for dengue was positive.

Dengue hemorrhagic fever and acute hepatitis: a case report.

Science.gov (United States)

Mourão, Maria Paula Gomes; Lacerda, Marcus Vinícius Guimarães de; Bastos, Michele de Souza; Albuquerque, Bernardino Cláudio de; Alecrim, Wilson Duarte

2004-12-01

Dengue fever is the world's most important viral hemorrhagic fever disease, the most geographically wide-spread of the arthropod-born viruses, and it causes a wide clinical spectrum of disease. We report a case of dengue hemorrhagic fever complicated by acute hepatitis. The initial picture of classical dengue fever was followed by painful liver enlargement, vomiting, hematemesis, epistaxis and diarrhea. Severe liver injury was detected by laboratory investigation, according to a syndromic surveillance protocol, expressed in a self-limiting pattern and the patient had a complete recovery. The serological tests for hepatitis and yellow fever viruses were negative. MAC-ELISA for dengue was positive.

Awareness among butchers regarding crimean congo hemorrhagic fever in rawalpindi cantt

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Khaleeq, T.A.; Rahman, M.U.; Tariq, N.A.; Mashhadi, S.F.; Jamil, R.

2016-01-01

To study the awareness of butchers regarding Crimean-Congo Haemorrhagic fever (CCHF) in relation to their education level. Study Design: Cross sectional survey. Place and Duration of Study: Conducted from January to March 2015 in Qasaiee Chowk and Tench Bhatta markets of ward 5 of Rawalpindi cantt. Material and Methods: Sample size was calculated using G-Power sample size calculator at 95 percent confidence level with an effect size of 0.38. Ward 5 of Rawalpindi cantt was chosen through lottery method and all available professional butchers in the markets were interviewed with informed consent. A pre-tested 14 items closed ended questionnaire was used and interview was conducted by a well briefed team of medical students. Data was analyzed using SPSS version 20.0. Results: Results showed that only 14 (9.33 percent) butchers knew the name of CCHF. Out of these 10 (71.4 percent) had some form of formal education. All 14 of these had heard about CCHF from television proving it to be an important medium of information. However none of the 150 respondents took any preventive measure against CCHF. Conclusion: Our study concluded that the level of awareness regarding CCHF in butchers is very low and no preventive measures are taken by them. Also the level of education has a significant effect on the awareness. (author)

Co-circulation of Crimean-Congo Hemorrhagic Fever virus strains Asia 1 and 2 between the border of Iran and Pakistan

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Nariman Shahhosseini

2017-11-01

Full Text Available Crimean-Congo Hemorrhagic Fever (CCHF is a tick-borne viral disease that is transmitted by numerous species of ticks, which serve both as a reservoir and vector of CCHF virus (CCHFV. Molecular and serological tests were undertaken on hard ticks (Ixodidae spp. and samples from livestock were collected in 2015 from Chabahar County in Southeast Iran. Using RT-PCR, the ticks were tested for the presence of CCHFV. In addition, seven livestock were serologically tested for the presence of IgG antibodies using an ELISA test. IgG antibodies against CCHFV were detected in one of 7 of the livestock that were tested. In total, 49 ticks including five species: Rhipicephalus sanguineus, Hyalomma anatolicum, Hy. asiaticum, Hy. dromedarii and Hy. marginatum with a prevalence of 46.9%, 32.7%, 4.1%, 4.1% and 2.1% respectively were identified. CCHFV was detected in three ticks among 49 collected ticks. The ticks infected with CCHFV belonged to the genus Hyalomma and Rhipicephalus. Phylogenetic analysis demonstrated that two sequences clustered in clade IV (Asia-1 and one sequence was located within clade IV (Asia-2. Most of the animal and human CCHF cases of the country are reported from Sistan and Baluchistan provinces. Regular monitoring programs in the tick population and livestock are needed in the future. Keywords: Virology

Infection prevention and control practice for Crimean-Congo hemorrhagic fever-A multi-center cross-sectional survey in Eurasia.

Science.gov (United States)

Fletcher, Tom E; Gulzhan, Abuova; Ahmeti, Salih; Al-Abri, Seif S; Asik, Zahide; Atilla, Aynur; Beeching, Nick J; Bilek, Heval; Bozkurt, Ilkay; Christova, Iva; Duygu, Fazilet; Esen, Saban; Khanna, Arjun; Kader, Çiğdem; Mardani, Masoud; Mahmood, Faisal; Mamuchishvili, Nana; Pshenichnaya, Natalia; Sunbul, Mustafa; Yalcin, Tuğba Y; Leblebicioglu, Hakan

2017-01-01

Crimean Congo Hemorrhagic Fever (CCHF) is a life threatening acute viral infection that presents significant risk of nosocomial transmission to healthcare workers. Evaluation of CCHF infection prevention and control (IP&C) practices in healthcare facilities that routinely manage CCHF cases in Eurasia. A cross-sectional CCHF IP&C survey was designed and distributed to CCHF centers in 10 endemic Eurasian countries in 2016. Twenty-three responses were received from centers in Turkey, Pakistan, Russia, Georgia, Kosovo, Bulgaria, Oman, Iran, India and Kazakhstan. All units had dedicated isolation rooms for CCHF, with cohorting of confirmed cases in 15/23 centers and cohorting of suspect and confirmed cases in 9/23 centers. There was adequate personal protective equipment (PPE) in 22/23 facilities, with 21/23 facilities reporting routine use of PPE for CCHF patients. Adequate staffing levels to provide care reported in 14/23 locations. All centers reported having a high risk CCHFV nosocomial exposure in last five years, with 5 centers reporting more than 5 exposures. Education was provided annually in most centers (13/23), with additional training requested in PPE use (11/23), PPE donning/doffing (12/23), environmental disinfection (12/23) and waste management (14/23). Staff and patient safety must be improved and healthcare associated CCHF exposure and transmission eliminated. Improvements are recommended in isolation capacity in healthcare facilities, use of PPE and maintenance of adequate staffing levels. We recommend further audit of IP&C practice at individual units in endemic areas, as part of national quality assurance programs.

Increased serum ferritin levels in patients with Crimean-Congo hemorrhagic fever: can it be a new severity criterion?

Science.gov (United States)

Barut, Sener; Dincer, Fatma; Sahin, Idris; Ozyurt, Huseyin; Akkus, Mehmet; Erkorkmaz, Unal

2010-01-01

Serum ferritin is one of the markers indicating hemophagocytosis that may have a role in the pathogenesis of Crimean-Congo hemorrhagic fever (CCHF). This study was designed to determine any correlation between serum ferritin and routine diagnostic laboratory markers of CCHF, and to investigate the relationship between serum ferritin levels and disease severity. Sixty-six patients with CCHF admitted to the hospital during the spring and summer months of 2006 and 2007 were included in the study. Serum ferritin levels were measured in sera obtained during the initial days of hospitalization. Data from 53 patients showing decreasing platelet counts over the first three days were used for further analysis and these patients were divided into two groups according to disease severity: group A included severe cases with lowest platelet counts 20x10(9)/l. Forty patients (60.6%) were male (mean age 43+/-17 years). Three patients died, thus the fatality rate was 4.5%. Fifty-one patients (77.3%) had abnormal serum ferritin levels, with levels above 500 ng/ml in 62.1%. There was a significant negative correlation between ferritin levels and concordant platelet counts (p or =1862ng/ml had a sensitivity of 87.5% and a specificity of 83.8% in differentiating severe cases from mild ones. Increased serum ferritin levels may suggest a significant role of hemophagocytosis in the pathogenesis of CCHF and may be a useful marker for diagnosis, disease activity, and prognosis. Copyright 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Development and preliminary evaluation of a multiplexed amplification and next generation sequencing method for viral hemorrhagic fever diagnostics.

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Annika Brinkmann

2017-11-01

Full Text Available We describe the development and evaluation of a novel method for targeted amplification and Next Generation Sequencing (NGS-based identification of viral hemorrhagic fever (VHF agents and assess the feasibility of this approach in diagnostics.An ultrahigh-multiplex panel was designed with primers to amplify all known variants of VHF-associated viruses and relevant controls. The performance of the panel was evaluated via serially quantified nucleic acids from Yellow fever virus, Rift Valley fever virus, Crimean-Congo hemorrhagic fever (CCHF virus, Ebola virus, Junin virus and Chikungunya virus in a semiconductor-based sequencing platform. A comparison of direct NGS and targeted amplification-NGS was performed. The panel was further tested via a real-time nanopore sequencing-based platform, using clinical specimens from CCHF patients.The multiplex primer panel comprises two pools of 285 and 256 primer pairs for the identification of 46 virus species causing hemorrhagic fevers, encompassing 6,130 genetic variants of the strains involved. In silico validation revealed that the panel detected over 97% of all known genetic variants of the targeted virus species. High levels of specificity and sensitivity were observed for the tested virus strains. Targeted amplification ensured viral read detection in specimens with the lowest virus concentration (1-10 genome equivalents and enabled significant increases in specific reads over background for all viruses investigated. In clinical specimens, the panel enabled detection of the causative agent and its characterization within 10 minutes of sequencing, with sample-to-result time of less than 3.5 hours.Virus enrichment via targeted amplification followed by NGS is an applicable strategy for the diagnosis of VHFs which can be adapted for high-throughput or nanopore sequencing platforms and employed for surveillance or outbreak monitoring.

Development and preliminary evaluation of a multiplexed amplification and next generation sequencing method for viral hemorrhagic fever diagnostics.

Science.gov (United States)

Brinkmann, Annika; Ergünay, Koray; Radonić, Aleksandar; Kocak Tufan, Zeliha; Domingo, Cristina; Nitsche, Andreas

2017-11-01

We describe the development and evaluation of a novel method for targeted amplification and Next Generation Sequencing (NGS)-based identification of viral hemorrhagic fever (VHF) agents and assess the feasibility of this approach in diagnostics. An ultrahigh-multiplex panel was designed with primers to amplify all known variants of VHF-associated viruses and relevant controls. The performance of the panel was evaluated via serially quantified nucleic acids from Yellow fever virus, Rift Valley fever virus, Crimean-Congo hemorrhagic fever (CCHF) virus, Ebola virus, Junin virus and Chikungunya virus in a semiconductor-based sequencing platform. A comparison of direct NGS and targeted amplification-NGS was performed. The panel was further tested via a real-time nanopore sequencing-based platform, using clinical specimens from CCHF patients. The multiplex primer panel comprises two pools of 285 and 256 primer pairs for the identification of 46 virus species causing hemorrhagic fevers, encompassing 6,130 genetic variants of the strains involved. In silico validation revealed that the panel detected over 97% of all known genetic variants of the targeted virus species. High levels of specificity and sensitivity were observed for the tested virus strains. Targeted amplification ensured viral read detection in specimens with the lowest virus concentration (1-10 genome equivalents) and enabled significant increases in specific reads over background for all viruses investigated. In clinical specimens, the panel enabled detection of the causative agent and its characterization within 10 minutes of sequencing, with sample-to-result time of less than 3.5 hours. Virus enrichment via targeted amplification followed by NGS is an applicable strategy for the diagnosis of VHFs which can be adapted for high-throughput or nanopore sequencing platforms and employed for surveillance or outbreak monitoring.

Host preferences support the prominent role of Hyalomma ticks in the ecology of Crimean-Congo hemorrhagic fever.

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Jessica R Spengler

2018-02-01

Full Text Available Crimean-Congo hemorrhagic fever virus (CCHFV is a tick-borne zoonotic agent that is maintained in nature in an enzootic vertebrate-tick-vertebrate cycle. Hyalomma genus ticks have been implicated as the main CCHFV vector and are key in maintaining silent endemic foci. However, what contributes to their central role in CCHFV ecology is unclear. To assess the significance of host preferences of ticks in CCHFV ecology, we performed comparative analyses of hosts exploited by 133 species of ticks; these species represent 5 genera with reported geographical distribution over the range of CCHFV. We found that the composition of vertebrate hosts on which Hyalomma spp. feed is different than for other tick genera. Immatures of the genus Hyalomma feed preferentially on species of the orders Rodentia, Lagomorpha, and the class Aves, while adults concentrate mainly on the family Bovidae. With the exception of Aves, these hosts include the majority of the vertebrates consistently reported to be viremic upon CCHFV infection. While other tick genera also feed on these hosts, Hyalomma spp. almost completely concentrate their populations on them. Hyalomma spp. feed on less phylogenetically diverse hosts than any other tick genus, implying that this network of hosts has a low resilience. Indeed, removing the most prominent hosts quickly collapsed the network of parasitic interactions. These results support the intermittent activity of CCHFV foci: likely, populations of infected Hyalomma spp. ticks exceed the threshold of contact with humans only when these critical hosts reach adequate population density, accounting for the sporadic occurence of clinical tick-transmitted cases. Our data describe the association of vertebrate host preferences with the role of Hyalomma spp. ticks in maintaining endemic CCHFV foci, and highlight the importance of host-tick dynamics in pathogen ecology.

Alkhurma Hemorrhagic Fever in Saudi Arabia

Centers for Disease Control (CDC) Podcasts

This podcast looks at the epidemiologic characteristics of Alkhurma Hemorrhagic Fever in humans in Najran City, Saudi Arabia. CDC epidemiologist Dr. Adam MacNeil discusses the severity and risk factors for the illness.

The Non-structural Protein of Crimean-Congo Hemorrhagic Fever Virus Disrupts the Mitochondrial Membrane Potential and Induces Apoptosis*

Science.gov (United States)

Barnwal, Bhaskar; Karlberg, Helen; Mirazimi, Ali; Tan, Yee-Joo

2016-01-01

Viruses have developed distinct strategies to overcome the host defense system. Regulation of apoptosis in response to viral infection is important for virus survival and dissemination. Like other viruses, Crimean-Congo hemorrhagic fever virus (CCHFV) is known to regulate apoptosis. This study, for the first time, suggests that the non-structural protein NSs of CCHFV, a member of the genus Nairovirus, induces apoptosis. In this report, we demonstrated the expression of CCHFV NSs, which contains 150 amino acid residues, in CCHFV-infected cells. CCHFV NSs undergoes active degradation during infection. We further demonstrated that ectopic expression of CCHFV NSs induces apoptosis, as reflected by caspase-3/7 activity and cleaved poly(ADP-ribose) polymerase, in different cell lines that support CCHFV replication. Using specific inhibitors, we showed that CCHFV NSs induces apoptosis via both intrinsic and extrinsic pathways. The minimal active region of the CCHFV NSs protein was determined to be 93–140 amino acid residues. Using alanine scanning, we demonstrated that Leu-127 and Leu-135 are the key residues for NSs-induced apoptosis. Interestingly, CCHFV NSs co-localizes in mitochondria and also disrupts the mitochondrial membrane potential. We also demonstrated that Leu-127 and Leu-135 are important residues for disruption of the mitochondrial membrane potential by NSs. Therefore, these results indicate that the C terminus of CCHFV NSs triggers mitochondrial membrane permeabilization, leading to activation of caspases, which, ultimately, leads to apoptosis. Given that multiple factors contribute to apoptosis during CCHFV infection, further studies are needed to define the involvement of CCHFV NSs in regulating apoptosis in infected cells. PMID:26574543

A Multiplex PCR/LDR Assay for the Simultaneous Identification of Category A Infectious Pathogens: Agents of Viral Hemorrhagic Fever and Variola Virus.

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Sanchita Das

Full Text Available CDC designated category A infectious agents pose a major risk to national security and require special action for public health preparedness. They include viruses that cause viral hemorrhagic fever (VHF syndrome as well as variola virus, the agent of smallpox. VHF is characterized by hemorrhage and fever with multi-organ failure leading to high morbidity and mortality. Smallpox, a prior scourge, has been eradicated for decades, making it a particularly serious threat if released nefariously in the essentially non-immune world population. Early detection of the causative agents, and the ability to distinguish them from other pathogens, is essential to contain outbreaks, implement proper control measures, and prevent morbidity and mortality. We have developed a multiplex detection assay that uses several species-specific PCR primers to generate amplicons from multiple pathogens; these are then targeted in a ligase detection reaction (LDR. The resultant fluorescently-labeled ligation products are detected on a universal array enabling simultaneous identification of the pathogens. The assay was evaluated on 32 different isolates associated with VHF (ebolavirus, marburgvirus, Crimean Congo hemorrhagic fever virus, Lassa fever virus, Rift Valley fever virus, Dengue virus, and Yellow fever virus as well as variola virus and vaccinia virus (the agent of smallpox and its vaccine strain, respectively. The assay was able to detect all viruses tested, including 8 sequences representative of different variola virus strains from the CDC repository. It does not cross react with other emerging zoonoses such as monkeypox virus or cowpox virus, or six flaviviruses tested (St. Louis encephalitis virus, Murray Valley encephalitis virus, Powassan virus, Tick-borne encephalitis virus, West Nile virus and Japanese encephalitis virus.

A Multiplex PCR/LDR Assay for the Simultaneous Identification of Category A Infectious Pathogens: Agents of Viral Hemorrhagic Fever and Variola Virus.

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Das, Sanchita; Rundell, Mark S; Mirza, Aashiq H; Pingle, Maneesh R; Shigyo, Kristi; Garrison, Aura R; Paragas, Jason; Smith, Scott K; Olson, Victoria A; Larone, Davise H; Spitzer, Eric D; Barany, Francis; Golightly, Linnie M

2015-01-01

CDC designated category A infectious agents pose a major risk to national security and require special action for public health preparedness. They include viruses that cause viral hemorrhagic fever (VHF) syndrome as well as variola virus, the agent of smallpox. VHF is characterized by hemorrhage and fever with multi-organ failure leading to high morbidity and mortality. Smallpox, a prior scourge, has been eradicated for decades, making it a particularly serious threat if released nefariously in the essentially non-immune world population. Early detection of the causative agents, and the ability to distinguish them from other pathogens, is essential to contain outbreaks, implement proper control measures, and prevent morbidity and mortality. We have developed a multiplex detection assay that uses several species-specific PCR primers to generate amplicons from multiple pathogens; these are then targeted in a ligase detection reaction (LDR). The resultant fluorescently-labeled ligation products are detected on a universal array enabling simultaneous identification of the pathogens. The assay was evaluated on 32 different isolates associated with VHF (ebolavirus, marburgvirus, Crimean Congo hemorrhagic fever virus, Lassa fever virus, Rift Valley fever virus, Dengue virus, and Yellow fever virus) as well as variola virus and vaccinia virus (the agent of smallpox and its vaccine strain, respectively). The assay was able to detect all viruses tested, including 8 sequences representative of different variola virus strains from the CDC repository. It does not cross react with other emerging zoonoses such as monkeypox virus or cowpox virus, or six flaviviruses tested (St. Louis encephalitis virus, Murray Valley encephalitis virus, Powassan virus, Tick-borne encephalitis virus, West Nile virus and Japanese encephalitis virus).

Hemorrhagic Fever with Renal Syndrome (HFRS)

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... Care includes careful management of the patient’s fluid (hydration) and electrolyte (e.g., sodium, potassium, chloride) levels, ... TG, Peters CJ. Viral Hemorrhagic Fevers. Seminars in Pediatric Infectious Diseases 1997;8(Suppl 1):64-73 . ...

Detection, isolation and confirmation of Crimean-Congo hemorrhagic fever virus in human, ticks and animals in Ahmadabad, India, 2010-2011.

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Devendra T Mourya

Full Text Available BACKGROUND: In January 2011, human cases with hemorrhagic manifestations in the hospital staff were reported from a tertiary care hospital in Ahmadabad, India. This paper reports a detailed epidemiological investigation of nosocomial outbreak from the affected area of Ahmadabad, Gujarat, India. PRINCIPAL FINDINGS: Samples from 3 suspected cases, 83 contacts, Hyalomma ticks and livestock were screened for Crimean-Congo hemorrhagic fever (CCHF virus by qRT-PCR of which samples of two medical professionals (case C and E and the husband of the index case (case D were positive for CCHFV. The sensitivity and specificity of indigenous developed IgM ELISA to screen CCHFV specific antibodies in human serum was 75.0% and 97.5% respectively as compared to commercial kit. About 17.0% domestic animals from Kolat, Ahmadabad were positive for IgG antibodies while only two cattle and a goat showed positivity by qRT-PCR. Surprisingly, 43.0% domestic animals (Buffalo, cattle, sheep and goat showed IgG antibodies in the adjoining village Jivanpara but only one of the buffalo was positive for CCHFV. The Hyalomma anatolicum anatolicum ticks were positive in PCR and virus isolation. CCHFV was isolated from the blood sample of case C, E in Vero E-6 cells and Swiss albino mice. In partial nucleocapsid gene phylogeny from CCHFV positive human samples of the years 2010 and 2011, livestock and ticks showed this virus was similar to Tajikistan (strain TAJ/H08966, which belongs in the Asian/middle east genetic lineage IV. CONCLUSIONS: The likely source of CCHFV was identified as virus infected Hyalomma ticks and livestock at the rural village residence of the primary case (case A. In addition, retrospective sample analysis revealed the existence of CCHFV in Gujarat and Rajasthan states before this outbreak. An indigenous developed IgM ELISA kit will be of great use for screening this virus in India.

Hemorrhagic fever with renal syndrome and coexisting hantavirus pulmonary syndrome

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Young Min Hong

2012-06-01

Full Text Available Hemorrhagic fever with renal syndrome (HFRS is an acute viral disease with fever, hemorrhage and renal failure caused by hantavirus infection. Hantavirus induces HFRS or hantavirus pulmonary syndrome (HPS. HPS progression to a life-threatening pulmonary disease is found primarily in the USA and very rarely in South Korea. Here, we report a case of HFRS and coexisting HPS.

Reverse transcription PCR-based detection of Crimean-Congo hemorrhagic fever virus isolated from ticks of domestic ruminants in Kurdistan province of Iran.

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Fakoorziba, Mohammad Reza; Golmohammadi, Parvaneh; Moradzadeh, Rahmatollah; Moemenbellah-Fard, Mohammad Djaefar; Azizi, Kourosh; Davari, Behrooz; Alipour, Hamzeh; Ahmadnia, Sara; Chinikar, Sadegh

2012-09-01

Crimean-Congo hemorrhagic fever (CCHF) is a potentially fatal viral vector-borne zoonosis which has a mortality rate of up to 30% without treatment in humans. CCHF virus is transmitted to humans by ticks, predominantly from the Hyalomma genus. Following the report of two confirmed and one suspected death due to CCHF virus in Kurdistan province of Iran in 2007, this study was undertaken to determine the fauna of hard ticks on domestic ruminants (cattle, sheep, and goats) and their possible infection with CCHF virus using reverse transcription PCR technique. This is the first detection of CCHF virus in ticks from the Kurdistan province of Iran. Overall, 414 ixodid ticks were collected from two districts in this province. They represented four genera from which 10 separate species were identified. The Hyalomma genus was the most abundant tick genus (70%). It was the only genus shown to be infected with the CCHF virus using RT-PCR technique. The number of ticks positive for CCHF virus was 5 out of 90 (5.6%) adult ticks. The three remaining genera (Haemaphysalis, Rhipicephalus, and Dermacentor) were all negative following molecular survey. Four of the five virally-infected ticks were from cattle mainly in the Sanandaj district. We concluded that CCHF virus is present in the Hyalomma ticks on domestic ruminants (cattle) in Kurdistan province of Iran.

Public Knowledge and Attitude toward Crimean Congo Hemorrhagic Fever in Tokat Turkey

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R Yilmaz

2009-12-01

Full Text Available Background: The World health Organization (WHO declares Crimean Congo hemorrhagic fe­ver (CCHF endemic in Turkey. Despite the magnitude of problem, no documented evi­dence exists in Turkey, which reveals the aware­ness and practices of the country's adult popula­tion regarding CCHF, its spread, symptoms, treatment, and preven­tion. This study was conducted to assess the level of knowledge, attitudes, and practices regarding CCHF in people visit­ing terti­ary care hospital in Tokat, Turkey.Methods: This questionnaire based cross-sectional survey was conducted among patients' rela­tives or guardians who ad­mitted pediatric outpatient clinics during May-July 2008. The question­naire was composed of 25 questions.Results: A total of 1034 respondents participated in the survey. Sufficient knowledge about CCHF was not found in 28.9% of the sample. Literate individuals were relatively better informed about CCHF as compared to the illiterate peo­ple. Television and radio were con­sidered as the most important and useful source of information on the disease.Conclusion: We have found insufficient knowledge on CCHF in our population. It is thought to have no chance of suc­cess against a fatal disease such as CCHF, which has serious consequences, without the contribution of commu­nity. It is clear that there are important tasks for health, agri­culture, and media sectors to improve public knowledge and awareness about CCHF.

Guillain-Barre syndrome associated with hemorrhagic fever with renal syndrome in China: a case report.

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Jiao, Jie; Wu, Lei; Yin, Jianyuan; Quan, Xiaojiao; Chen, Wei; Hu, Jie

2018-03-27

We describe a case of Guillain-Barre syndrome (GBS) associated with hemorrhagic fever with renal syndrome. To our knowledge, only five cases of GBS associated with Hantavirus infection have been reported so far. A 62-year-old man presented intermittent fever, chill and oliguria. According to remarkable leukocytosis, atypical lymphocytes, thrombocytopenia and former dwelling in hemorrhagic fever-endemic area, he was suspected as hemorrhagic fever with renal syndromeand certified with positive Hantavirus IgG. Later, the patient had symmetrical flaccid paralysis of all extremities. Electromyography showed peripheral nerve injury (mainly in axon). The patient was diagnosed as having acute motor sensory axonal neuropathy (AMSAN). After immunoglobulin infusion, patient showed progressive recovery and was transferred 3 weeks after his first admission to a rehabilitation center. Our case was the 6th reported case of GBS associated with hemorrhagic fever with renal syndrome. Moreover, we for the first time classified the subtype of GBS (AMSAN) based on the electrophysiology characteristics. GBS should be suspected in patients who are already diagnosed as hemorrhagic fever with renal syndrome when delayed symmetrical limb paralysis occurs. Until recent now, GBS was only reported in hemorrhagic fever patients in Europe and Asia, which termed as hemorrhagic fever with renal syndrome.

Host genetic diversity enables Ebola hemorrhagic fever pathogenesis and resistance.

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Rasmussen, Angela L; Okumura, Atsushi; Ferris, Martin T; Green, Richard; Feldmann, Friederike; Kelly, Sara M; Scott, Dana P; Safronetz, David; Haddock, Elaine; LaCasse, Rachel; Thomas, Matthew J; Sova, Pavel; Carter, Victoria S; Weiss, Jeffrey M; Miller, Darla R; Shaw, Ginger D; Korth, Marcus J; Heise, Mark T; Baric, Ralph S; de Villena, Fernando Pardo-Manuel; Feldmann, Heinz; Katze, Michael G

2014-11-21

Existing mouse models of lethal Ebola virus infection do not reproduce hallmark symptoms of Ebola hemorrhagic fever, neither delayed blood coagulation and disseminated intravascular coagulation nor death from shock, thus restricting pathogenesis studies to nonhuman primates. Here we show that mice from the Collaborative Cross panel of recombinant inbred mice exhibit distinct disease phenotypes after mouse-adapted Ebola virus infection. Phenotypes range from complete resistance to lethal disease to severe hemorrhagic fever characterized by prolonged coagulation times and 100% mortality. Inflammatory signaling was associated with vascular permeability and endothelial activation, and resistance to lethal infection arose by induction of lymphocyte differentiation and cellular adhesion, probably mediated by the susceptibility allele Tek. These data indicate that genetic background determines susceptibility to Ebola hemorrhagic fever. Copyright © 2014, American Association for the Advancement of Science.

Acute gingival bleeding as a complication of dengue hemorrhagic fever

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Saif Khan

2013-01-01

Full Text Available Dengue fever is mosquito borne disease caused by dengue virus (DENV of Flaviviridae family. The clinical manifestations range from fever to severe hemorrhage, shock and death. Here, we report a case of 20-year-old male patient undergoing orthodontic treatment presenting with acute gingival bleeding with a history of fever, weakness, backache, retro orbital pain and ecchymosis over his right arm. The hematological investigations revealed anemia, thrombocytopenia and positive dengue non-structural protein-1 antigen and also positive immunoglobulin M and immunoglobulin G antibodies for DENV. Patient was diagnosed as a case of dengue hemorrhagic fever and was immediately referred for appropriate management. This case report emphasizes the importance of taking correct and thorough medical history.

Establishment of recombinase polymerase amplification assay for five hemorrhagic fever-related viruses

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Xue-feng CAO

2017-08-01

Full Text Available Objective To establish a one-step recombinase polymerase amplification (RPA method for pathogen screening and rapid detection in the field targeting for five hemorrhagic fever related viruses (Zaire ebola virus, Sudan ebola virus, Marburg virus, Lassa virus and Yellow fever virus. Methods The specific nucleic acid (NA fragments of each virus were selected as target genes by genome sequence analysis, and the primers and probes for RPA assays were designed according to the sequence. A series of diluted template genes were used for RPA detection to determine the sensitivity. The hemorrhagic fever-related viral nucleic acids were used for RPA detection to determine the specificity. The amplification experiments were carried out at different temperature ranging from 37℃ to 42℃ to validate the reaction temperature range. Results The RPA reaction systems of the five hemorrhagic fever viruses could effectively amplify the target genes, the sensitivities were between 1.5×102 and 1.5×103 copies. No cross reactions existed with the other hemorrhagic fever-related viral genes. Meanwhile, RPA assay could effectively amplify the target genes at 37-42℃. Conclusion The isothermal RPA assays of five hemorrhagic fever viruses are established, which may amply target genes fast and react at a wide temperature range, and be potentially useful for in field pathogens detection. DOI: 10.11855/j.issn.0577-7402.2017.06.09

Seasonality in hospital admissions of Crimean-Congo hemorrhagic fever and its dependence on ambient temperature—empirical evidence from Pakistan

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Abbas, Tariq; Xu, Zhiwei; Younus, Muhammad; Qayyum, Abdul; Riaz, Muhammad T.

2017-11-01

Crimean-Congo hemorrhagic fever (CCHF) has been reported from all provinces of Pakistan. Little is known about the seasonal variations in the disease and its association with weather conditions. In this study, we explored time-series data about monthly number of CCHF admissions (2007-2010) in three public sector hospitals of Quetta—the capital city of Baluchistan province of Pakistan. Cosinor analysis was carried out to investigate seasonality in the data. To assess the effect of average monthly ambient temperature (°C) on disease, a distributed lag nonlinear model (DLNM) was applied. Cosinor model revealed statistically significant seasonality in monthly number of CCHF patients admitted to the study hospitals. The estimated amplitude was 3.24 cases per month with phase in mid-June and low point in mid-December. DLNM confirmed nonlinear and delayed effect of temperature on hospital admissions. At a lag of 2 months, the cumulative relative risk was more than 1 at temperature at 18.37 °C and above. In addition, relative risk was significantly high at 60th (21.98 °C), 70th (24.50 °C), 80th (27.33 °C), and 90th (29.25 °C) percentiles of temperature (relative to median value, 18.37 °C). Inclusion of Eid-al-Adha as a predictor did not improve the fitness of DLNM. Based on our analysis, we concluded significant seasonality in CCHF hospital admissions. Our findings also suggested average monthly ambient temperature (°C) as a significant predictor of CCHF hospitalizations. DLNM presented in this study may be improved with inclusion of other possible time-varying predictors particularly meteorological conditions of this region.

Infection control during filoviral hemorrhagic fever outbreaks

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N Raabe Vanessa

2012-01-01

Full Text Available Breaking the human-to-human transmission cycle remains the cornerstone of infection control during filoviral (Ebola and Marburg hemorrhagic fever outbreaks. This requires effective identification and isolation of cases, timely contact tracing and monitoring, proper usage of barrier personal protection gear by health workers, and safely conducted burials. Solely implementing these measures is insufficient for infection control; control efforts must be culturally sensitive and conducted in a transparent manner to promote the necessary trust between the community and infection control team in order to succeed. This article provides a review of the literature on infection control during filoviral hemorrhagic fever outbreaks focusing on outbreaks in a developing setting and lessons learned from previous outbreaks. The primary search database used to review the literature was PUBMED, the National Library of Medicine website.

Influence of laboratory animal hosts on the life cycle of Hyalomma marginatum and implications for an in vivo transmission model for Crimean-Congo hemorrhagic fever virus

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Aysen eGargili

2013-08-01

Full Text Available Crimean-Congo hemorrhagic fever virus (CCHFV is one of the most geographically widespread arboviruses and causes a severe hemorrhagic syndrome in humans. The virus circulates in nature in a vertebrate-tick cycle and ticks of the genus Hyalomma are the main vectors and reservoirs. Although the tick vector plays a central role in the maintenance and transmission of CCHFV in nature, comparatively little is known of CCHFV-tick interactions. This is mostly due to the fact that establishing tick colonies is laborious, and working with CCHFV requires a biosafety level 4 laboratory (BSL4 in many countries. Nonetheless, an in vivo transmission model is essential to understand the epidemiology of the transmission cycle of CCHFV. In addition, important parameters such as vectorial capacity of tick species, levels of infection in the host necessary to infect the tick, and aspects of virus transmission by tick bite including the influence of tick saliva, cannot be investigated any other way. Here, we evaluate the influence of different laboratory animal species as hosts supporting the life cycle of Hyalomma marginatum, a two-host tick. Rabbits were considered the host of choice for the maintenance of the uninfected colonies due to high larval attachment rates, shorter larval-nymphal feeding times, higher nymphal molting rates, high egg hatching rates and higher conversion efficiency index. Furthermore, we describe the successful establishment of an in vivo transmission model CCHFV in a BSL4 biocontainment setting using interferon knockout mice. This will give us a new tool to study the transmission and interaction of CCHFV with its tick vector.

Detection panel for identification of twelve hemorrhagic viruses using real-time RT-PCR.

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Fajfr, M; Neubauerová, V; Pajer, P; Kubíčková, P; Růžek, D

2014-09-01

Viral hemorrhagic fevers are caused by viruses from four viral families and develop diseases with high fatality rates. However, no commercial diagnostic assay for these pathogens is available. We developed real-time RT-PCR assays for viruses Ebola, Marburg, Lassa, Guanarito, Machupo, Junin, Sabiá, Seoul, Puumala, Hantaan, Crimean-Congo hemorrhagic fever virus and Rift Valley fever virus. The assays were optimized for identical reaction conditions and can be performed using several types of real-time PCR instruments, both capillary and plate, including a portable Ruggedized Advanced Pathogen Identification Device (R.A.P.I.D.) (Idaho Technology, Inc.). In combination with primers and probes from previously published studies, we present a simple system for rapid identification of hemorrhagic filoviruses, arenaviruses and bunyaviruses with sufficient sensitivity for first contact laboratory and diagnosis under field conditions.

Acute atrial fibrillation during dengue hemorrhagic fever

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Henrique Horta Veloso

Full Text Available Dengue fever is a viral infection transmitted by the mosquito, Aedes aegypti. Cardiac rhythm disorders, such as atrioventricular blocks and ventricular ectopic beats, appear during infection and are attributed to viral myocarditis. However, supraventricular arrhythmias have not been reported. We present a case of acute atrial fibrillation, with a rapid ventricular rate, successfully treated with intravenous amiodarone, in a 62-year-old man with dengue hemorrhagic fever, who had no structural heart disease.

Acute atrial fibrillation during dengue hemorrhagic fever

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Veloso Henrique Horta

2003-01-01

Full Text Available Dengue fever is a viral infection transmitted by the mosquito, Aedes aegypti. Cardiac rhythm disorders, such as atrioventricular blocks and ventricular ectopic beats, appear during infection and are attributed to viral myocarditis. However, supraventricular arrhythmias have not been reported. We present a case of acute atrial fibrillation, with a rapid ventricular rate, successfully treated with intravenous amiodarone, in a 62-year-old man with dengue hemorrhagic fever, who had no structural heart disease.

Alkhurma Hemorrhagic Fever in Saudi Arabia

Centers for Disease Control (CDC) Podcasts

2010-10-28

This podcast looks at the epidemiologic characteristics of Alkhurma Hemorrhagic Fever in humans in Najran City, Saudi Arabia. CDC epidemiologist Dr. Adam MacNeil discusses the severity and risk factors for the illness.  Created: 10/28/2010 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 11/17/2010.

NNDSS - Table II. Cryptosporidiosis to Dengue Hemorrhagic Fever

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U.S. Department of Health & Human Services — NNDSS - Table II. Cryptosporidiosis to Dengue Hemorrhagic Fever - 2014.In this Table, all conditions with a 5-year average annual national total of more than or...

Crimean-Congo hemorrhagic fever virus clades V and VI (Europe 1 and 2 in ticks in Kosovo, 2012.

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Kurtesh Sherifi

2014-09-01

Full Text Available Despite being a small country, Kosovo represents one of the few foci of Crimean-Congo hemorrhagic fever (CCHF in Europe. The distribution of Kosovar tick vectors and the evolution of CCHF virus in ticks are both as yet unknown. A better description of the extent and the genetic diversity of CCHFV in ticks from endemic settings is essential, in order to be controlled. We investigated the 2012 distribution of Kosovar ticks alongside the prevalence and the phylogeography of tick-derived CCHFV. Hyalomma marginatum dominated in the endemic municipalities with 90.2% versus 24.3% in the non-endemic regions. Of 1,102 tested ticks, 40 (3.6% were CCHFV-positive, belonging to H. marginatum (29, Rhipicephalus bursa (10, and Ixodes ricinus (1. The virus strains clustered with clade V and VI related sequences. They fell into two lineages: Kosovo I and II. Kosovo I comprised strains recovered exclusively from R. bursa ticks and was closely related to AP92 prototype strain. Kosovo II clustered into Kosovo IIa, including human-derived strains, and IIb including only strains detected in H. marginatum and I. ricinus. Our phylogeographic reconstruction suggests two temporally distinct CCHFV introductions: the most probable location of the most recent common ancestor of Kosovo I lineage was in Greece (63 years ago and that of lineages IIa-b in Turkey (35 years ago. After each CCHFV introduction into Kosovo, subsequent lineage expansions suggest periods of in situ evolution. The study provides the first insight into the genetic variability and the origin of CCHFV in ticks from Kosovo. Our findings indicate the spreading of CCHFV to non-endemic areas, which underlines the importance of further studies in order to monitor and predict future CCHF outbreaks in Kosovo. The AP92-like strains appear to be more widespread than previously thought and may provide a promising target for experimental studies due to their assumed low pathogenicity.

Ebola and Marburg Hemorrhagic Fevers: Neglected Tropical Diseases?

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MacNeil, Adam; Rollin, Pierre E.

2012-01-01

Ebola hemorrhagic fever (EHF) and Marburg hemorrhagic fever (MHF) are rare viral diseases, endemic to central Africa. The overall burden of EHF and MHF is small in comparison to the more common protozoan, helminth, and bacterial diseases typically referred to as neglected tropical diseases (NTDs). However, EHF and MHF outbreaks typically occur in resource-limited settings, and many aspects of these outbreaks are a direct consequence of impoverished conditions. We will discuss aspects of EHF and MHF disease, in comparison to the “classic” NTDs, and examine potential ways forward in the prevention and control of EHF and MHF in sub-Saharan Africa, as well as examine the potential for application of novel vaccines or antiviral drugs for prevention or control of EHF and MHF among populations at highest risk for disease. PMID:22761967

Immunological features underlying viral hemorrhagic fevers.

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Messaoudi, Ilhem; Basler, Christopher F

2015-10-01

Several enveloped RNA viruses of the arenavirus, bunyavirus, filovirus and flavivirus families are associated with a syndrome known as viral hemorrhagic fever (VHF). VHF is characterized by fever, vascular leakage, coagulation defects and multi organ system failure. VHF is currently viewed as a disease precipitated by viral suppression of innate immunity, which promotes systemic virus replication and excessive proinflammatory cytokine responses that trigger the manifestations of severe disease. However, the mechanisms by which immune dysregulation contributes to disease remain poorly understood. Infection of nonhuman primates closely recapitulates human VHF, notably Ebola and yellow fever, thereby providing excellent models to better define the immunological basis for this syndrome. Here we review the current state of our knowledge and suggest future directions that will better define the immunological mechanisms underlying VHF. Copyright © 2015 Elsevier Ltd. All rights reserved.

Dengue Hemorrhagic Fever: Epidemiology, Pathogenesis, and Its Transmission Risk Factors

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Aryu Candra

2010-12-01

Full Text Available Dengue hemorrhagic fever is an infectious disease resulting spectrum of clinical manifestations that vary from the lightest, dengue fever, hemorrhagic fever and dengue fever are accompanied by shock or dengue shock syndrome. Its caused by dengue virus, transmitted by Aedes mosquitoes. The case is spread in the tropics, especially in Southeast Asia, Central America, America and the Caribbean, many causes of death in children 90% of them attacking children under 15 years old. Until now pathogenesis is unclear. There are two theories or hypotheses immuno-patogenesis DHF and DSS is still controversial which secondary infections (secondary heterologus infection and antibody-dependent enhancement. Risk factors for dengue transmission are rapid urban population growth, mobilization of the population because of improved transportation facilities and disrupted or weakened so that population control. Another risk factor is poverty which result in people not has the ability to provide a decent home and healthy, drinking water supply and proper waste disposal.

Ebola hemorrhagic fever associated with novel virus strain, Uganda, 2007-2008.

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Wamala, Joseph F; Lukwago, Luswa; Malimbo, Mugagga; Nguku, Patrick; Yoti, Zabulon; Musenero, Monica; Amone, Jackson; Mbabazi, William; Nanyunja, Miriam; Zaramba, Sam; Opio, Alex; Lutwama, Julius J; Talisuna, Ambrose O; Okware, Sam I

2010-07-01

During August 2007-February 2008, the novel Bundibugyo ebolavirus species was identified during an outbreak of Ebola viral hemorrhagic fever in Bundibugyo district, western Uganda. To characterize the outbreak as a requisite for determining response, we instituted a case-series investigation. We identified 192 suspected cases, of which 42 (22%) were laboratory positive for the novel species; 74 (38%) were probable, and 77 (40%) were negative. Laboratory confirmation lagged behind outbreak verification by 3 months. Bundibugyo ebolavirus was less fatal (case-fatality rate 34%) than Ebola viruses that had caused previous outbreaks in the region, and most transmission was associated with handling of dead persons without appropriate protection (adjusted odds ratio 3.83, 95% confidence interval 1.78-8.23). Our study highlights the need for maintaining a high index of suspicion for viral hemorrhagic fevers among healthcare workers, building local capacity for laboratory confirmation of viral hemorrhagic fevers, and institutionalizing standard precautions.

[Present status of zoonotic hemorrhagic fevers of South America].

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Chastel, C

1993-01-01

Since 1958, the geographical distribution of Argentine hemorrhagic fever (AHF) has especially extended non only into the province of Buenos Aires but also towards the provinces of Santa Fe and Cordoba, leading to an estimated population at risk of about 1.2 M inhabitants. Recent epidemiological field studies has confirmed the major role of Calomys musculinus and C. laucha rodents in both transmission to man and conservation of Junin virus in nature. However, the human infection may result essentially from contacts with infected C. musculinus. Clinical condition of patients with AHF was greatly improved using AHF convalescent plasma and additional administration of vidarabin may still improve the results of treatment. A live attenuated vaccine, Candid No 1, is presently under evaluation in endemic foci of AHF. On the contrary Bolivian hemorrhagic fever (BHV) appears at present quite silent. A new disease resembling both AHF and BHF, the Venezuelan hemorrhagic fever, appeared in 1989 in the rural areas of central Llanos of Venezuela. The mortality was very high, reaching 23% or more among severely ill patients. The wild small rodents responsible for the disease were identified as Sigmodon alstoni and Zygotontomys brevicauda. Recent extension of agricultural practices and massive immigration may probably explain the recent emergence of this new viral zoonosis.

An outbreak of West Nile fever among migrants in Kisangani, Democratic Republic of Congo

NARCIS (Netherlands)

Y.A. Nur; J. Groen (Jan); H. Heuvelmans; W. Tuynman; C. Copra (Cederick); A.D.M.E. Osterhaus (Albert)

1999-01-01

textabstractIn February 1998, an outbreak of acute febrile illness was reported from the Kapalata military camp in Kisangani, the Democratic Republic of Congo. The illness was characterized by an acute onset of fever associated with severe headache, arthralgia, backache, neurologic

Renal Artery Embolization of Perirenal Hematoma in Hemorrhagic Fever with Renal Syndrome: A Case Report

International Nuclear Information System (INIS)

Choi, Hee Seok; Lee, Yong Seok; Lim, Ji Hyon; Kim, Kyung Soo; Yoon, Yup; Hwang, Jae Cheol

2007-01-01

Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease characterized by fever, hemorrhage and renal failure. Among the various hemorrhagic complications of HFRS, spontaneous rupture of the kidney and perirenal hematoma are very rare findings. We report here on a case of HFRS complicated by massive perirenal hematoma, and this was treated with transcatheter arterial embolization. Hemorrhagic fever with renal syndrome (HFRS) is an acute infectious disease caused by hantavirus. HFRS is clinically characterized by fever, renal failure and hemorrhage in organs such as lung, kidney, spleen and the pituitary gland. Renal medullary hemorrhage is a well-known complication in the kidney, but spontaneous rupture of the kidney and perirenal hematoma in HFRS is rare, and patients showing continuous bleeding and massive perirenal hematoma have often been surgically treated. We report here on a case of HFRS complicated by massive perirenal hematoma, and the patient was treated with transcatheter arterial embolization. In summary, spontaneous rupture of the kidney and perirenal hematoma is a rare complication of HFRS. We report here on a case of HFRS that caused massive perirenal hematoma, and this was treated with superselective renal artery embolization

Renal Artery Embolization of Perirenal Hematoma in Hemorrhagic Fever with Renal Syndrome: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Choi, Hee Seok; Lee, Yong Seok; Lim, Ji Hyon; Kim, Kyung Soo; Yoon, Yup [Dongguk University College of Medicine, Goyang (Korea, Republic of); Hwang, Jae Cheol [Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan (Korea, Republic of)

2007-08-15

Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease characterized by fever, hemorrhage and renal failure. Among the various hemorrhagic complications of HFRS, spontaneous rupture of the kidney and perirenal hematoma are very rare findings. We report here on a case of HFRS complicated by massive perirenal hematoma, and this was treated with transcatheter arterial embolization. Hemorrhagic fever with renal syndrome (HFRS) is an acute infectious disease caused by hantavirus. HFRS is clinically characterized by fever, renal failure and hemorrhage in organs such as lung, kidney, spleen and the pituitary gland. Renal medullary hemorrhage is a well-known complication in the kidney, but spontaneous rupture of the kidney and perirenal hematoma in HFRS is rare, and patients showing continuous bleeding and massive perirenal hematoma have often been surgically treated. We report here on a case of HFRS complicated by massive perirenal hematoma, and the patient was treated with transcatheter arterial embolization. In summary, spontaneous rupture of the kidney and perirenal hematoma is a rare complication of HFRS. We report here on a case of HFRS that caused massive perirenal hematoma, and this was treated with superselective renal artery embolization.

An outbreak of West Nile fever among migrants in Kisangani, Democratic Republic of Congo.

NARCIS (Netherlands)

Y.A. Nur; J. Groen (Jan); H. Heuvelmans; W. Tuynman; C. Copra (Cederick); A.D.M.E. Osterhaus (Albert)

1999-01-01

textabstractIn February 1998, an outbreak of acute febrile illness was reported from the Kapalata military camp in Kisangani, the Democratic Republic of Congo. The illness was characterized by an acute onset of fever associated with severe headache, arthralgia, backache, neurologic signs, abdominal

Investigation of hemorrhagic fever viruses inside wild populations of ticks: One of the pioneer studies in Saudi Arabia

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Rania Ali El Hadi Mohamed

2017-05-01

Full Text Available Objective: To screen hemorrhagic fever viruses inside wild populations of ticks collected from Riyadh, Saudi Arabia between January and March 2016. Methods: Ticks were identified depending on their morphological features using classical keys then grouped into pools. Ticks in each pool were processed separately using the sterile pestles and mortars. Viral RNA was extracted using Qiagen RNeasy Mini Kit and Qiagen RNAeasy Columns (Qiagen, Hilden, Germany according to the instructions of manufacturers. A total number of 1 282 hard ticks were collected, and 582 of them were precisely identified then screened for the presence of arboviruses using quantitative real-time PCR. The four species were screened for six viruses: Rift Valley fever virus (RVFV, Chikungunya virus (CHIKV, Crimean-Congo hemorrhagic fever virus (CCHFV, Alkhurma virus (INKV, Sindbis virus (SINV, and Pan Hanta virus (HANTA. CT value for the negative control (RNA free water was zero. Negative and positive controls were tested for each test to confirm the specificity of the selected primer pairs. SYBR Green One step RT-PCR Master Mix (KAPA Biosystems, Boston, MA was tested along with primers. Results: Ticks identification resulted into four species: Hyalomma schulzei, Hyalomma onatoli, Boophilus kdhlsi, and Hyalomm dromedarii. All the ticks’ species (except Boophilus kdhlsi were positive for the following viruses: SINV, RVFV, CHIKV, and CCHFV. While HANTA viruses have been detected in a single species (Hyalomm dromedarii. Conclusions: According to our knowledge this research may be one of the pioneer studies in Kingdom of Saudi Arabia. Incrimination of the above mentioned ticks species as well as their vectorial capacity are highly recommended for investigation in the upcoming researches.

Ebola hemorrhagic fever outbreaks: strategies for effective epidemic management, containment and control

OpenAIRE

Matua, Gerald Amandu; Wal, Dirk Mostert Van der; Locsin, Rozzano C.

2015-01-01

Ebola hemorrhagic fever, caused by the highly virulent RNA virus of the filoviridae family, has become one of the world's most feared pathogens. The virus induces acute fever and death, often associated with hemorrhagic symptoms in up to 90% of infected patients. The known sub-types of the virus are Zaire, Sudan, Taï Forest, Bundibugyo and Reston Ebola viruses. In the past, outbreaks were limited to the East and Central African tropical belt with the exception of Ebola Reston outbreaks that o...

CRIME CONGO HEMORHAGIC FEVER EPIDEMY: A PRELIMINARY REPORT OF ISFAHAN PROVINCE IN IRAN

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K MOSTAFAVIZADE

2002-03-01

Full Text Available Crimean-Congo hemorrhagic fever (CCHF is a viral disease of Buynaviridae family. Disease is primarily zoonosis but sporadic and epidemic human infection can occur. During year 2001 many outbreaks have been reported from Kosovo, Iran, Albania and Pakistan. A Hyalomma tick can transmit the disease and virus reservoirs are rodents, ostrich, ground frequenting birds and hyalomma tick. Another way of human infection is contact with infected animal blood and products or crushing a tick with bare hands. Contact with infected human blood can also transmit the disease. During outbreak, 18 cases were confirmed by serologic methods. 12 men and 6 women aged 20-40 years old. Ten of men and 5 of women had history of contact with infected animal blood or tissue and a lady had been bitten by a tick. A young assistant of internal medicine who came in contact with the first patient, developed the disease. We were not able to determine route of transmission in one case. The most frequent clinical signs included fever, myalgia, weakness, fatique, bleeding tendency, petechia, purpura and jundice. Lab exam revealed thrombocytopenia, elevated liver enzymes and prolongation of prothrombin time. Althoug the most common route of human infection is tick bite, but in this outbreak the main route was contact with infected animal blood and tissue. This point confirms that unsanitary slaughtering of animal could be dangerous. It seems that reeducating physicians, veterinarians and those who take care of such patients maybe helpful to neighboring countries triggered the outbreak, so that educating people who are involved in husbandry may limiting human infection.

Hospital-based surveillance for viral hemorrhagic fevers and hepatitides in Ghana.

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Joseph Humphrey Kofi Bonney

Full Text Available BACKGROUND: Viral hemorrhagic fevers (VHF are acute diseases associated with bleeding, organ failure, and shock. VHF may hardly be distinguished clinically from other diseases in the African hospital, including viral hepatitis. This study was conducted to determine if VHF and viral hepatitis contribute to hospital morbidity in the Central and Northern parts of Ghana. METHODOLOGY/PRINCIPAL FINDINGS: From 2009 to 2011, blood samples of 258 patients with VHF symptoms were collected at 18 hospitals in Ashanti, Brong-Ahafo, Northern, Upper West, and Upper East regions. Patients were tested by PCR for Lassa, Rift Valley, Crimean-Congo, Ebola/Marburg, and yellow fever viruses; hepatitis A (HAV, B (HBV, C (HCV, and E (HEV viruses; and by ELISA for serological hepatitis markers. None of the patients tested positive for VHF. However, 21 (8.1% showed anti-HBc IgM plus HBV DNA and/or HBsAg; 37 (14% showed HBsAg and HBV DNA without anti-HBc IgM; 26 (10% showed anti-HAV IgM and/or HAV RNA; and 20 (7.8% were HCV RNA-positive. None was positive for HEV RNA or anti-HEV IgM plus IgG. Viral genotypes were determined as HAV-IB, HBV-A and E, and HCV-1, 2, and 4. CONCLUSIONS/SIGNIFICANCE: VHFs do not cause significant hospital morbidity in the study area. However, the incidence of acute hepatitis A and B, and hepatitis B and C with active virus replication is high. These infections may mimic VHF and need to be considered if VHF is suspected. The data may help decision makers to allocate resources and focus surveillance systems on the diseases of relevance in Ghana.

Serological evaluation of Crimean-Congo hemorrhagic fever in humans with high-risk professions living in enzootic regions of Isfahan province of Iran and genetic analysis of circulating strains.

Science.gov (United States)

Chinikar, Sadegh; Ghiasi, Seyed M; Naddaf, Saeed; Piazak, Norair; Moradi, Maryam; Razavi, Mohammad R; Afzali, Neda; Haeri, Ali; Mostafavizadeh, Kamyar; Ataei, Behrouz; Khalilifard-Brojeni, Mohammad; Husseini, Sayed M; Bouloy, Michele

2012-09-01

Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic viral disease that is asymptomatic in infected livestock, but causes a serious threat to humans with a mortality rate up to 50%. Although the CCHF virus (CCHFV) is often transmitted by ticks, livestock-to-human and human-to-human transmission also occurs. In the current study, we focused on CCHF in the province of Isfahan, located in the center of Iran and deemed to be the second most infected province. Human and livestock sera and resident ticks in the livestock are collected from different regions of the province and analyzed with specific IgG ELISA and RT-PCR tests. Overall, 12% and 12.7% of studied human and livestock populations were IgG positive, respectively. The genome of CCHFV was detected in 9% of ticks resident in livestock involved in this survey. The CCHFV isolates from infected ticks were genetically examined. Nucleotide sequence of the S-segment revealed that the different isolates were closely related to each other, with nucleotide sequence identities higher than 98%. Phylogenetic analysis demonstrated that a variant isolate clustered with the Iraq strain. This high proportion of IgG-positive sera and nearly high proportion of infected ticks increases the risk of CCHF outbreaks in the province and probably posits a great danger to other provinces.

Hemorrhagic Fever Caused by a Novel Bunyavirus in China: Pathogenesis and Correlates of Fatal Outcome

NARCIS (Netherlands)

Zhang, Yong-Zhen; He, Yong-Wen; Dai, Yong-An; Xiong, Yanwen; Zheng, Han; Zhou, Dun-Jin; Li, Juan; Sun, Qiangzheng; Luo, Xue-Lian; Cheng, Yu-Li; Qin, Xin-Cheng; Tian, Jun-Hua; Chen, Xiao-Ping; Yu, Bin; Jin, Dong; Guo, Wen-Ping; Li, Wei; Wang, Wen; Peng, Jin-Song; Zhang, Guo-Bin; Zhang, Shaomin; Chen, Xiao-Min; Wang, Yan; Li, Ming-Hui; Li, Zhenjun; Lu, Shan; Ye, Changyun; de Jong, Menno D.; Xu, Jianguo

2012-01-01

Background. Hemorrhagic fever-like illness caused by a novel Bunyavirus, Huaiyangshan virus (HYSV, also known as Severe Fever with Thrombocytopenia virus [SFTSV] and Fever, Thrombocytopenia and Leukopenia Syndrome [FTLS]), has recently been described in China. Methods. Patients with

[Clinical picture of hemorrhagic fever with renal syndrome in Croatia].

Science.gov (United States)

Kuzman, Ilija

2003-01-01

Among many viral hemorrhagic fevers, only hemorrhagic fever with renal syndrome (HFRS) occurs in Croatia. HFRS is a natural focus zoonosis with sudden onset, characterized by high fever and other clinical symptoms, renal insufficiency and hemorrhages. In Croatia, HFRS is caused by two types of hantaviruses--Puumala (PUU) and Dobrava (DOB). The basic pathologic and patophysiologic disorder in HFRS is capillary damage (vasculitis). Incubation of HFRS has not been precisely determined, it is most frequently around two weeks. The disease onset is usually abrupt. At the beginning, general symptoms include high fever and myalgias, especially in the lumbar region, and abdominal pain, as well as strong headaches, malaise and nausea, and often vomiting or diarrhea. In half of the patients respiratory symptoms occur. Later on, some patients may experience hypotension, oliguria and other signs of renal failure, and apart from petechial, severe hemorrhages may also occur in other organs. During typical clinical presentation of the disease, some characteristic symptoms are clearly distinguished in particular stages of the disease. Therefore, the course of HFRS is usually divided into five distinct stages (febrile, hypotensive, oliguric, polyuric and convalescent). Such a course of the disease is more commonly present in case of DOB virus than PUU virus infection. The febrile stage with sudden onset usually lasts from 3 to 7 days, when thrombocytopenia and hemoconcentration, as well as albuminuria and hematuria are almost always recorded. The hypotensive stage lasts from one to 2 days on an average and is characterized by lower blood pressure and signs of renal failure. The oliguric stage usually starts at the beginning of the second week of the disease, when extensive hemorrhage may occur and urea and creatinine reach their highest values. The oliguric stage is followed by the polyuric stage which can last for up to two weeks, and is characterized by excretion of a large

Vaccines against viral hemorrhagic fevers: non-human primate models.

Science.gov (United States)

Carrion, Ricardo; Patterson, Jean L

2011-06-01

Viral hemorrhagic fevers are a group of disease syndromes caused by infection with certain RNA viruses. The disease is marked by a febrile response, malaise, coagulopathy and vascular permeability culminating in death. Case fatality rates can reach 90% depending on the etiologic agent. Currently, there is no approved antiviral treatment. Because of the high case fatality, risk of importation and the potential to use these agents as biological weapons, development of countermeasures to these agents is a high priority. The sporadic nature of disease outbreaks and the ethical issues associated with conducting a human trial for such diseases make human studies impractical; therefore, development of countermeasures must occur in relevant animal models. Non-human primates are superior models to study infectious disease because their immune system is similar to humans and they are good predictors of efficacy in vaccine development and other intervention strategies. This review article summarizes viral hemorrhagic fever non-human primate models.

Epidemiologic characteristics and military implications of hemorrhagic fever with renal syndrome in croatia.

Science.gov (United States)

Mulić, Rosanda; Ropac, Darko

2002-10-01

To analyze epidemiologic characteristics of hemorrhagic fever with renal syndrome in Croatia, including military implications of the disease and measures for its prevention. We analyzed data from obligatory infectious disease reports and notification of deaths due to infectious diseases, data on the hemorrhagic fever with renal syndrome epidemics in Croatia, and data collected by survey of the population, serological findings, and studies of wild rodents serving as reservoirs of the infection. During the 1987-2001 period, 235 cases of hemorrhagic fever with renal syndrome were recorded in Croatia, with 147 (62.6%) of them among Croatian Army soldiers. Mortality rate was up to 15.4% (mean 2.2%) (5/235). The highest number of cases was recorded in months of June and July, ie, during the warm season characterized by increased activity of both the animals acting as infection reservoirs and humans as hosts. The known natural foci of hemorrhagic fever with renal syndrome have been Plitvice and Slunj areas, Velika and Mala Kapela mountains, Zagreb area (Velika Gorica and Jastrebarsko), west Slavonia, Novska area, and Dinara Mountain. The disease has not been recorded in the littoral area and Adriatic islands. The identified causative agents include Dobrava and Puumala viruses of the genus Hantavirus, whereas rodents Clethrionomys glareolus, Apodemus flavicollis, Apodemus agrarius, and Apodemus sylvaticus serve as the main reservoirs of the infection. Typical biotopes of the infection in Croatia are deciduous woods. The measures of prevention in Croatia include pest control, disinfection, hygienic waste disposal, preventing rodent access to food and water, proper choice of camping sites, and health education. Hemorrhagic fever with renal syndrome occurs predominantly in soldiers, in a sporadic or epidemic form. Because of the course of disease and potentially lethal outcome, the disease has a considerable impact on the field task performance and combat readiness of

Small molecule inhibitors of ER α-glucosidases are active against multiple hemorrhagic fever viruses.

Science.gov (United States)

Chang, Jinhong; Warren, Travis K; Zhao, Xuesen; Gill, Tina; Guo, Fang; Wang, Lijuan; Comunale, Mary Ann; Du, Yanming; Alonzi, Dominic S; Yu, Wenquan; Ye, Hong; Liu, Fei; Guo, Ju-Tao; Mehta, Anand; Cuconati, Andrea; Butters, Terry D; Bavari, Sina; Xu, Xiaodong; Block, Timothy M

2013-06-01

Host cellular endoplasmic reticulum α-glucosidases I and II are essential for the maturation of viral glycosylated envelope proteins that use the calnexin mediated folding pathway. Inhibition of these glycan processing enzymes leads to the misfolding and degradation of these viral glycoproteins and subsequent reduction in virion secretion. We previously reported that, CM-10-18, an imino sugar α-glucosidase inhibitor, efficiently protected the lethality of dengue virus infection of mice. In the current study, through an extensive structure-activity relationship study, we have identified three CM-10-18 derivatives that demonstrated superior in vitro antiviral activity against representative viruses from four viral families causing hemorrhagic fever. Moreover, the three novel imino sugars significantly reduced the mortality of two of the most pathogenic hemorrhagic fever viruses, Marburg virus and Ebola virus, in mice. Our study thus proves the concept that imino sugars are promising drug candidates for the management of viral hemorrhagic fever caused by variety of viruses. Copyright © 2013 Elsevier B.V. All rights reserved.

Non-fatal case of Crimean-Congo haemorrhagic fever imported into the United Kingdom (ex Bulgaria), June 2014.

Science.gov (United States)

Lumley, S; Atkinson, B; Dowall, Sd; Pitman, Jk; Staplehurst, S; Busuttil, J; Simpson, Aj; Aarons, Ej; Petridou, C; Nijjar, M; Glover, S; Brooks, Tj; Hewson, R

2014-07-31

Crimean-Congo haemorrhagic fever (CCHF) was diagnosed in a United Kingdom traveller who returned from Bulgaria in June 2014. The patient developed a moderately severe disease including fever, headaches and petechial rash. CCHF was diagnosed following identification of CCHF virus (CCHFV) RNA in a serum sample taken five days after symptom onset. Sequence analysis of the CCHFV genome showed that the virus clusters within the Europe 1 clade, which includes viruses from eastern Europe.

GEOSPATIAL ANALYSIS OF URBAN LAND USE PATTERN ANALYSIS FOR HEMORRHAGIC FEVER RISK – A REVIEW

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L. N. Izzah

2016-09-01

Full Text Available Human modification of the natural environment continues to create habitats in which vectors of a wide variety of human and animal pathogens (such as Plasmodium, Aedes aegypti, Arenavirus etc. thrive if unabated with an enormous potential to negatively affect public health. Typical examples of these modifications include impoundments, dams, irrigation systems, landfills and so on that provide enabled environment for the transmission of Hemorrhagic fever such as malaria, dengue, avian flu, Lassa fever etc. Furthermore, contemporary urban dwelling pattern appears to be associated with the prevalence of Hemorrhagic diseases in recent years. These observations are not peculiar to the developing world, as urban expansion also contributes significantly to mosquito and other vectors habitats. This habitats offer breeding ground to some vector virus populations. The key to disease control is developing an understanding of the contribution of human landscape modification to vector-borne pathogen transmission and how a balance may be achieved between human development, public health, and responsible urban land use. A comprehensive review of urban land use Pattern Analysis for Hemorrhagic fever risk has been conducted in this paper. The study found that most of the available literatures dwell more on the impact of urban land use on malaria and dengue fevers; however, studies are yet to be found discussing the implications of urban land use on the risk of Ebola, Lassa and other non-mosquito borne VHFs. A relational model for investigating the influence of urban land use change pattern on the risk of Hemorrhagic fever has been proposed in this study.

Hemorrhagic Fever with Renal Syndrome (Korean Hemorrhagic Fever).

Science.gov (United States)

1986-07-23

fever , chills, nausea, headache and muscle ache in July 1985. One day after admission he developed petechial haemorrhage over his body and limbs and in...ftOA179 565 NENORNAGIC FEVER WI TH RENAL SYNDOMNE (KOREAN HEMORRHAIC FEVER )(U) KOREN UNIV SEOUL COLL OF MEDICINE N N LEE 23 JUL " DAD7-94-G-4616...34,, , " S , S S .S =. 5 5 . S S S * B M Lfl IC) uIeuCc FVM WITH RENAL SYNDR~OME (KOREAN EMORRHAGIC FEVER ) ANNUAL AND FINAL REPORT S HO WANG LIZB N.D. 5

MassTag Polymerase Chain Reaction for Differential Diagnosis of Viral Hemorrhagic Fevers

National Research Council Canada - National Science Library

Palacios, Gustavo; Briese, Thomas; Kapoor, Vishal; Jabado, Omar; Liu, Zhiqiang; Venter, Marietjie; Zhai, Junhui; Renwick, Neil; Grolla, Allen; Geisbert, Thomas W; Drosten, Christian; Towner, Johnathan; Ju, Jingyue; Paweska, Janusz; Nichol, Stuart T; Swanepel, Robert; Feldmann, Heinz; Jahrling, Peter B; Lipkin, W. I

2006-01-01

Viral hemorrhagic fevers are associated with high rates of illness and death. Although therapeutic options are limited, early differential diagnosis has implications for containment and may aid in clinical management...

Hemodynamics in Korean Hemorrhagic Fever

International Nuclear Information System (INIS)

Han, Ji Young; Lee, Jung Sang; Koh, Chang Soon; Lee, Mun Ho

1974-01-01

The author in an attempt to evaluate hemodynamic changes in the clinical stages of Korean hemorrhagic fever measured plasma volume, cardiac output and effective renal plasma flow utilizing radioisoto as during various phases of the disease. Cardiac output was measured by radiocardiography with external monitoring method using RIHSA. Effective renal plasma flow was obtained from blood clearance curve drawn by external monitoring after radiohippuran injection according to the method described by Razzak et al. The study was carried out in thirty-eight cases of Korean hemorrhagic fever and the following conclusions were obtained. 1) Plasma volume was increased in the patients during the oliguric and hypertensive-diuretic phases, while it was normal in the patients during the normotensive-diuretic phase. 2) Cardiac index was increased in the patients during the oliguric phase and was slightly increased in the patients at the hypertensive diuretic phase. It was normal in the other phases. 3) Total peripheral resistance was increased in the hypertensive patients during diuretic phase, while it was normal in the rest of phases. 4) Effective renal plasma flow was significantly reduced in the patients during the oliguric and diuretic phases as well as at one month after the oliguric onset. There was no significant difference between the oliguric and the early diuretic phases. Renal plasma flow in the group of patients at one month after the oliguric onset was about 45% of the normal, however, it returned to normal level at six months after the onset. 5) Clinical syndrome of relative hypervolemia was observed in some patients during the oliguric phase or hypertensive diuretic phase. Characteristic hemodynamic findings were high cardiac output and normal to relatively increased peripheral resistance these cases. Relatively increased circulating blood volumes due to decreased effective vascular space was suggested for the mechanism of relative hypervolemia. 6) Cardiac

Yellow Fever Outbreak - Kongo Central Province, Democratic Republic of the Congo, August 2016.

Science.gov (United States)

Otshudiema, John O; Ndakala, Nestor G; Mawanda, Elande-Taty K; Tshapenda, Gaston P; Kimfuta, Jacques M; Nsibu, Loupy-Régence N; Gueye, Abdou S; Dee, Jacob; Philen, Rossanne M; Giese, Coralie; Murrill, Christopher S; Arthur, Ray R; Kebela, Benoit I

2017-03-31

On April 23, 2016, the Democratic Republic of the Congo's (DRC's) Ministry of Health declared a yellow fever outbreak. As of May 24, 2016, approximately 90% of suspected yellow fever cases (n = 459) and deaths (45) were reported in a single province, Kongo Central Province, that borders Angola, where a large yellow fever outbreak had begun in December 2015. Two yellow fever mass vaccination campaigns were conducted in Kongo Central Province during May 25-June 7, 2016 and August 17-28, 2016. In June 2016, the DRC Ministry of Health requested assistance from CDC to control the outbreak. As of August 18, 2016, a total of 410 suspected yellow fever cases and 42 deaths were reported in Kongo Central Province. Thirty seven of the 393 specimens tested in the laboratory were confirmed as positive for yellow fever virus (local outbreak threshold is one laboratory-confirmed case of yellow fever). Although not well-documented for this outbreak, malaria, viral hepatitis, and typhoid fever are common differential diagnoses among suspected yellow fever cases in this region. Other possible diagnoses include Zika, West Nile, or dengue viruses; however, no laboratory-confirmed cases of these viruses were reported. Thirty five of the 37 cases of yellow fever were imported from Angola. Two-thirds of confirmed cases occurred in persons who crossed the DRC-Angola border at one market city on the DRC side, where ≤40,000 travelers cross the border each week on market day. Strategies to improve coordination between health surveillance and cross-border trade activities at land borders and to enhance laboratory and case-based surveillance and health border screening capacity are needed to prevent and control future yellow fever outbreaks.

[EBOLA HEMORRHAGIC FEVER: DIAGNOSTICS, ETIOTROPIC AND PATHOGENETIC THERAPY, PREVENTION].

Science.gov (United States)

Zhdanov, K V; Zakharenko, S M; Kovalenko, A N; Semenov, A V; Fisun, A Ya

2015-01-01

The data on diagnostics, etiotropic and pathogenetic therapy, prevention of Ebola hemorrhagic fever are presented including diagnostic algorithms for different clinical situations. Fundamentals of pathogenetic therapy are described. Various groups of medications used for antiviral therapy of conditions caused by Ebola virus are characterized. Experimental drugs at different stages of clinical studies are considered along with candidate vaccines being developed for the prevention of the disease.

Thyroid Hormones and Thyroid Function status in each clinical phase of Korean Hemorrhagic Fever

International Nuclear Information System (INIS)

Shin, Young Tae; Jeon, Byung Sook; Yoon, Sung Yeul; Lee, Houn Young; Kim, Sam Yong; Ro, Heung Kyu

1983-01-01

Fifteen cases of Korean hemorrhagic fever who were admitted Chungnam National University Hospital from October 1981 to December 1981 were analysed on the evaluation of metabolic changes of the thyroid hormones, and thyroid function status in each clinical phase. 1) Serum T 3 , T 4 concentration, FT 4 I and T 4 /TBG ratio were significantly lower (p 4 , TSH and TBG concentration were within normal range in all phase of KHF. Thus in Korean hemorrhagic fever, euthyroidism is probably maintained by normal or elevated serum FT 4 . 2) T 4 /T 3 and rT 3 /T 3 ratio (p 4 to T 3 in oliguric and early diuretic phase.

History of U.S. Military Contributions to the Study of Viral Hemorrhagic Fevers

National Research Council Canada - National Science Library

Thomas, Stephen J; Lawler, James V; Endy, Timothy P

2005-01-01

.... The characteristics of the viral hemorrhagic fever viruses as arthropod or rodent-borne viruses that can result in human illnesses with high morbidity and mortality rates make these viruses a unique...

Early markers of blood coagulation and fibrinolysis activation in Argentine hemorrhagic fever

NARCIS (Netherlands)

Heller, M. V.; Marta, R. F.; Sturk, A.; Maiztegui, J. I.; Hack, C. E.; Cate, J. W.; Molinas, F. C.

1995-01-01

Junin virus, an arenaviridae, is the etiological agent of Argentine hemorrhagic fever. In addition to thrombocytopenia, patients present several alterations in both the blood coagulation and the fibrinolytic system, but diffuse intravascular coagulation could not be demonstrated. To investigate

Crimean-Congo haemorrhagic fever virus infection in birds: field investigations in Senegal.

Science.gov (United States)

Zeller, H G; Cornet, J P; Camicas, J L

1994-01-01

In Senegal, wild ground-feeding birds are frequently infested with immature ticks. In two areas where numerous Crimean-Congo haemorrhagic fever (CCHF) virus isolations were obtained from Hyalomma marginatum rufipes adult ticks collected on ungulates, 175 birds were captured and sera collected. CCHF antibodies were detected by ELISA in 6/22 red-beaked hornbills (Tockus erythrorhynchus), 2/11 glossy starlings (Lamprotornis sp.) and 1/3 guinea fowls. The virus was isolated from H. m. rufipes nymphs collected on a hornbill. The role of wild ground-feeding birds in CCHF virus ecology in West Africa is discussed.

Changes of Pituitary Hormones after Injection of Naloxone in the Hypotensive Phase of Korean Hemorrhagic Fever

Energy Technology Data Exchange (ETDEWEB)

Lim, Sang Moo; Cho, Bo Youn; Lee, Hong Gyu; Lee, Jung Sang; Koh, Chang Soon [Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Byung Tae [Hallym Medical College, Seoul (Korea, Republic of)

1986-09-15

The opiate antagonist, naloxone, was injected for the reversal of hypotension due to Korean hemorrhagic fever, and the authors observed changes in pituitary hormones. In the hypotensive phase of the Korean hemorrhagic fever, the beta-endorphin was high, and normalized gradually in the diuretic and convalescent period. The naloxone raised the pulse rate and the blood pressure within 30 minutes without change in the central venous pressure. Around 30 minuted after the injection of the naloxone, the beta-endorphin, ACTH and cortisol rose. The prolactin fell down 60 minutes after the naloxone injection.

Ebola hemorrhagic Fever: novel biomarker correlates of clinical outcome.

Science.gov (United States)

McElroy, Anita K; Erickson, Bobbie R; Flietstra, Timothy D; Rollin, Pierre E; Nichol, Stuart T; Towner, Jonathan S; Spiropoulou, Christina F

2014-08-15

Ebola hemorrhagic fever (EHF) outbreaks occur sporadically in Africa and result in high rates of death. The 2000-2001 outbreak of Sudan virus-associated EHF in the Gulu district of Uganda led to 425 cases, of which 216 were laboratory confirmed, making it the largest EHF outbreak on record. Serum specimens from this outbreak had been preserved in liquid nitrogen from the time of collection and were available for analysis. Available samples were tested using a series of multiplex assays to measure the concentrations of 55 biomarkers. The data were analyzed to identify statistically significant associations between the tested biomarkers and hemorrhagic manifestations, viremia, and/or death. Death, hemorrhage, and viremia were independently associated with elevated levels of several chemokines and cytokines. Death and hemorrhage were associated with elevated thrombomodulin and ferritin levels. Hemorrhage was also associated with elevated levels of soluble intracellular adhesion molecule. Viremia was independently associated with elevated levels of tissue factor and tissue plasminogen activator. Finally, samples from nonfatal cases had higher levels of sCD40L. These novel associations provide a better understanding of EHF pathophysiology and a starting point for researching new potential targets for therapeutic interventions. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Is the epidemiology of alkhurma hemorrhagic fever changing?: A three-year overview in Saudi Arabia.

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Ziad A Memish

Full Text Available BACKGROUND: The epidemiology of Alkhurma hemorrhagic fever disease is yet to be fully understood since the virus was isolated in 1994 in the Kingdom of Saudi Arabia. SETTING: Preventive Medicine department, Ministry of Health, Kingdom of Saudi Arabia. DESIGN: Retrospective analysis of all laboratory confirmed cases of Alkhurma hemorrhagic fever disease collected through active and passive surveillance from 1(st-January 2009 to December, 31, 2011. RESULTS: Alkhurma hemorrhagic fever (AHFV disease increased from 59 cases in 2009 to 93 cases in 2011. Cases are being discovered outside of the region where it was initially diagnosed in Saudi Arabia. About a third of cases had no direct contact with animals or its products. Almost all cases had gastro-intestinal symptoms. Case fatality rate was less than 1%. CONCLUSIONS: Findings in this study showed the mode of transmission of AHFV virus may not be limited to direct contact with animals or its products. Gastro-intestinal symptoms were not previously documented. Observed low case fatality rate contradicted earlier reports. Close monitoring of the epidemiology of AHFV is recommended to aid appropriate diagnosis. Housewives are advised to wear gloves when handling animals and animal products as a preventive measure.

Protective Role of Cytotoxic T Lymphocytes in Filovirus Hemorrhagic Fever

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Kelly Lyn Warfield

2011-01-01

Full Text Available Infection with many emerging viruses, such as the hemorrhagic fever disease caused by the filoviruses, Marburg (MARV, and Ebola virus (EBOV, leaves the host with a short timeframe in which to mouse a protective immune response. In lethal cases, uncontrolled viral replication and virus-induced immune dysregulation are too severe to overcome, and mortality is generally associated with a lack of notable immune responses. Vaccination studies in animals have demonstrated an association of IgG and neutralizing antibody responses against the protective glycoprotein antigen with survival from lethal challenge. More recently, studies in animal models of filovirus hemorrhagic fever have established that induction of a strong filovirus-specific cytotoxic T lymphocyte (CTL response can facilitate complete viral clearance. In this review, we describe assays used to discover CTL responses after vaccination or live filovirus infection in both animal models and human clinical trials. Unfortunately, little data regarding CTL responses have been collected from infected human survivors, primarily due to the low frequency of disease and the inability to perform these studies in the field. Advancements in assays and technologies may allow these studies to occur during future outbreaks.

Genistein, a general kinase inhibitor, as a potential antiviral for arenaviral hemorrhagic fever as described in the Pirital virus-Syrian golden hamster model.

Science.gov (United States)

Vela, Eric M; Knostman, Katherine A; Mott, Jason M; Warren, Richard L; Garver, Jennifer N; Vela, Lela Johnson; Stammen, Rachelle L

2010-09-01

Arenaviruses are rodent-borne negative strand RNA viruses and infection of these viruses in humans may result in disease and hemorrhagic fever. To date, supportive care, ribavirin, and in some cases immune plasma remain the foremost treatment options for arenaviral hemorrhagic fever. Research with the hemorrhagic fever causing-arenaviruses usually requires a Biosafety level (BSL)-4 environment; however, surrogate animal model systems have been developed to preliminarily study and screen various vaccines and antivirals. The Syrian golden hamster-Pirital virus (PIRV) surrogate model of hemorrhagic fever provides an opportunity to test new antivirals in an ABSL-3 setting. Thus, we challenged hamsters, implanted with telemetry, with PIRV and observed viremia and tissue viral titers, and changes in core body temperature, hematology, clinical chemistry, and coagulation parameters. Physical signs of disease of the PIRV-infected hamsters included weight loss, lethargy, petechial rashes, epistaxis, ocular orbital and rectal hemorrhage, and visible signs of neurologic disorders. However, treating animals with genistein, a plant derived isoflavone and general kinase inhibitor, resulted in increased survival rates and led to an improved clinical profile. In all, the results from this study demonstrate the potential of a general kinase inhibitor genistein as an antiviral against arenaviral hemorrhagic fever. 2010 Elsevier B.V. All rights reserved.

Seroepidemiological study of Crimean-Congo haemorrhagic fever in Greece, 2009-2010.

Science.gov (United States)

Sidira, P; Maltezou, H C; Haidich, A-B; Papa, A

2012-02-01

To estimate endemic areas for Crimean-Congo haemorrhagic fever (CCHF) in Greece, a country-wide seroepidemiological study was conducted, and 1611 human sera were prospectively collected along with data regarding possible risk factors for acquisition of infection, and tested for CCHF virus IgG antibodies by ELISA. The overall seroprevalence was 4.2%, with significant differences among prefectures, ranging from 0 to 27.5%. Multivariate analysis revealed that slaughtering and agricultural activities were significant risk factors for CCHFV seropositivity. The significantly high seroprevalence in specific prefectures, together with the extremely low number of CCHF cases, suggest that this phenomenon might be strain-related. © 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases.

Simian Hemorrhagic Fever Virus Cell Entry Is Dependent on CD163 and Uses a Clathrin-Mediated Endocytosis-Like Pathway

OpenAIRE

Caì, Yíngyún; Postnikova, Elena N.; Bernbaum, John G.; Yú, Shuǐqìng; Mazur, Steven; Deiuliis, Nicole M.; Radoshitzky, Sheli R.; Lackemeyer, Matthew G.; McCluskey, Adam; Robinson, Phillip J.; Haucke, Volker; Wahl-Jensen, Victoria; Bailey, Adam L.; Lauck, Michael; Friedrich, Thomas C.

2014-01-01

Simian hemorrhagic fever virus (SHFV) causes a severe and almost uniformly fatal viral hemorrhagic fever in Asian macaques but is thought to be nonpathogenic for humans. To date, the SHFV life cycle is almost completely uncharacterized on the molecular level. Here, we describe the first steps of the SHFV life cycle. Our experiments indicate that SHFV enters target cells by low-pH-dependent endocytosis. Dynamin inhibitors, chlorpromazine, methyl-β-cyclodextrin, chloroquine, and concanamycin A ...

A case of acute liver failure in dengue hemorrhagic fever

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Rama Biswas

2013-07-01

Full Text Available Dengue is an arboviral disease endemic in many parts of the world. The clinical presentation of dengue viral infection ranges from asymptomatic illness to fatal dengue shock syndrome. Although, it is known to cause hepatic involvement, it occasionally results in acute hepatic failure. We report a case of dengue hemorrhagic fever presenting with acute liver failure. The case recovered completely after treatment. Ibrahim Med. Coll. J. 2013; 7(2: 41-42

First reported chikungunya fever outbreak in the republic of Congo, 2011.

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Nanikaly Moyen

Full Text Available Chikungunya is an Aedes -borne disease characterised by febrile arthralgia and responsible for massive outbreaks. We present a prospective clinical cohort study and a retrospective serological study relating to a CHIK outbreak, in the Republic of Congo in 2011.We analysed 317 suspected cases, of which 308 (97.2% lived in the city of Brazzaville (66.6% in the South area. Amongst them, 37 (11.7% were CHIKV+ve patients (i.e., biologically confirmed by a real-time RT-PCR assay, of whom 36 (97.3% had fever, 22 (66.7% myalgia and 32 (86.5% arthralgia. All tested negative for dengue. The distribution of incident cases within Brazzaville districts was compared with CHIKV seroprevalence before the outbreak (34.4% in 517 blood donors, providing evidence for previous circulation of CHIKV. We applied a CHIK clinical score to 126 patients recruited within the two first day of illness (including 28 CHIKV+ves (22.2% with sensitivity (78.6% and specificity (72.4% values comparing with those of the referent study in Reunion Island. The negative predictive value was high (92%, but the positive predictive value (45% indicate poor potential contribution to medical practice to identify CHIKV+ve patients in low prevalence outbreaks. However, the score allowed a slightly more accurate follow-up of the evolution of the outbreak than the criterion "fever+arthralgia". The complete sequencing of a Congolase isolate (Brazza_MRS1 demonstrated belonging to the East/Central/South African lineage and was further used for producing a robust genome-scale CHIKV phylogenetic analysis.We describe the first Chikungunya outbreak declared in the Republic of Congo. The seroprevalence study conducted amongst blood donors before outbreak provided evidence for previous CHIKV circulation. We suggest that a more systematic survey of the entomological situation and of arbovirus circulation is necessary in Central Africa for better understanding the environmental, microbiological and

Pathogenic Mechanisms Involved in the Hematological Alterations of Arenavirus-induced Hemorrhagic Fevers

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Roberto G. Pozner

2013-01-01

Full Text Available Viral hemorrhagic fevers (VHFs caused by arenaviruses are acute diseases characterized by fever, headache, general malaise, impaired cellular immunity, eventual neurologic involvement, and hemostatic alterations that may ultimately lead to shock and death. The causes of the bleeding are still poorly understood. However, it is generally accepted that these causes are associated to some degree with impaired hemostasis, endothelial cell dysfunction and low platelet counts or function. In this article, we present the current knowledge about the hematological alterations present in VHF induced by arenaviruses, including new aspects on the underlying pathogenic mechanisms.

Hiding the evidence: two strategies for innate immune evasion by hemorrhagic fever viruses.

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Hastie, Kathryn M; Bale, Shridhar; Kimberlin, Christopher R; Saphire, Erica Ollmann

2012-04-01

The innate immune system is one of the first lines of defense against invading pathogens. Pathogens have, in turn, evolved different strategies to counteract these responses. Recent studies have illuminated how the hemorrhagic fever viruses Ebola and Lassa fever prevent host sensing of double-stranded RNA (dsRNA), a key hallmark of viral infection. The ebolavirus protein VP35 adopts a unique bimodal configuration to mask key cellular recognition sites on dsRNA. Conversely, the Lassa fever virus nucleoprotein actually digests the dsRNA signature. Collectively, these structural and functional studies shed new light on the mechanisms of pathogenesis of these viruses and provide new targets for therapeutic intervention. Copyright © 2012. Published by Elsevier B.V.

Phylogenetic analysis in a recent controlled outbreak of Crimean-Congo haemorrhagic fever in the south of Iran, December 2008

DEFF Research Database (Denmark)

Chinikar, S; Ghiasi, Seyed Mojtaba; Mojtaba Ghiasi, S

2010-01-01

Crimean-Congo haemorrhagic fever (CCHF) is a viral zoonotic disease with a high mortality rate in humans. The CCHF virus is transmitted to humans through the bite of Ixodid ticks or contact with blood or tissues of CCHF patients or infected livestock. In December 2008, a re-emerging outbreak...... of CCHF occurred in the southern part of Iran. Five people were hospitalised with sudden fever and haemorrhaging, and CCHF was confirmed by RT-PCR and serological assays. One of the cases had a fulminant course and died. Livestock was identified as the source of infection; all animals in the incriminated...

Ribavirin: an effective treatment of crimean-congo hemorrhagic fever

International Nuclear Information System (INIS)

Sheikh, A.S.

2004-01-01

Objective: To determine the efficiency of Ribavirin, an anti-viral drug, in patients diagnosed to have CCHF. Patients and Methods: A total of 94 cases were included in the study on high index of suspicion of CCHF. The major criteria of admission were a short history of high-grade fever associated with bleeding from more than one site, i.e., haematemesis, epistaxis etc. the mean age was 34.71 plus minus 12.81 years. All the suspected cases were kept in isolation unit of the hospital and barrier nursing was advised. Results: All the 94 cases were sent to CDC, Atlanta, USA for confirmation and 39 (41.4%) were confirmed to have CCHF. Symptomatic treatment like platelet concentration transfusions, fresh-blood transfusions and antipyretics were given to all cases. Oral Ribavirin was given only to the confirmed cases. It was started in a dose of 2 gm initially, followed by 1 gm 6 hourly for 4 days and then 500 mg 8 hours for 6 days. After a mean period of 2.30 plus minus 0.69 days to treatment with Ribavirin, the clinical as well as the laboratory parameters started improving and returned to normal level after 10 -day course of treatment. Mild anemia and thrombocytosis were seen as adverse effects in some of the patients. Conclusion: For treatment of this fatal disease, we recommended use of oral Ribavirin in all patients diagnosed to have CCHF in the above-mentioned doses, on the basis of our study results.(author)

Severe Crimean-Congo haemorrhagic fever presented with massive retroperitoneal haemorrhage that recovered without antiviral treatment

DEFF Research Database (Denmark)

Gharabaghi, Mehrnaz Asadi; Chinikar, Sadegh; Ghiasi, Seyyed Mojtaba

2011-01-01

Crimean-Congo haemorrhagic fever (CCHF) is a tickborne viral zoonosis with up to 50% mortality in humans caused by CCHF virus belonging to the genus Nairovirus, family Bunyaviridae. The geographical distribution of CCHF cases corresponds closely with the distribution of principle tick vectors...... that is species of Hyaloma. The disease presents with non-specific febrile symptoms, but progress to a serious haemorrhagic syndrome that, soon after, a full blown multi organ failure may develop with prominent features of liver damage and bleeding diathesis. The authors present a case of a 39-year-old man...

Interventions Against West Nile Virus, Rift Valley Fever Virus, and Crimean-Congo Hemorrhagic Fever Virus: Where Are We?

NARCIS (Netherlands)

Kortekaas, J.A.; Ergonul, O.; Moormann, R.J.M.

2010-01-01

ARBO-ZOONET is an international network financed by the European Commission's seventh framework program. The major goal of this initiative is capacity building for the control of emerging viral vector-borne zoonotic diseases, with a clear focus on West Nile virus, Rift Valley fever virus, and

Forecasting dengue hemorrhagic fever cases using ARIMA model: a case study in Asahan district

Science.gov (United States)

Siregar, Fazidah A.; Makmur, Tri; Saprin, S.

2018-01-01

Time series analysis had been increasingly used to forecast the number of dengue hemorrhagic fever in many studies. Since no vaccine exist and poor public health infrastructure, predicting the occurrence of dengue hemorrhagic fever (DHF) is crucial. This study was conducted to determine trend and forecasting the occurrence of DHF in Asahan district, North Sumatera Province. Monthly reported dengue cases for the years 2012-2016 were obtained from the district health offices. A time series analysis was conducted by Autoregressive integrated moving average (ARIMA) modeling to forecast the occurrence of DHF. The results demonstrated that the reported DHF cases showed a seasonal variation. The SARIMA (1,0,0)(0,1,1)12 model was the best model and adequate for the data. The SARIMA model for DHF is necessary and could applied to predict the incidence of DHF in Asahan district and assist with design public health maesures to prevent and control the diseases.

Vitamin D serostatus and dengue fever progression to dengue hemorrhagic fever/dengue shock syndrome.

Science.gov (United States)

Villamor, E; Villar, L A; Lozano, A; Herrera, V M; Herrán, O F

2017-10-01

Vitamin D could modulate pathways leading to dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS). We examined the associations of serum total 25-hydroxy vitamin D [25(OH)D] and vitamin D binding protein (VDBP) concentrations in patients with uncomplicated dengue fever (DF) with risk of progression to DHF/DSS. In a case-control study nested in a cohort of DF patients who were followed during the acute episode in Bucaramanga, Colombia, we compared 25(OH)D and VDBP at onset of fever between 110 cases who progressed to DHF/DSS and 235 DF controls who did not progress. 25(OH)D concentrations were also compared between the acute sample and a sample collected >1 year post-convalescence in a subgroup. Compared with 25(OH)D ⩾75 nmol/l, adjusted odds ratios (95% CI) for progression were 0·44 (0·22-0·88) and 0·13 (0·02-1·05) for 50 to 75 nmol/l (vitamin D insufficiency) and <50 nmol/l (vitamin D deficiency), respectively (P, trend = 0·003). Mean 25(OH)D concentrations were much lower post-convalescence compared with the acute episode, regardless of case status. Compared with controls, mean VDBP was non-significantly lower in cases. We conclude that low serum 25(OH)D concentrations in DF patients predict decreased odds of progression to DHF/DSS.

Co-circulation of multiple hemorrhagic fever diseases with distinct clinical characteristics in Dandong, China.

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Zhi-Hai Chen

Full Text Available Hemorrhagic fevers (HF caused by viruses and bacteria are a major public health problem in China and characterized by variable clinical manifestations, such that it is often difficult to achieve accurate diagnosis and treatment. The causes of HF in 85 patients admitted to Dandong hospital, China, between 2011-2012 were determined by serological and PCR tests. Of these, 34 patients were diagnosed with Huaiyangshan hemorrhagic fever (HYSHF, 34 with Hemorrhagic Fever with Renal Syndrome (HFRS, one with murine typhus, and one with scrub typhus. Etiologic agents could not be determined in the 15 remaining patients. Phylogenetic analyses of recovered bacterial and viral sequences revealed that the causative infectious agents were closely related to those described in other geographical regions. As these diseases have no distinctive clinical features in their early stage, only 13 patients were initially accurately diagnosed. The distinctive clinical features of HFRS and HYSHF developed during disease progression. Enlarged lymph nodes, cough, sputum, and diarrhea were more common in HYSHF patients, while more HFRS cases presented with headache, sore throat, oliguria, percussion pain kidney area, and petechiae. Additionally, HYSHF patients displayed significantly lower levels of white blood cells (WBC, higher levels of creations kinase (CK and alanine aminotransferase (ALT, while HFRS patients presented with an elevation of blood urea nitrogen (BUN and creatinine (CREA. These clinical features will assist in the accurate diagnosis of both HYSHF and HFRS. Overall, our data reveal the complexity of pathogens causing HFs in a single Chinese hospital, and highlight the need for accurate early diagnosis and a better understanding of their distinctive clinical features.

Vaccine Platforms to Control Arenaviral Hemorrhagic Fevers.

Science.gov (United States)

Carrion, Ricardo; Bredenbeek, Peter; Jiang, Xiaohong; Tretyakova, Irina; Pushko, Peter; Lukashevich, Igor S

2012-11-20

Arenaviruses are rodent-borne emerging human pathogens. Diseases caused by these viruses, e.g., Lassa fever (LF) in West Africa and South American hemorrhagic fevers (HFs), are serious public health problems in endemic areas. We have employed replication-competent and replication-deficient strategies to design vaccine candidates potentially targeting different groups "at risk". Our leader LF vaccine candidate, the live reassortant vaccine ML29, is safe and efficacious in all tested animal models including non-human primates. In this study we showed that treatment of fatally infected animals with ML29 two days after Lassa virus (LASV) challenge protected 80% of the treated animals. In endemic areas, where most of the target population is poor and many live far from health care facilities, a single-dose vaccination with ML29 would be ideal solution. Once there is an outbreak, a fast-acting vaccine or post-exposure prophylaxis would be best. The 2(nd) vaccine technology is based on Yellow Fever (YF) 17D vaccine. We designed YF17D-based recombinant viruses expressing LASV glycoproteins (GP) and showed protective efficacy of these recombinants. In the current study we developed a novel technology to clone LASV nucleocapsid within YF17D C gene. Low immunogenicity and stability of foreign inserts must be addressed to design successful LASV/YFV bivalent vaccines to control LF and YF in overlapping endemic areas of West Africa. The 3(rd) platform is based on the new generation of alphavirus replicon virus-like-particle vectors (VLPV). Using this technology we designed VLPV expressing LASV GP with enhanced immunogenicity and bivalent VLPV expressing cross-reactive GP of Junin virus (JUNV) and Machupo virus (MACV), causative agents of Argentinian and Bolivian HF, respectively. A prime-boost regimen required for VLPV immunization might be practical for medical providers, military, lab personnel, and visitors in endemic areas.

Deteksi Penyakit Dengue Hemorrhagic Fever dengan Pendekatan One Class Classification

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Zida Ziyan Azkiya

2017-10-01

Full Text Available Two class classification problem maps input into two target classes. In certain cases, training data is available only in the form of a single class, as in the case of Dengue Hemorrhagic Fever (DHF patients, where only data of positive patients is available. In this paper, we report our experiment in building a classification model for detecting DHF infection using One Class Classification (OCC approach. Data from this study is sourced from laboratory tests of patients with dengue fever. The OCC methods compared are One-Class Support Vector Machine and One-Class K-Means. The result shows SVM method obtained precision value = 1.0, recall = 0.993, f-1 score = 0.997, and accuracy of 99.7% while the K-Means method obtained precision value = 0.901, recall = 0.973, f- 1 score = 0.936, and accuracy of 93.3%. This indicates that the SVM method is slightly superior to K-Means for One-Class Classification of DHF patients.

Surveillance and laboratory detection system of Crimean-Congo haemorrhagic fever in Iran

DEFF Research Database (Denmark)

Chinikar, S; Goya, M M; Shirzadi, M R

2008-01-01

Crimean-Congo haemorrhagic fever (CCHF) is a viral zoonotic disease with a high mortality rate in humans. The CCHF virus (CCHFV) is transmitted to humans through the bite of Ixodid ticks or by contact with blood or tissues of infected livestock. In addition to zoonotic transmission, CCHFV can be ....... After two decades and observations of CCHF in some provinces of Iran, a CCHF surveillance and detection system was established in 1999, leading to a dramatically decreased mortality rate from 20% (year 2000) to 2% (year 2007)....... symptoms, the diagnosis of CCHF is based on the use of serological tests for the detection of immunoglobulin M and immunoglobulin G antibodies and on the use of molecular tools such as RT-PCR. From 1970 to 1978, serological and epidemiological studies were performed in humans and in livestock of Iran...

WEB Services Implementation on The Report of Dengue Hemorrhagic Fever (DHF At Health Office Karanganyar

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Ragil Saputra

2013-06-01

Full Text Available Abstract— Dengue Hemorrhagic Fever (DHF is one of the infectious diseases that frequently leads to Extraordinary Situation. The management of report is conducted by Health Community Center which subsequently gives report to Health Office. A problem arising from the report management is the fact that the report is conducted manually, therefore, the data is less valid and is not processed as quickly as possible. The quick and accurate data report system enables to lessen the risk of Dengue Hemorrhagic Fever. Due to this fact, it is undeniable necessary to provide an integrated inter-system of Dengue Fever report. This system includes an inter-system between one Health Community Center to another and to the system in Health Office. The integration of inter-system report is able to be conducted by the use of web service technology. Therefore, this research focuses on the development of Web Service based integrated system on the report of Dengue Fever. Data exchange is conducted in XML form by the application of SOAP and WSDL technologies. Library NuSOAP is necessary to provide class soapClient and soapServer. In other words, it functions as the listener whose functions are to receive and to respond at the access demand toward web service. The result is web service based report system which has dual functions since the system has functions to be either server or client. Keywords— web service, integration, SOAP, DHF.

Duplex ultrasonography in the hemorrhagic fever with renal syndrome; Correlation with laboratory findings

International Nuclear Information System (INIS)

Han, Chun Hee; Cho, K. S.; Auh, Y. h.; Park, C. S.; Park, S. K.; Kim, S. B.

1994-01-01

Assuming that the duplex Doppler sonography might be useful in predicting the disease evolution of hemorrhagic fever with renal syndrome, we compared the resistive index (RI) with the clinical and laboratory findings in 18 patients. We underwent 30 duplex Doppler examinations in 18 patients: one examination in nine, two examinations in six, and three examinations in three patients. Duplex Dopper waveforms were obtained from the main, segmental,interlobar, and arcuate arteries of both kidneys, and the RI was calculated for each study. In oliguric phase, the mean RI was high (average, 0.94), and the serum BUN(averate, 92.3mg/dl) and creatinine(average, 10.4mg/dl) levels were elevated. In diuretic phase the mean RI was normalized (average, 0.7), and the serum BUN(average, 31.1mg/dl)and serum creatinine (average, 2.9mg/dl) levels were low. There was statistically significant correlation between the mean RI and the serum levels of BUN and creatinine and 24 hour urine output (P<0.001). We conclude that the mean RI is a useful indicator in predicting the disease evolution in patients with hemorrhagic fever with renal syndrome

Dengue hemorrhagic fever and typhoid fever association based on spatial standpoint using scan statistics in DKI Jakarta

Science.gov (United States)

Hervind, Widyaningsih, Y.

2017-07-01

Concurrent infection with multiple infectious agents may occur in one patient, it appears frequently in dengue hemorrhagic fever (DHF) and typhoid fever. This paper depicted association between DHF and typhoid based on spatial point of view. Since paucity of data regarding dengue and typhoid co-infection, data that be used are the number of patients of those diseases in every district (kecamatan) in Jakarta in 2014 and 2015 obtained from Jakarta surveillance website. Poisson spatial scan statistics is used to detect DHF and typhoid hotspots area district in Jakarta separately. After obtain the hotspot, Fisher's exact test is applied to validate association between those two diseases' hotspot. The result exhibit hotspots of DHF and typhoid are located around central Jakarta. The further analysis used Poisson space-time scan statistics to reveal the hotspot in term of spatial and time. DHF and typhoid fever more likely occurr from January until May in the area which is relatively similar with pure spatial result. Preventive action could be done especially in the hotspot areas and it is required further study to observe the causes based on characteristics of the hotspot area.

Dengue fever (image)

Science.gov (United States)

Dengue fever, or West Nile fever, is a mild viral illness transmitted by mosquitoes which causes fever, ... second exposure to the virus can result in Dengue hemorrhagic fever, a life-threatening illness.

Hemorrhagic fever with renal syndrome accompanied by panhypopituitarism and central diabetes insipidus: a case report.

Science.gov (United States)

Ahn, Hee Jung; Chung, Jong-Hoon; Kim, Dong-Min; Yoon, Na-Ra; Kim, Choon-Mee

2018-03-05

Central diabetes insipidus (DI) was detected in a patient with hemorrhagic fever with renal syndrome (HFRS) who had been molecularly and serologically diagnosed with Hantaan virus infection. We recommend that clinicians differentiate central DI in HFRS patients with a persistent diuretic phase even when pituitary MRI findings are normal.

Animal Models of Tick-Borne Hemorrhagic Fever Viruses

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Heinz Feldmann

2013-05-01

Full Text Available Tick-borne hemorrhagic fever viruses (TBHFV are detected throughout the African and Eurasian continents and are an emerging or re-emerging threat to many nations. Due to the largely sporadic incidences of these severe diseases, information on human cases and research activities in general have been limited. In the past decade, however, novel TBHFVs have emerged and areas of endemicity have expanded. Therefore, the development of countermeasures is of utmost importance in combating TBHFV as elimination of vectors and interrupting enzootic cycles is all but impossible and ecologically questionable. As in vivo models are the only way to test efficacy and safety of countermeasures, understanding of the available animal models and the development and refinement of animal models is critical in negating the detrimental impact of TBHFVs on public and animal health.

Material Proximities and Hotspots: Toward an Anthropology of Viral Hemorrhagic Fevers

Science.gov (United States)

Brown, Hannah; Kelly, Ann H

2014-01-01

This article outlines a research program for an anthropology of viral hemorrhagic fevers (collectively known as VHFs). It begins by reviewing the social science literature on Ebola, Marburg, and Lassa fevers and charting areas for future ethnographic attention. We theoretically elaborate the hotspot as a way of integrating analysis of the two routes of VHF infection: from animal reservoirs to humans and between humans. Drawing together recent anthropological investigations of human–animal entanglements with an ethnographic interest in the social production of space, we seek to enrich conceptualizations of viral movement by elaborating the circumstances through which viruses, humans, objects, and animals come into contact. We suggest that attention to the material proximities—between animals, humans, and objects—that constitute the hotspot opens a frontier site for critical and methodological development in medical anthropology and for future collaborations in VHF management and control. PMID:24752909

Hospital preparations for viral hemorrhagic fever patients and experience gained from admission of an Ebola patient

NARCIS (Netherlands)

Haverkort, J. J Mark; Minderhoud, A.L.C (Ben); Wind, Jelte D D; Leenen, Luke P H; Hoepelman, Andy I M; Ellerbroek, Pauline M.

2016-01-01

The Major Incident Hospital of the University Medical Centre of Utrecht has a longstanding history of preparing for the management of highly pathogenic and infectious organisms. An assessment of the hospital’s preparations for an outbreak of viral hemorrhagic fever and its experience during

Evidence for widespread infection of African bats with Crimean-Congo hemorrhagic fever-like viruses

Czech Academy of Sciences Publication Activity Database

Müller, M. A.; Devignot, S.; Lattwein, E.; Corman, V. M.; Maganga, G. D.; Gloza-Rausch, F.; Binger, T.; Vallo, Peter; Emmerich, P.; Cottontail, V. M.; Tschapka, M.; Oppong, S.; Drexler, J. F.; Weber, F.; Leroy, E. M.; Drosten, C.

2016-01-01

Roč. 6, č. 26637 (2016), č. článku 26637. ISSN 2045-2322 EU Projects: European Commission(XE) 278976 - ANTIGONE; European Commission(XE) 260427 - CCH Fever Institutional support: RVO:68081766 Keywords : sheep disease virus * family Bunyaviridae * serological relationships * antibody-response * migratory birds * rapid detection * viral load * ticks * nairovirus * genus Subject RIV: FN - Epidemiology, Contagious Diseases ; Clinical Immunology Impact factor: 4.259, year: 2016

Capacity building permitting comprehensive monitoring of a severe case of Lassa hemorrhagic fever in Sierra Leone with a positive outcome: Case Report

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Fonnie Mbalu

2011-06-01

Full Text Available Abstract Lassa fever is a neglected tropical disease with a significant impact on the health care system of endemic West African nations. To date, case reports of Lassa fever have focused on laboratory characterisation of serological, biochemical and molecular aspects of the disease imported by infected individuals from Western Africa to the United States, Canada, Europe, Japan and Israel. Our report presents the first comprehensive real time diagnosis and characterization of a severe, hemorrhagic Lassa fever case in a Sierra Leonean individual admitted to the Kenema Government Hospital Lassa Fever Ward. Fever, malaise, unresponsiveness to anti-malarial and antibiotic drugs, followed by worsening symptoms and onset of haemorrhaging prompted medical officials to suspect Lassa fever. A recombinant Lassa virus protein based diagnostic was employed in diagnosing Lassa fever upon admission. This patient experienced a severe case of Lassa hemorrhagic fever with dysregulation of overall homeostasis, significant liver and renal system involvement, the interplay of pro- and anti-inflammatory cytokines during the course of hospitalization and an eventual successful outcome. These studies provide new insights into the pathophysiology and management of this viral illness and outline the improved infrastructure, research and real-time diagnostic capabilities within LASV endemic areas.

Becoming an International Scientist in South Korea: Ho Wang Lee’s Research Activity about Epidemic Hemorrhagic Fever

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Miyoung SHIN

2017-04-01

Full Text Available In the 1960-70s, South Korea was still in the position of a science latecomer. Although the scientific research environment in South Korea at that time was insufficient, there was a scientist who achieved outcomes that could be recognized internationally while acting in South Korea. He was Ho Wang Lee(1928~ who found Hantann Virus that causes epidemic hemorrhagic fever for the first time in the world. It became a clue to identify causative viruses of hemorrhagic diseases that were scattered here and there throughout the world. In addition, these outcomes put Ho Wang Lee on the global center of research into epidemic hemorrhagic fever. This paper examines how a Korean scientist who was in the periphery of virology could go into the central area of virology. Also this article shows the process through which the virus found by Ho Wang Lee was registered with the international academia and he proceeded with follow-up research based on this progress to reach the level at which he generalized epidemic hemorrhagic fever related studies throughout the world. While he was conducting the studies, experimental methods that he had never experienced encountered him as new difficulties. He tried to solve the new difficulties faced in his changed status through devices of cooperation and connection. Ho Wang Lee’s growth as a researcher can be seen as well as a view of a researcher that grew from a regional level to an international level and could advance from the area of non-mainstream into the mainstream. This analytic tool is meaningful in that it can be another method of examining the growth process of scientists in South Korea or developing countries.

Hemorrhagic Fevers - Multiple Languages

Science.gov (United States)

... dialect) (繁體中文) Expand Section Vaccine Information Statement (VIS) -- Yellow Fever Vaccine: What You Need to Know - English PDF Vaccine Information Statement (VIS) -- Yellow Fever Vaccine: What You Need to Know - 繁體中文 (Chinese, Traditional ( ...

Differential Regulation of PAI-1 in Hantavirus Cardiopulmonary Syndrome and Hemorrhagic Fever With Renal Syndrome

OpenAIRE

Bellomo, Carla; Korva, Miša; Papa, Anna; Mäkelä, Satu; Mustonen, Jukka; Avšič-Županc, Tatjana; Vaheri, Antti; Martinez, Valeria P; Strandin, Tomas

2018-01-01

Abstract We analyzed the levels of circulating tissue plasminogen activator (tPA) and plasminogen activator inhibitor (PAI)–1 in acute hantavirus cardiopulmonary syndrome (HCPS) and hemorrhagic fever with renal syndrome (HFRS). The levels of tPA commonly increased in both diseases, whereas PAI-1 correlated with disease severity in HCPS but not in HFRS.

Potential Analysis of Promoting the Dengue Hemorrhagic Fever Prevention Through Youtube

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Mara Ipa

2014-11-01

Full Text Available Background: Deal with health promotion efforts in terms of disease control using media or social networking is an innovative breakthrough in a region having a broad range of territory, such as Indonesia and others countries alike. The use of social media /video platforms such as youtube, vimeo, veoh in health promotion has been significantly increased. This study aims to determine the potential availability of information about dengue hemorrhagic fever (DHF on YouTube social media and social media potential of as a medium for dissemination of knowledge of health promotion. Methods: This study used a social media site or website which is the most popular video hosting sites in the world, ‘YouTube’, with the keyword of ‘dengue hemorrhagic fever’. The selected video directly associated with DHF, videos in English that were included in this study using Latin letters in the description of the video; with duration less than or equal to 5 minutes. 76 videos analyzed with content analysis methods. Results:Showed that 76 videos divided into categories of prevention, control, transmission, treatment, dengue fever treatment, and other categories. Other information classification categories explain the severity of dengue virus infection, dengue vector (morphology, bionomics, intrinsic phase dengue virus and some research conducted as dengue vaccine discovery efforts. Conclusion: The availability of information about dengue on YouTube social media is still very deficient. Recommendation: YouTube has the potential of social media as a medium for disseminating health promotion information about dengue.

Question about the Clinical Characteristics of Crimean Hemorrhagic Fever

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A.I. Bogdanova

2016-11-01

Full Text Available Background. The research was organized in order to analyze features of the main clinical symptoms in patients with Crimean hemorrhagic fever (CHF. Materials and methods. In furtherance of this goal 37 patients with the diagnosis of moderate CHF were exa­mined; they were treated at BPHF Nichoga Regional Clinical Hospital of Infectious Diseases during 2005–2016. Results. The main complaints were general weakness (100 %, diffuse headache (91 %, loss of appetite (76 %, arthralgias (80 %, giddiness (32 %, nausea (52 %, vomiting (46 %, myalgia (65 % and arthralgia (78 %. Hemorrhagic syndrome manifested with petechial rash (79 %, post-injection (32.2 % and traumatic (7.5 % hematomas, blee­ding gums (52.3 %. Among cavity bleedings the examined patients had nasal (14.3 %, gastrointestinal (15.7 %, and microhematuria (18.3 %. There was no impairment of respiratory and cardiovascular systems. In 78 % of cases the symptoms of CNS dysfunction like retardation, bradyphrasia, rapid debilitating symptom and in several cases (8.1 % a sleep disorder were noted. Conclusions. Thus, the clinical picture of the main symptoms of CHF testifies the existence of HS as a main pathogenetic factor of illness which influences the disease course and finally defines the forecast of the disease.

Anterior pituitary lobe atrophy as late complication of hemorrhagic fever with renal syndrome

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Jovanović Dragan

2009-01-01

Full Text Available Introduction. Hemorrhagic fever with renal syndrome (HFRS is acute infective multisystemic disease followed by febrility, hemorrhages and acute renal insufficiency. Bleeding in the anterior pituitary lobe leading to tissue necrosis occurs in acute stage of severe clinical forms of HFRS, while atrophy of the anterior pituitary lobe with diminution of the gland function occurs after recovery stage. Case report. We presented a patient with the development of chronic renal insufficiency and hypopituitarism as complication that had been diagnosed six years after Hantavirus infection. Magnetic resonance of the pituitary gland revealed atrophy and empty sella turcica. Conclusion. Regarding frequency of this viral infection and its endemic character in some parts of our country partial and/or complete loss of pituitary function should be considered during the late stage of HFRS.

A hamster model for Marburg virus infection accurately recapitulates Marburg hemorrhagic fever.

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Marzi, Andrea; Banadyga, Logan; Haddock, Elaine; Thomas, Tina; Shen, Kui; Horne, Eva J; Scott, Dana P; Feldmann, Heinz; Ebihara, Hideki

2016-12-15

Marburg virus (MARV), a close relative of Ebola virus, is the causative agent of a severe human disease known as Marburg hemorrhagic fever (MHF). No licensed vaccine or therapeutic exists to treat MHF, and MARV is therefore classified as a Tier 1 select agent and a category A bioterrorism agent. In order to develop countermeasures against this severe disease, animal models that accurately recapitulate human disease are required. Here we describe the development of a novel, uniformly lethal Syrian golden hamster model of MHF using a hamster-adapted MARV variant Angola. Remarkably, this model displayed almost all of the clinical features of MHF seen in humans and non-human primates, including coagulation abnormalities, hemorrhagic manifestations, petechial rash, and a severely dysregulated immune response. This MHF hamster model represents a powerful tool for further dissecting MARV pathogenesis and accelerating the development of effective medical countermeasures against human MHF.

Identification of Dengue and Chikungunya Cases Among Suspected Cases of Yellow Fever in the Democratic Republic of the Congo.

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Makiala-Mandanda, Sheila; Ahuka-Mundeke, Steve; Abbate, Jessica L; Pukuta-Simbu, Elisabeth; Nsio-Mbeta, Justus; Berthet, Nicolas; Leroy, Eric Maurice; Becquart, Pierre; Muyembe-Tamfum, Jean-Jacques

2018-05-16

For more than 95% of acute febrile jaundice cases identified through surveillance for yellow fever, a reemerging arthropod-borne viral disease, no etiological exploration is ever done. The aim of this study was to test for other arthropod-borne viruses that can induce the same symptoms in patients enrolled in the yellow fever surveillance in the Democratic Republic of the Congo (DRC). Of 652 patients included in the surveillance of yellow fever in DRC from January 2003 to January 2012, 453 patients that tested negative for yellow fever virus (YFV) immunoglobulin M (IgM) antibodies were selected for the study. Real-time polymerase chain reaction was performed for the detection of dengue, West Nile, Chikungunya, O'nyong-nyong, Rift Valley fever, Zika, and YFV. The average age of patients was 22.1 years. We reported 16 cases (3.5%; confidence interval [CI]: 0.8-5.2) of dengue (serotypes 1 and 2) and 2 cases (0.4%; CI: 0.0-1.0) of Chikungunya. Three patients were co-infected with the two serotypes of dengue virus. Three cases of dengue were found in early July 2010 from the city of Titule (Oriental province) during a laboratory-confirmed outbreak of yellow fever, suggesting simultaneous circulation of dengue and yellow fever viruses. This study showed that dengue and Chikungunya viruses are potential causes of acute febrile jaundice in the DRC and highlights the need to consider dengue and Chikungunya diagnosis in the integrated disease surveillance and response program in the DRC. A prospective study is necessary to establish the epidemiology of these diseases.

T Cells and Pathogenesis of Hantavirus Cardiopulmonary Syndrome and Hemorrhagic Fever with Renal Syndrome

OpenAIRE

Francis A. Ennis; Masanori Terajima

2011-01-01

We previously hypothesized that increased capillary permeability observed in both hantavirus cardiopulmonary syndrome (HCPS) and hemorrhagic fever with renal syndrome (HFRS) may be caused by hantavirus-specific cytotoxic T cells attacking endothelial cells presenting viral antigens on their surface based on clinical observations and in vitro experiments. In HCPS, hantavirus-specific T cell responses positively correlated with disease severity. In HFRS, in one report, contrary to HCPS, T cell ...

Crimean-Congo haemorrhagic fever virus in Kazakhstan (1948-2013).

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Nurmakhanov, Talgat; Sansyzbaev, Yerlan; Atshabar, Bakhyt; Deryabin, Pavel; Kazakov, Stanislav; Zholshorinov, Aitmagambet; Matzhanova, Almagul; Sadvakassova, Alya; Saylaubekuly, Ratbek; Kyraubaev, Kakimzhan; Hay, John; Atkinson, Barry; Hewson, Roger

2015-09-01

Crimean-Congo haemorrhagic fever (CCHF) is a pathogenic and often fatal arboviral disease with a distribution spanning large areas of Africa, Europe and Asia. The causative agent is a negative-sense single-stranded RNA virus classified within the Nairovirus genus of the Bunyaviridae family. Cases of CCHF have been officially recorded in Kazakhstan since the disease was first officially reported in modern medicine. Serological surveillance of human and animal populations provide evidence that the virus was perpetually circulating in a local enzoonotic cycle involving mammals, ticks and humans in the southern regions of the country. Most cases of human disease were associated with agricultural professions such as farming, shepherding and fruit-picking; the typical route of infection was via tick-bite although several cases of contact transmission associated with caring for sick patients have been documented. In total, 704 confirmed human cases of CCHF have been registered in Kazakhstan from 1948-2013 with an overall case fatality rate of 14.8% for cases with a documented outcome. The southern regions of Kazakhstan should be considered endemic for CCHF with cases reported from these territories on an annual basis. Modern diagnostic technologies allow for rapid clinical diagnosis and for surveillance studies to monitor for potential expansion in known risk areas. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

A recombinase polymerase amplification assay for rapid detection of Crimean-Congo Haemorrhagic fever Virus infection.

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Laura C Bonney

2017-10-01

Full Text Available Crimean-Congo Haemorrhagic fever Virus (CCHFV is a rapidly emerging vector-borne pathogen and the cause of a virulent haemorrhagic fever affecting large parts of Europe, Africa, the Middle East and Asia.An isothermal recombinase polymerase amplification (RPA assay was successfully developed for molecular detection of CCHFV. The assay showed rapid (under 10 minutes detection of viral extracts/synthetic virus RNA of all 7 S-segment clades of CCHFV, with high target specificity. The assay was shown to tolerate the presence of inhibitors in crude preparations of mock field samples, indicating that this assay may be suitable for use in the field with minimal sample preparation. The CCHFV RPA was successfully used to screen and detect CCHFV positives from a panel of clinical samples from Tajikistan.The assay is a rapid, isothermal, simple-to-perform molecular diagnostic, which can be performed on a light, portable real-time detection device. It is ideally placed therefore for use as a field-diagnostic or in-low resource laboratories, for monitoring of CCHF outbreaks at the point-of-need, such as in remote rural regions in affected countries.

Ebola Virus Disease, Democratic Republic of the Congo, 2014.

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Nanclares, Carolina; Kapetshi, Jimmy; Lionetto, Fanshen; de la Rosa, Olimpia; Tamfun, Jean-Jacques Muyembe; Alia, Miriam; Kobinger, Gary; Bernasconi, Andrea

2016-09-01

During July-November 2014, the Democratic Republic of the Congo underwent its seventh Ebola virus disease (EVD) outbreak. The etiologic agent was Zaire Ebola virus; 66 cases were reported (overall case-fatality rate 74.2%). Through a retrospective observational study of confirmed EVD in 25 patients admitted to either of 2 Ebola treatment centers, we described clinical features and investigated correlates associated with death. Clinical features were mainly generic. At admission, 76% of patients had >1 gastrointestinal symptom and 28% >1 hemorrhagic symptom. The case-fatality rate in this group was 48% and was higher for female patients (67%). Cox regression analysis correlated death with initial low cycle threshold, indicating high viral load. Cycle threshold was a robust predictor of death, as were fever, hiccups, diarrhea, dyspnea, dehydration, disorientation, hematemesis, bloody feces during hospitalization, and anorexia in recent medical history. Differences from other outbreaks could suggest guidance for optimizing clinical management and disease control.

Acute Cholecystitis as a Cause of Fever in Aneurysmal Subarachnoid Hemorrhage

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Na Rae Yang

2017-05-01

Full Text Available Background Fever is a very common complication that has been related to poor outcomes after aneurysmal subarachnoid hemorrhage (aSAH. The incidence of acalculous cholecystitis is reportedly 0.5%–5% in critically ill patients, and cerebrovascular disease is a risk factor for acute cholecystitis (AC. However, abdominal evaluations are not typically performed for febrile patients who have recently undergone aSAH surgeries. In this study, we discuss our experiences with febrile aSAH patients who were eventually diagnosed with AC. Methods We retrospectively reviewed 192 consecutive patients who underwent aSAH from January 2009 to December 2012. We evaluated their characteristics, vital signs, laboratory findings, radiologic images, and pathological data from hospitalization. We defined fever as a body temperature of >38.3°C, according to the Society of Critical Care Medicine guidelines. We categorized the causes of fever and compared them between patients with and without AC. Results Of the 192 enrolled patients, two had a history of cholecystectomy, and eight (4.2% were eventually diagnosed with AC. Among them, six patients had undergone laparoscopic cholecystectomy. In their pathological findings, two patients showed findings consistent with coexistent chronic cholecystitis, and two showed necrotic changes to the gall bladder. Patients with AC tended to have higher white blood cell counts, aspartame aminotransferase levels, and C-reactive protein levels than patients with fevers from other causes. Predictors of AC in the aSAH group were diabetes mellitus (odds ratio [OR], 8.758; P = 0.033 and the initial consecutive fasting time (OR, 1.325; P = 0.024. Conclusions AC may cause fever in patients with aSAH. When patients with aSAH have a fever, diabetes mellitus and a long fasting time, AC should be suspected. A high degree of suspicion and a thorough abdominal examination of febrile aSAH patients allow for prompt diagnosis and treatment of this

Spatiotemporal Analysis of the Ebola Hemorrhagic Fever in West Africa in 2014

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Xu, M.; Cao, C. X.; Guo, H. F.

2017-09-01

Ebola hemorrhagic fever (EHF) is an acute hemorrhagic diseases caused by the Ebola virus, which is highly contagious. This paper aimed to explore the possible gathering area of EHF cases in West Africa in 2014, and identify endemic areas and their tendency by means of time-space analysis. We mapped distribution of EHF incidences and explored statistically significant space, time and space-time disease clusters. We utilized hotspot analysis to find the spatial clustering pattern on the basis of the actual outbreak cases. spatial-temporal cluster analysis is used to analyze the spatial or temporal distribution of agglomeration disease, examine whether its distribution is statistically significant. Local clusters were investigated using Kulldorff's scan statistic approach. The result reveals that the epidemic mainly gathered in the western part of Africa near north Atlantic with obvious regional distribution. For the current epidemic, we have found areas in high incidence of EVD by means of spatial cluster analysis.

Pathologic highlights of dengue hemorrhagic fever in 13 autopsy cases from Myanmar.

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Aye, Khin Saw; Charngkaew, Komgrid; Win, Ne; Wai, Kyaw Zin; Moe, Kyaw; Punyadee, Nuntaya; Thiemmeca, Somchai; Suttitheptumrong, Aroonroong; Sukpanichnant, Sanya; Prida, Malasit; Halstead, Scott B

2014-06-01

Vascular permeability, thrombocytopenia, liver pathology, complement activation, and altered hemostasis accompanying a febrile disease are the hallmarks of the dengue hemorrhagic fever/dengue shock syndrome, a major arthropod-borne viral disease that causes significant morbidity and mortality throughout tropical countries. We studied tissues from 13 children who died of acute dengue hemorrhagic fever/dengue shock syndrome at the Childrens' Hospital, Yangon, Myanmar. Dengue viral RNA from each of the 4 dengue viruses (DENVs) was detected by reverse transcriptase polymerase chain reaction in 11 cases, and dengue viral proteins (envelope, NS1, or NS3) were detected in 1 or more tissues from all 13 cases. Formalin-fixed and frozen tissues were studied for evidence of virus infection using monoclonal antibodies against DENV structural and nonstructural antigens (E, NS1, and nonsecreting NS3). In the liver, DENV infection occurred in hepatocytes and Kupffer cells but not in endothelial cells. Liver damage was associated with deposition on hepatocytes of complement components of both classical and alternative pathways. Evidence of dengue viral replication was observed in macrophage-like cells in spleens and lymph nodes. No dengue antigens were detected in endothelial cells in any organ. Germinal centers of the spleen and lymph nodes showed a marked reduction in the number of lymphocytes that were replaced by eosinophilic deposits, which contained dengue antigens as well as immunoglobulins, and complement components (C3, C1q, and C9). The latter findings had previously been reported but overlooked as a diagnostic feature. Copyright © 2014 Elsevier Inc. All rights reserved.

Search for the Ebola virus reservoir in Kikwit, Democratic Republic of the Congo

DEFF Research Database (Denmark)

Leirs, Herwig; Mills, James N.; Krebs, John W.

1999-01-01

A 3-month ecologic investigation was done to identify the reservoir of Ebola virus following the 1995 outbreak in Kikwit, Democratic Republic of the Congo, Efforts focused on the fields where the putative primary case had worked but included other habitats near Kikwit, Samples were collected from...... 3066 vertebrates and tested for the presence of antibodies to Ebola (subtype Zaire) virus: All tests were negative, and attempts to isolate Ebola virus were unsuccessful. The investigation was hampered by a lack of information beyond the daily activities of the primary case, a lack of information...... on Ebola virus ecology, which precluded the detailed study of select groups of animals, and sample-size limitations for rare species, The epidemiology of Ebola hemorrhagic fever suggests that humans have only intermittent contact with the virus, which complicates selection of target species. Further study...

Chapare virus, a newly discovered arenavirus isolated from a fatal hemorrhagic fever case in Bolivia.

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Simon Delgado

2008-04-01

Full Text Available A small focus of hemorrhagic fever (HF cases occurred near Cochabamba, Bolivia, in December 2003 and January 2004. Specimens were available from only one fatal case, which had a clinical course that included fever, headache, arthralgia, myalgia, and vomiting with subsequent deterioration and multiple hemorrhagic signs. A non-cytopathic virus was isolated from two of the patient serum samples, and identified as an arenavirus by IFA staining with a rabbit polyvalent antiserum raised against South American arenaviruses known to be associated with HF (Guanarito, Machupo, and Sabiá. RT-PCR analysis and subsequent analysis of the complete virus S and L RNA segment sequences identified the virus as a member of the New World Clade B arenaviruses, which includes all the pathogenic South American arenaviruses. The virus was shown to be most closely related to Sabiá virus, but with 26% and 30% nucleotide difference in the S and L segments, and 26%, 28%, 15% and 22% amino acid differences for the L, Z, N, and GP proteins, respectively, indicating the virus represents a newly discovered arenavirus, for which we propose the name Chapare virus. In conclusion, two different arenaviruses, Machupo and Chapare, can be associated with severe HF cases in Bolivia.

A Syrian golden hamster model recapitulating ebola hemorrhagic fever.

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Ebihara, Hideki; Zivcec, Marko; Gardner, Donald; Falzarano, Darryl; LaCasse, Rachel; Rosenke, Rebecca; Long, Dan; Haddock, Elaine; Fischer, Elizabeth; Kawaoka, Yoshihiro; Feldmann, Heinz

2013-01-15

Ebola hemorrhagic fever (EHF) is a severe viral infection for which no effective treatment or vaccine is currently available. While the nonhuman primate (NHP) model is used for final evaluation of experimental vaccines and therapeutic efficacy, rodent models have been widely used in ebolavirus research because of their convenience. However, the validity of rodent models has been questioned given their low predictive value for efficacy testing of vaccines and therapeutics, a result of the inconsistent manifestation of coagulopathy seen in EHF. Here, we describe a lethal Syrian hamster model of EHF using mouse-adapted Ebola virus. Infected hamsters displayed most clinical hallmarks of EHF, including severe coagulopathy and uncontrolled host immune responses. Thus, the hamster seems to be superior to the existing rodent models, offering a better tool for understanding the critical processes in pathogenesis and providing a new model for evaluating prophylactic and postexposure interventions prior to testing in NHPs.

PATHOGENESIS OF HEMORRHAGIC DUE TO DENGUE VIRUS

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Arief Suseno

2015-01-01

Full Text Available Dengue is a viral disease that is mediated by a mosquito, which causes morbidity and mortality. Viruses can increase vascular permeability which can lead to hemorrhagic diathesis or disseminated intravascular coagulation (DIC known as dengue hemorrhagic fever (DHF. In Indonesia, dengue hemorrhagic fever (DHF are caused by dengue virus infection which was found to be endemic accompanied by an explosion of extraordinary events that appear at various specified period. The diagnosis of dengue is determined based on the criteria of the World Health Organization (WHO, 1999, which are sudden high fever accompanied by a marked tendency to hemorrhage positive tourniquet test, petechiae, ecchymosis, purpura, mucosal hemorrhagic, hematemesis or melena and thrombocytopenia. The problem that still exists today is the mechanism of thrombocytopenia in patients with varying degrees of dengue involving levels of vWF (von Willebrand factor and prostaglandin I2 (PGI2 can not be explained. The mechanism of hemorrhagic in dengue virus infections acquired as a result of thrombocytopenia, platelet disfunction decreased coagulation factors, vasculopathy with endothelial injury and disseminated intravascular coagulation (DIC.

20 Years Spatial-Temporal Analysis of Dengue Fever and Hemorrhagic Fever in Mexico.

Science.gov (United States)

Hernández-Gaytán, Sendy Isarel; Díaz-Vásquez, Francisco Javier; Duran-Arenas, Luis Gerardo; López Cervantes, Malaquías; Rothenberg, Stephen J

2017-10-01

Dengue Fever (DF) is a human vector-borne disease and a major public health problem worldwide. In Mexico, DF and Dengue Hemorrhagic Fever (DHF) cases have increased in recent years. The aim of this study was to identify variations in the spatial distribution of DF and DHF cases over time using space-time statistical analysis and geographic information systems. Official data of DF and DHF cases were obtained in 32 states from 1995-2015. Space-time scan statistics were used to determine the space-time clusters of DF and DHF cases nationwide, and a geographic information system was used to display the location of clusters. A total of 885,748 DF cases was registered of which 13.4% (n = 119,174) correspond to DHF in the 32 states from 1995-2015. The most likely cluster of DF (relative risk = 25.5) contained the states of Jalisco, Colima, and Nayarit, on the Pacific coast in 2009, and the most likely cluster of DHF (relative risk = 8.5) was in the states of Chiapas, Tabasco, Campeche, Oaxaca, Veracruz, Quintana Roo, Yucatán, Puebla, Morelos, and Guerrero principally on the Gulf coast over 2006-2015. The geographic distribution of DF and DHF cases has increased in recent years and cases are significantly clustered in two coastal areas (Pacific and Gulf of Mexico). This provides the basis for further investigation of risk factors as well as interventions in specific areas. Copyright © 2018 IMSS. Published by Elsevier Inc. All rights reserved.

Genetic characterization of Erve virus, a European Nairovirus distantly related to Crimean-Congo hemorrhagic fever virus

OpenAIRE

Dilcher, Meik; Koch, Andrea; Hasib, Lekbira; Dobler, Gerhard; Hufert, Frank T.; Weidmann, Manfred

2012-01-01

Erve virus (ERVEV) is a European Nairovirus that is suspected to cause severe headache (thunderclap headache) and intracerebral hemorrhage. The mode of transmission to humans (ticks or mosquitoes) is still unknown. Currently, no standardized testing method for ERVEV exists and only a small partial sequence of the polymerase gene is available. Here, we present the first complete genome sequence of ERVEV S, M, and L segments. Phylogenetic comparison of the amino acid sequence of the L-protein (...

The neglected arboviral infections in mainland China.

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Xiaoyan Gao

2010-04-01

Full Text Available The major arboviral diseases in mainland China include Japanese encephalitis, dengue fever, Crimean-Congo hemorrhagic fever (also known as Xinjiang hemorrhagic fever, and tick-borne encephalitis. These and other newly found arbovirus infections due to Banna virus and Tahyna virus contribute to a large and relatively neglected disease burden in China. Here we briefly review the literature regarding these arboviral infections in mainland China with emphasis on their epidemiology, primary vectors, phylogenetic associations, and the prevention programs associated with these agents in China.

Protective efficacy of neutralizing monoclonal antibodies in a nonhuman primate model of Ebola hemorrhagic fever.

Science.gov (United States)

Marzi, Andrea; Yoshida, Reiko; Miyamoto, Hiroko; Ishijima, Mari; Suzuki, Yasuhiko; Higuchi, Megumi; Matsuyama, Yukie; Igarashi, Manabu; Nakayama, Eri; Kuroda, Makoto; Saijo, Masayuki; Feldmann, Friederike; Brining, Douglas; Feldmann, Heinz; Takada, Ayato

2012-01-01

Ebola virus (EBOV) is the causative agent of severe hemorrhagic fever in primates, with human case fatality rates up to 90%. Today, there is neither a licensed vaccine nor a treatment available for Ebola hemorrhagic fever (EHF). Single monoclonal antibodies (MAbs) specific for Zaire ebolavirus (ZEBOV) have been successfully used in passive immunization experiments in rodent models, but have failed to protect nonhuman primates from lethal disease. In this study, we used two clones of human-mouse chimeric MAbs (ch133 and ch226) with strong neutralizing activity against ZEBOV and evaluated their protective potential in a rhesus macaque model of EHF. Reduced viral loads and partial protection were observed in animals given MAbs ch133 and ch226 combined intravenously at 24 hours before and 24 and 72 hours after challenge. MAbs circulated in the blood of a surviving animal until virus-induced IgG responses were detected. In contrast, serum MAb concentrations decreased to undetectable levels at terminal stages of disease in animals that succumbed to infection, indicating substantial consumption of these antibodies due to virus replication. Accordingly, the rapid decrease of serum MAbs was clearly associated with increased viremia in non-survivors. Our results indicate that EBOV neutralizing antibodies, particularly in combination with other therapeutic strategies, might be beneficial in reducing viral loads and prolonging disease progression during EHF.

Protective efficacy of neutralizing monoclonal antibodies in a nonhuman primate model of Ebola hemorrhagic fever.

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Andrea Marzi

Full Text Available Ebola virus (EBOV is the causative agent of severe hemorrhagic fever in primates, with human case fatality rates up to 90%. Today, there is neither a licensed vaccine nor a treatment available for Ebola hemorrhagic fever (EHF. Single monoclonal antibodies (MAbs specific for Zaire ebolavirus (ZEBOV have been successfully used in passive immunization experiments in rodent models, but have failed to protect nonhuman primates from lethal disease. In this study, we used two clones of human-mouse chimeric MAbs (ch133 and ch226 with strong neutralizing activity against ZEBOV and evaluated their protective potential in a rhesus macaque model of EHF. Reduced viral loads and partial protection were observed in animals given MAbs ch133 and ch226 combined intravenously at 24 hours before and 24 and 72 hours after challenge. MAbs circulated in the blood of a surviving animal until virus-induced IgG responses were detected. In contrast, serum MAb concentrations decreased to undetectable levels at terminal stages of disease in animals that succumbed to infection, indicating substantial consumption of these antibodies due to virus replication. Accordingly, the rapid decrease of serum MAbs was clearly associated with increased viremia in non-survivors. Our results indicate that EBOV neutralizing antibodies, particularly in combination with other therapeutic strategies, might be beneficial in reducing viral loads and prolonging disease progression during EHF.

Occurrence of hemorrhagic fever with renal syndrome in military unit stationed in the combat zone

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Ćirić Slaviša

2003-01-01

Full Text Available Since it has been recognized as a separate disease during the Korean war hemorrhagic fever with renal syndrome (HFRS has often been discovered among the members of different armies in various countries, military personnel being the highest risk group for the disease. In the period from March to May 1999 we treated 6 soldiers coming from the military formation stationed at Kosovo and Metohia. The reaction of indirect hemagglutination test proved the presence of antibodies against Hantavira in each of them. They were infected during the stay in a dugout in the area with great population of field rodents. Only one patient was slightly ill, on the admission to the hospitalall. The others had severe clinical and laboratory findings: several days lasting fever, strong abdominal pain, as well as the pain in the loins dyspeptical discomfort, manifold increased blood urea nitrogen and serum creatinine values, thrombocytopenia, etc. Oliguria occurred in 4 patients. Hemorrhagic manifestations were slight (epistaxis, petechial rash conjunctival injection, or absent. Because of the aggravation of the acute renal failure, hemodialysis was performed in 3 patients, while other 3 underwent conservative treatment. Two of the patients had severe anemia because of which transfusions of erythrocytes and plasma were performed. Complications occurred in 2 patients (convulsive crises and lung infections. All patients recovered completely.

Ebola hemorrhagic fever under scope, view of knowledge, attitude and practice from rural Sudan in 2015.

Science.gov (United States)

Mohamed, Mohamed M G; Shwaib, Hussam M; Fahim, Monica M; Ahmed, Elhamy A; Omer, Mawadda K; Monier, Islam A; Balla, Siham A

Ebola hemorrhagic fever (EHF) is an emerging threat to public health. The last epidemic in West Africa had a great effect on the affected communities. Timely and effective interventions were necessary in addition to community participation to control the epidemic. The knowledge, attitude and practices of vulnerable communities remain unknown, particularly in Sudan. The aim of this study was to explore the knowledge, attitude and practices of rural residents in Sudan regarding Ebola hemorrhagic fever. We conducted a cross sectional, community-based large-scale study in Al Gaziera state in rural Sudan in eight localities. In total, 1500 random adult participants were selected. The participants were assessed by a predesigned pretested questionnaire regarding their knowledge, attitude and practices regarding Ebola. Their sources of information were determined, and we assessed demographic factors as predictors of knowledge. We found poor knowledge, a fair attitude and suboptimal practices among the participants. The main sources of information were the press and media. Education was the only predictor of knowledge regarding Ebola. A lack of knowledge and suboptimal preventive practices mandates orientation and education programs to raise public awareness. Health care providers are advised to engage more in educating the community. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

[Manifestations of hemorrhagic fever with renal syndrome in a military unit stationed in a combat zone].

Science.gov (United States)

Cirić, Slavisa; Denić, Vesna; Mitrović, Vekoslav; Mitrović-Perisić, Natasa; Denić, Nebojsa; Cirić, Slobodan

2003-01-01

Since it has been recognized as a separate disease during the Korean war, hemorrhagic fever with renal syndrome (HFRS) has often been discovered among the members of different armies in various countries, military personnel being the highest risk group for the disease. In the period from March to May 1999 we treated 6 soldiers coming from the military formation stationed at Kosovo and Metohia. The reaction of indirect hemagglutination test proved the presence of antibodies against Hantavira in each of them. They were infected during the stay in a dugout in the area with great population of field rodents. Only one patient was slightly ill, on the admission to the hospital. The others had severe clinical and laboratory findings: several days lasting fever, strong abdominal pain, as well as the pain in the loins, dyspeptical discomfort, manifold increased blood urea nitrogen and serum creatinine values, thrombocytopenia, etc. Oliguria occurred in 4 patients. Hemorrhagic manifestations were slight (epistaxis, petechial rash, conjunctival injection), or absent. Because of the aggravation of the acute renal failure, hemodialysis was performed in 3 patients, while other 3 underwent conservative treatment. Two of the patients had severe anemia because of which transfusions of erythrocytes and plasma were performed. Complications occurred in 2 patients (convulsive crises and lung infections). All patients recovered completely.

Ebola hemorrhagic fever outbreaks: strategies for effective epidemic management, containment and control.

Science.gov (United States)

Matua, Gerald Amandu; Van der Wal, Dirk Mostert; Locsin, Rozzano C

2015-01-01

Ebola hemorrhagic fever, caused by the highly virulent RNA virus of the filoviridae family, has become one of the world's most feared pathogens. The virus induces acute fever and death, often associated with hemorrhagic symptoms in up to 90% of infected patients. The known sub-types of the virus are Zaire, Sudan, Taï Forest, Bundibugyo and Reston Ebola viruses. In the past, outbreaks were limited to the East and Central African tropical belt with the exception of Ebola Reston outbreaks that occurred in animal facilities in the Philippines, USA and Italy. The on-going outbreak in West Africa that is causing numerous deaths and severe socio-economic challenges has resulted in widespread anxiety globally. This panic may be attributed to the intense media interest, the rapid spread of the virus to other countries like United States and Spain, and moreover, to the absence of an approved treatment or vaccine. Informed by this widespread fear and anxiety, we analyzed the commonly used strategies to manage and control Ebola outbreaks and proposed new approaches that could improve epidemic management and control during future outbreaks. We based our recommendations on epidemic management practices employed during recent outbreaks in East, Central and West Africa, and synthesis of peer-reviewed publications as well as published "field" information from individuals and organizations recently involved in the management of Ebola epidemics. The current epidemic management approaches are largely "reactive", with containment efforts aimed at halting spread of existing outbreaks. We recommend that for better outcomes, in addition to "reactive" interventions, "pre-emptive" strategies also need to be instituted. We conclude that emphasizing both "reactive" and "pre-emptive" strategies is more likely to lead to better epidemic preparedness and response at individual, community, institutional, and government levels, resulting in timely containment of future Ebola outbreaks. Copyright

Interleukin-10 as a Marker of Disease Progression in Dengue Hemorrhagic Fever

International Nuclear Information System (INIS)

Tauseef, A.; Akmal, A.; Umar, N.; Sabir, S.; Sajjad, S.; Zulfiqar, S.

2016-01-01

Objective: To evaluate the plasma interleukin-10 (IL-10) levels in patients suffering from dengue hemorrhagic fever between 4 to 7 days of onset of disease and 24 hours after the first sample, to find out the association of plasma IL-10 levels with the outcome. Study Design: Analytical study. Place and Duration of Study: All major hospitals of Lahore, Pakistan, from August to November 2012. Methodology: Participants included 50 registered patients of dengue hemorrhagic fever (DHF) aged between 15 - 50 years. Plasma IL-10 concentrations were measured on above stated day. Outcome was described as recovery and shock. Platelet count and hematocrit percentages were also recorded. Statistical analyses were done using SPSS version 19. A p-value 0.05 was considered significant. Results: Plasma IL-10 levels were found to be raised in DHF patients and were associated with fatal outcome (p=0.004). In recovered DHF patients, plasma IL-10 levels decreased after 24 hours (mean 26.54 ± 16.03 pg/ml) as compared to admission time (mean 74.39 ± 61.69 pg/ml) but in case of DHF patients suffering from shock, plasma IL-10 was found to be higher after 24 hours (mean 87.69 ± 7.77 pg/ml) as compared to levels at admission time (mean 42.56 ± 28.09 pg/ml). ROC curve analysis revealed a change (30 units pg/ml) of plasma IL-10 concentration, within 24 hours of admission, raised from the base line to be 105 times more critical for shock in DHF patients (100 percentage sensitivity and 71.4 percentage specificity, p < 0.001). Conclusion: Elevated plasma IL-10 is a potential predictor of disease severity and fatal outcome in DHF patients. (author)

Retinoids, race and the pathogenesis of dengue hemorrhagic fever.

Science.gov (United States)

Mawson, Anthony R

2013-12-01

Dengue hemorrhagic fever (DHF) is the most significant mosquito-borne viral disease worldwide in terms of illness, mortality and economic cost, but the pathogenesis of DHF is not well understood and there is no specific treatment or vaccine. Based on evidence of liver involvement, it is proposed that dengue virus and retinoids interact to cause cholestatic liver damage, resulting in the spillage of stored retinoids into the circulation and in an endogenous form of hypervitaminosisis A manifested by the signs and symptoms of the disease, including: fever, severe joint and bone pain, capillary leakage, thrombocytopenia, headache, and gastrointestinal symptoms. While retinoids in low concentration are essential for numerous biological functions, they are prooxidant, cytotoxic, mutagenic and teratogenic in higher concentration, especially when unbound to protein, and an endogenous form of vitamin A intoxication is recognized in cholestasis. The model tentatively explains the observations that 1) repeat infections are more severe than initial dengue virus infections; 2) the incidence of denue has increased dramatically worldwide in recent decades; 3) DHF is less prevalent in people of African ancestry than those of other racial backgrounds; and 4) infants are protected from dengue. The retinoid toxicity hypothesis of DHF predicts the co-existence of low serum concentrations of retinol coupled with high concentrations of retinoic acid and an increased percentage of retinyl esters to total vitamin A. Subject to such tests, it may be possible to treat DHF effectively using drugs that target the metabolism and expression of retinoids. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Dengue hemorrhagic fever complicated with acute liver failure: a case report.

Science.gov (United States)

Dalugama, Chamara; Gawarammana, Indika Bandara

2017-12-08

Dengue is a common arboviral infection with a clinically diverse spectrum of presentations. Although hepatic dysfunction is commonly identified in patients will dengue illness, acute liver failure is rare. The etiopathogenesis of hepatic dysfunction is multifactorial and related to direct viral invasion of hepatocytes, immunological factors and hypoxia particularly in cases of shock in dengue hemorrhagic fever. Ideal management of dengue-related hepatic dysfunction and acute liver failure is still debated. We report a 53-year-old Sri Lankan Sinhalese male with serologically confirmed dengue fever presenting with evidence of plasma leakage developing acute liver failure evidenced by deranged liver functions, coagulopathy and altered sensorium. In addition to the 'standard care', the patient was managed with intravenous N-acetyl cysteine and blood transfusions even in the absence of bleeding or dropping packed cell volume (PCV), targeting a higher PCV in anticipation of better oxygenation at tissue level. He made a full recovery with no sequential infections. N-acetyl cysteine and packed cell transfusion aiming at a higher PCV to maintain adequate tissue perfusion during shock may be beneficial in acute liver failure due to dengue virus. Large randomized trials should be carried out to establish the efficacy of these treatment strategies to support these observations and change the current practice.

Factors Associated with Marburg Hemorrhagic Fever: Analysis of Patient Data from Uige, Angola

Science.gov (United States)

Roddy, Paul; Thomas, Sara L.; Jeffs, Benjamin; Folo, Pascoal Nascimento; Palma, Pedro Pablo; Henrique, Bengi Moco; Villa, Luis; Machado, Fernando Paixao Damiao; Bernal, Oscar; Jones, Steven M.; Strong, James E.; Feldmann, Heinz; Borchert, Matthias

2012-01-01

Background Reliable on-site polymerase chain reaction (PCR) testing for Marburg hemorrhagic fever (MHF) is not always available. Therefore, clinicians triage patients on the basis of presenting symptoms and contact history. Using patient data collected in Uige, Angola, in 2005, we assessed the sensitivity and specificity of these factors to evaluate the validity of World Health Organization (WHO)–recommended case definitions for MHF. Methods Multivariable logistic regression was used to identify independent predictors of PCR confirmation of MHF. A data-derived algorithm was developed to obtain new MHF case definitions with improved sensitivity and specificity. Results A MHF case definition comprising (1) an epidemiological link or (2) the combination of myalgia or arthralgia and any hemorrhage could potentially serve as an alternative to current case definitions. Our data-derived case definitions maintained the sensitivity and improved the specificity of current WHO-recommended case definitions. Conclusions Continued efforts to improve clinical documentation during filovirus outbreaks would aid in the refinement of case definitions and facilitate outbreak control. PMID:20441515

IL-10 and socs3 Are Predictive Biomarkers of Dengue Hemorrhagic Fever

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Lilian Karem Flores-Mendoza

2017-01-01

Full Text Available Background. Cytokines play important roles in the physiopathology of dengue infection; therefore, the suppressors of cytokine signaling (socs that control the type and timing of cytokine functions could be involved in the origin of immune alterations in dengue. Objective. To explore the association of cytokine and socs levels with disease severity in dengue patients. Methods. Blood samples of 48 patients with confirmed dengue infection were analyzed. Amounts of interleukins IL-2, IL-4, IL-6, and IL-10, interferon- (IFN- γ, and tumor necrosis factor- (TNF- α were quantified by flow cytometry, and the relative expression of socs1 and socs3 mRNA was quantified by real-time RT-PCR. Results. Increased levels of IL-10 and socs3 and lower expression of socs1 were found in patients with dengue hemorrhagic fever (DHF with respect to those with dengue fever (DF (p199.8-fold, socs1 (134 pg/ml have the highest sensitivity and specificity to discriminate between DF and DHF. Conclusion. Simultaneous changes in IL-10 and socs1/socs3 could be used as prognostic biomarkers of dengue severity.

Rift Valley fever outbreak--Kenya, November 2006-January 2007.

Science.gov (United States)

2007-02-02

In mid-December 2006, several unexplained fatalities associated with fever and generalized bleeding were reported to the Kenya Ministry of Health (KMOH) from Garissa District in North Eastern Province (NEP). By December 20, a total of 11 deaths had been reported. Of serum samples collected from the first 19 patients, Rift Valley fever (RVF) virus RNA or immunoglobulin M (IgM) antibodies against RVF virus were found in samples from 10 patients; all serum specimens were negative for yellow fever, Ebola, Crimean-Congo hemorrhagic fever, and dengue viruses. The outbreak was confirmed by isolation of RVF virus from six of the specimens. Humans can be infected with RVF virus from bites of mosquitoes or other arthropod vectors that have fed on animals infected with RVF virus, or through contact with viremic animals, particularly livestock. Reports of livestock deaths and unexplained animal abortions in NEP provided further evidence of an RVF outbreak. On December 20, an investigation was launched by KMOH, the Kenya Field Epidemiology and Laboratory Training Program (FELTP), the Kenya Medical Research Institute (KEMRI), the Walter Reed Project of the U.S. Army Medical Research Unit, CDC-Kenya's Global Disease Detection Center, and other partners, including the World Health Organization (WHO) and Médecins Sans Frontières (MSF). This report describes the findings from that initial investigation and the control measures taken in response to the RVF outbreak, which spread to multiple additional provinces and districts, resulting in 404 cases with 118 deaths as of January 25, 2007.

Marburg haemorrhagic fever: recent advances | AdegborO | African ...

African Journals Online (AJOL)

With the exception of a vaccine for yellow fever and ribavirin, which is used for treatment of some arenaviral infections, no specific chemotherapy for viral hemorrhagic fever exists. Only supportive treatment is possible The filoviruses, Marburg virus (MARV) and Ebola virus (EBOV), have been associated with hemorrhagic ...

High Prevalence and Diversity of Hepatitis Viruses in Suspected Cases of Yellow Fever in the Democratic Republic of Congo.

Science.gov (United States)

Makiala-Mandanda, Sheila; Le Gal, Frédéric; Ngwaka-Matsung, Nadine; Ahuka-Mundeke, Steve; Onanga, Richard; Bivigou-Mboumba, Berthold; Pukuta-Simbu, Elisabeth; Gerber, Athenaïs; Abbate, Jessica L; Mwamba, Dieudonné; Berthet, Nicolas; Leroy, Eric Maurice; Muyembe-Tamfum, Jean-Jacques; Becquart, Pierre

2017-05-01

The majority of patients with acute febrile jaundice (>95%) identified through a yellow fever surveillance program in the Democratic Republic of Congo (DRC) test negative for antibodies against yellow fever virus. However, no etiological investigation has ever been carried out on these patients. Here, we tested for hepatitis A (HAV), hepatitis B (HBV), hepatitis C (HCV), hepatitis D (HDV), and hepatitis E (HEV) viruses, all of which can cause acute febrile jaundice, in patients included in the yellow fever surveillance program in the DRC. On a total of 498 serum samples collected from suspected cases of yellow fever from January 2003 to January 2012, enzyme-linked immunosorbent assay (ELISA) techniques were used to screen for antibodies against HAV (IgM) and HEV (IgM) and for antigens and antibodies against HBV (HBsAg and anti-hepatitis B core protein [HBc] IgM, respectively), HCV, and HDV. Viral loads and genotypes were determined for HBV and HVD. Viral hepatitis serological markers were diagnosed in 218 (43.7%) patients. The seroprevalences were 16.7% for HAV, 24.6% for HBV, 2.3% for HCV, and 10.4% for HEV, and 26.1% of HBV-positive patients were also infected with HDV. Median viral loads were 4.19 × 10 5 IU/ml for HBV (range, 769 to 9.82 × 10 9 IU/ml) and 1.4 × 10 6 IU/ml for HDV (range, 3.1 × 10 2 to 2.9 × 10 8 IU/ml). Genotypes A, E, and D of HBV and genotype 1 of HDV were detected. These high hepatitis prevalence rates highlight the necessity to include screening for hepatitis viruses in the yellow fever surveillance program in the DRC. Copyright © 2017 Makiala-Mandanda et al.

Clinical and immunological characteristics of hemorrhagic fever with renal syndrome in women of different age groups

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Kutdusova A.M.

2012-09-01

Full Text Available Objective: To evaluate the clinical and immunological features of the hemorrhagic fever with renal syndrome in women of different age groups. Materials and methods: Clinical and laboratory characteristics of hemorrhagic fever with renal syndrome in 148 women aged 17 to 65 years old have been investigated. Patients have been divided into two groups: group I included 101 patients with normal menstrual rhythm, group II included 47 female patients with menopause. In 57 women (36 from group I, 21 — from group II the content of CD3+, CD4+, CD8+, CD16+, CD19+ — sub-populations of peripheral blood lymphocytes has been determined. Results: In compared groups significant differences in structure and frequency of complications of the disease have been revealed. Unidirectional tendency to increase significantly reduced absolute rates of investigated lymphocyte subpopulations in dynamics of the disease has been identified. It also has been stated that by the time of early convalescence in case of severe form of HFRS the indices did not reach the standard level. In an older group of women deeper damage and long-term recovery of immune system have been marked. Conclusion: According to the results of clinical and immunological studies the research work has revealed that in young women the response of the immune system to HFRS has developed faster and stronger than that in patients during the menopause period.

Febres hemorrágicas por vírus no Brasil Viral hemorrhagic fevers in Brazil

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Luiz Tadeu Moraes Figueiredo

2006-04-01

Full Text Available Chamando a atenção para as febres hemorrágicas por vírus, que em sua maioria tem escassa informação divulgada e provavelmente são subnotificadas, mostra-se neste artigo casos clínicos das 4 doenças deste tipo que ocorrem no Brasil: febre amarela, dengue hemorrágico/síndrome de choque do dengue, febre hemorrágica por arenavírus e síndrome pulmonar e cardiovascular por hantavírus. Também, relevantes aspectos clínicos, laboratoriais e epidemiológicos destas viroses são aqui abordados. São doenças que têm alta letalidade e induzem extravasamento capilar e coagulopatia, que podem ser evidenciados pela elevação do hematócrito e plaquetopenia. A suspeita clínica e o tratamento precoce são fundamentais à sobrevida dos pacientes.To call atention to viral hemorrhagic fevers, diseases that are mostly underdivulged and, probably, undereported, we present here case reports of the 4 diseases of this kind that occur in Brazil: yellow fever, dengue haemorrhagic fever/dengue shock syndrome, arenavirus haemorrhagic fever and hantavirus cardiopulmonary syndrome. Relevant clinical, epidemiological and laboratorial diagnostic aspects of these viral haemorrhagic fevers are also shown here. These diseases have a high case fatality rate, induce capillary leaking and blood coagulation disturbances that are evidenced by hemoconcentrantion and thrombocytopenia. An early clinical diagnosis and treatment is fundamental for patient survival.

Effective oral favipiravir (T-705 therapy initiated after the onset of clinical disease in a model of arenavirus hemorrhagic Fever.

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Michelle Mendenhall

2011-10-01

Full Text Available Lassa and Junín viruses are the most prominent members of the Arenaviridae family of viruses that cause viral hemorrhagic fever syndromes Lassa fever and Argentine hemorrhagic fever, respectively. At present, ribavirin is the only antiviral drug indicated for use in treatment of these diseases, but because of its limited efficacy in advanced cases of disease and its toxicity, safer and more effective antivirals are needed.Here, we used a model of acute arenaviral infection in outbred guinea pigs based on challenge with an adapted strain of Pichindé virus (PICV to further preclinical development of T-705 (Favipiravir, a promising broad-spectrum inhibitor of RNA virus infections. The guinea pig-adapted passage 19 PICV was uniformly lethal with an LD(50 of ∼5 plaque-forming units and disease was associated with fever, weight loss, thrombocytopenia, coagulation defects, increases in serum aspartate aminotransferase (AST concentrations, and pantropic viral infection. Favipiravir (300 mg/kg/day, twice daily orally for 14 days was highly effective, as all animals recovered fully from PICV-induced disease even when therapy was initiated one week after virus challenge when animals were already significantly ill with marked fevers and thrombocytopenia. Antiviral activity and reduced disease severity was evidenced by dramatic reductions in peak serum virus titers and AST concentrations in favipiravir-treated animals. Moreover, a sharp decrease in body temperature was observed shortly after the start of treatment. Oral ribavirin was also evaluated, and although effective, the slower rate of recovery may be a sign of the drug's known toxicity.Our findings support further development of favipiravir for the treatment of severe arenaviral infections. The optimization of the experimental favipiravir treatment regimen in the PICV guinea pig model will inform critical future studies in the same species based on challenge with highly pathogenic arenaviruses

Tick infestation: a 200-patients' series | Guven | African Journal of ...

African Journals Online (AJOL)

Conclusions: Although non-of the patients of our study has been diagnosed with Crimean-Congo hemorrhagic fever we informed all of them for the incubation period and call for observation during the time. Tick borne infections may present with vary of symptoms, the most sever of which is hemorrhagic diathesis and ...

Dengue and dengue hemorrhagic fever in the Americas: lessons and challenges.

Science.gov (United States)

Guzman, María G; Kouri, Gustavo

2003-05-01

The incidence of dengue and dengue hemorrhagic fever (DF/DHF) has increased significantly over the last decades. Yearly, an estimated 50-100 million cases of DF and about 250000-500000 cases of DHF occur worldwide. The epidemiological situation in Latin America now resembles that in Southeast Asia. Here, the main clinical, epidemiological and virological observations in the American region are presented and compared with those previously reported from Southeast Asia. During 2002, more than 30 Latin American countries reported over 1000000 DF cases. DHF occurred in 20 countries with more than 17000 DHF cases, including 225 fatalities. The co-circulation of multiple serotypes has been reported from many countries. In the Americas, DHF is observed both in children and adults; secondary infection by a different dengue virus serotype has been confirmed as an important risk factor for this severe form of the disease. However, some new risk factors such as the interval of dengue virus infections and the ethnicity and underlying chronic conditions of the patient have also been identified. The sequence of dengue virus infections and association with certain genotypes are further factors of importance. We also discuss the control and prevention strategies. In conclusion, without urgent action for the prevention and control of dengue/DHF and its vector, the current situation will worsen and, more dramatical, there is a risk of the urbanization of yellow fever.

Yellow fever live attenuated vaccine: A very successful live attenuated vaccine but still we have problems controlling the disease.

Science.gov (United States)

Barrett, Alan D T

2017-10-20

Yellow fever (YF) is regarded as the original hemorrhagic fever and has been a major public health problem for at least 250years. A very effective live attenuated vaccine, strain 17D, was developed in the 1930s and this has proved critical in the control of the disease. There is little doubt that without the vaccine, YF virus would be considered a biosafety level 4 pathogen. Significantly, YF is currently the only disease where an international vaccination certificate is required under the International Health Regulations. Despite having a very successful vaccine, there are occasional issues of supply and demand, such as that which occurred in Angola and Democratic Republic of Congo in 2016 when there was insufficient vaccine available. For the first time fractional dosing of the vaccine was approved on an emergency basis. Thus, continued vigilance and improvements in supply and demand are needed in the future. Copyright © 2017. Published by Elsevier Ltd.

Data mining for dengue hemorrhagic fever (DHF) prediction with naive Bayes method

Science.gov (United States)

Arafiyah, Ria; Hermin, Fariani

2018-01-01

Handling of infectious diseases is determined by the accuracy and speed of diagnosis. Government through the Regulation of the Minister of Health of the Republic of Indonesia No. 82 of 2014 on the Control of Communicable Diseases establishes Dengue Hemorrhagic Fever (DHF) has made DHF prevention a national priority. Various attempts were made to overcome this misdiagnosis. The treatment and diagnosis of DHF using ANFIS has result an application program that can decide whether a patient has dengue fever or not [1]. An expert system of dengue prevention by using ANFIS has predict the weather and the number of sufferers [2]. The large number of data on DHF often cannot affect a person in making decisions. The use of data mining method, able to build data base support in decision makers diagnose DHF disease [3]. This study predicts DHF with the method of Naive Bayes. Parameter of The input variable is the patient’s medical data (temperature, spotting, bleeding, and tornuine test) and the output variable suffers from DBD or not while the system output is diagnosis of the patient suffering from DHF or not. Result of model test by using tools of Orange 3.4.5 obtained level of precision model is 77,3%.

Simian hemorrhagic fever virus cell entry is dependent on CD163 and uses a clathrin-mediated endocytosis-like pathway.

Science.gov (United States)

Caì, Yíngyún; Postnikova, Elena N; Bernbaum, John G; Yú, Shu Qìng; Mazur, Steven; Deiuliis, Nicole M; Radoshitzky, Sheli R; Lackemeyer, Matthew G; McCluskey, Adam; Robinson, Phillip J; Haucke, Volker; Wahl-Jensen, Victoria; Bailey, Adam L; Lauck, Michael; Friedrich, Thomas C; O'Connor, David H; Goldberg, Tony L; Jahrling, Peter B; Kuhn, Jens H

2015-01-01

Simian hemorrhagic fever virus (SHFV) causes a severe and almost uniformly fatal viral hemorrhagic fever in Asian macaques but is thought to be nonpathogenic for humans. To date, the SHFV life cycle is almost completely uncharacterized on the molecular level. Here, we describe the first steps of the SHFV life cycle. Our experiments indicate that SHFV enters target cells by low-pH-dependent endocytosis. Dynamin inhibitors, chlorpromazine, methyl-β-cyclodextrin, chloroquine, and concanamycin A dramatically reduced SHFV entry efficiency, whereas the macropinocytosis inhibitors EIPA, blebbistatin, and wortmannin and the caveolin-mediated endocytosis inhibitors nystatin and filipin III had no effect. Furthermore, overexpression and knockout study and electron microscopy results indicate that SHFV entry occurs by a dynamin-dependent clathrin-mediated endocytosis-like pathway. Experiments utilizing latrunculin B, cytochalasin B, and cytochalasin D indicate that SHFV does not hijack the actin polymerization pathway. Treatment of target cells with proteases (proteinase K, papain, α-chymotrypsin, and trypsin) abrogated entry, indicating that the SHFV cell surface receptor is a protein. Phospholipases A2 and D had no effect on SHFV entry. Finally, treatment of cells with antibodies targeting CD163, a cell surface molecule identified as an entry factor for the SHFV-related porcine reproductive and respiratory syndrome virus, diminished SHFV replication, identifying CD163 as an important SHFV entry component. Simian hemorrhagic fever virus (SHFV) causes highly lethal disease in Asian macaques resembling human illness caused by Ebola or Lassa virus. However, little is known about SHFV's ecology and molecular biology and the mechanism by which it causes disease. The results of this study shed light on how SHFV enters its target cells. Using electron microscopy and inhibitors for various cellular pathways, we demonstrate that SHFV invades cells by low-pH-dependent, actin

Hemorrhagic Lacrimation and Epistaxis in Acute Hemorrhagic Edema of Infancy

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Shireen Mreish

2016-01-01

Full Text Available Acute hemorrhagic edema of infancy is an uncommon benign cutaneous vasculitis. Despite its worrisome presentation, it carries good prognosis with rarely reported systemic involvement. Management of these cases has been an area of debate with majority of physicians adopting conservative modalities. We report a case that presented with classic triad of rash, low grade fever, and peripheral edema along with two rarely reported manifestations in literature: hemorrhagic lacrimation and epistaxis.

An evaluation of modified case definitions for the detection of dengue hemorrhagic fever. Puerto Rico Association of Epidemiologists.

Science.gov (United States)

Rigau-Pérez, J G; Bonilla, G L

1999-12-01

The case definition for dengue hemorrhagic fever (DHF) requires fever, platelets plasma leakage evidenced by hemoconcentration > or = 20%, pleural or abdominal effusions, hypoproteinemia or hypoalbuminemia. We evaluated the specificity and yield of modified DHF case definitions and the recently proposed World Health Organization criteria for a provisional diagnosis of DHF, using a data base of laboratory-positive and laboratory-negative reports of hospitalizations for suspected dengue in Puerto Rico, 1994 to 1996. By design, all modifications had 100% sensitivity. More liberal criteria for plasma leakage were examined: 1) adding as evidence a single hematocrit > or = 50% (specificity 97.4%); 2) accepting hemoconcentration > or = 10% (specificity 90.1%); and 3) accepting either hematocrit > or = 50% or hemoconcentration > or = 10% (specificity 88.8%). The new DHF cases identified by these definitions (and percent laboratory positive) were 25 (100.0%), 95 (90.5%), and 107 (91.6%), respectively. In contrast, the provisional diagnosis of DHF (fever and hemorrhage, and one or more of platelets or = 20%, or at least a rising hematocrit [redefined quantitatively as a 5% or greater relative change]) showed a specificity of 66.8%, and identified 318 new DHF cases, of which 282 (88.7%) were laboratory-positive. Very small changes in the criteria may result in a large number of new cases. The modification that accepted either hematocrit > or = 50% or hemoconcentration > or = 10% had acceptable specificity, while doubling the detection of DHF-compatible, laboratory-positive severe cases, but "provisional diagnosis" showed even lower specificity, and may produce inflated DHF incidence figures. Modified case definitions should be prospectively evaluated with patients in a health-care facility before they are recommended for widespread use.

Ebola hemorrhagic Fever and the current state of vaccine development.

Science.gov (United States)

Hong, Joo Eun; Hong, Kee-Jong; Choi, Woo Young; Lee, Won-Ja; Choi, Yeon Hwa; Jeong, Chung-Hyeon; Cho, Kwang-Il

2014-12-01

Current Ebola virus outbreak in West Africa already reached the total number of 1,323 including 729 deaths by July 31st. the fatality is around 55% in the southeastern area of Guinea, Sierra Leone, Liberia, and Nigeria. The number of patients with Ebola Hemorrhagic Fever (EHF) was continuously increasing even though the any effective therapeutics or vaccines has not been developed yet. The Ebola virus in Guinea showed 98% homology with Zaire Ebola Virus. Study of the pathogenesis of Ebola virus infection and assess of the various candidates of vaccine have been tried for a long time, especially in United States and some European countries. Even though the attenuated live vaccine and DNA vaccine containing Ebola viral genes were tested and showed efficacy in chimpanzees, those candidates still need clinical tests requiring much longer time than the preclinical development to be approved for the practical treatment. It can be expected to eradicate Ebola virus by a safe and efficient vaccine development similar to the case of smallpox virus which was extinguished from the world by the variola vaccine.

Newly Discovered Ebola Virus Associated with Hemorrhagic Fever Outbreak in Uganda

Science.gov (United States)

Towner, Jonathan S.; Sealy, Tara K.; Khristova, Marina L.; Albariño, César G.; Conlan, Sean; Reeder, Serena A.; Quan, Phenix-Lan; Lipkin, W. Ian; Downing, Robert; Tappero, Jordan W.; Okware, Samuel; Lutwama, Julius; Bakamutumaho, Barnabas; Kayiwa, John; Comer, James A.; Rollin, Pierre E.; Ksiazek, Thomas G.; Nichol, Stuart T.

2008-01-01

Over the past 30 years, Zaire and Sudan ebolaviruses have been responsible for large hemorrhagic fever (HF) outbreaks with case fatalities ranging from 53% to 90%, while a third species, Côte d'Ivoire ebolavirus, caused a single non-fatal HF case. In November 2007, HF cases were reported in Bundibugyo District, Western Uganda. Laboratory investigation of the initial 29 suspect-case blood specimens by classic methods (antigen capture, IgM and IgG ELISA) and a recently developed random-primed pyrosequencing approach quickly identified this to be an Ebola HF outbreak associated with a newly discovered ebolavirus species (Bundibugyo ebolavirus) distantly related to the Côte d'Ivoire ebolavirus found in western Africa. Due to the sequence divergence of this new virus relative to all previously recognized ebolaviruses, these findings have important implications for design of future diagnostic assays to monitor Ebola HF disease in humans and animals, and ongoing efforts to develop effective antivirals and vaccines. PMID:19023410

Ebola virus: the role of macrophages and dendritic cells in the pathogenesis of Ebola hemorrhagic fever.

Science.gov (United States)

Bray, Mike; Geisbert, Thomas W

2005-08-01

Ebola hemorrhagic fever is a severe viral infection characterized by fever, shock and coagulation defects. Recent studies in macaques show that major features of illness are caused by effects of viral replication on macrophages and dendritic cells. Infected macrophages produce proinflammatory cytokines, chemokines and tissue factor, attracting additional target cells and inducing vasodilatation, increased vascular permeability and disseminated intravascular coagulation. However, they cannot restrict viral replication, possibly because of suppression of interferon responses. Infected dendritic cells also secrete proinflammatory mediators, but cannot initiate antigen-specific responses. In consequence, virus disseminates to these and other cell types throughout the body, causing multifocal necrosis and a syndrome resembling septic shock. Massive "bystander" apoptosis of natural killer and T cells further impairs immunity. These findings suggest that modifying host responses would be an effective therapeutic strategy, and treatment of infected macaques with a tissue-factor inhibitor reduced both inflammation and viral replication and improved survival.

Adventures in Infectious Diseases

Energy Technology Data Exchange (ETDEWEB)

Fisher-Hoch, Susan [University of Texas School of Public Health

2011-11-01

Dr. Susan Fisher-Hoch, Virologist and Epidemiologist, will discuss her research and travels associated with viral hemorrhagic fevers. From the Ebola outbreak in Reston, Virginia to outbreaks of Crimean Congo Hemorrhagic Fever in South Africa, Senegal, and Saudi Arabia, Dr. Fisher-Hoch has studied and tracked the pathophysiology of these viral diseases. These studies have led her from the Center for Disease Control in the United States, to Lyon, France where she was instrumental in designing, constructing, and rendering operational a laboratory capable of containing some of the world's most dangerous diseases.

Dengue fever: a Wikipedia clinical review

OpenAIRE

Heilman, James M; Wolff, Jacob De; Beards, Graham M; Basden, Brian J

2014-01-01

Dengue fever, also known as breakbone fever, is a mosquito-borne infectious tropical disease caused by the dengue virus. Symptoms include fever, headache, muscle and joint pains, and a characteristic skin rash that is similar to measles. In a small proportion of cases, the disease develops into life-threatening dengue hemorrhagic fever, which results in bleeding, thrombocytopenia, and leakage of blood plasma, or into dengue shock syndrome, in which dangerously low blood pressure occurs. Treat...

The International Conference on Hemorrhagic Fever with Renal Syndrome (1st) Held in Seoul, Korea on 4-6 May 1989

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1990-05-01

suggest that the body is important for a maker of 1lFRS-virus infection. 69 PROSPECTIVE STUDY ON PANHYPOPITUITARISM AS A SEQUELA OF HEMORRHAGIC FEVER...necrosis is a characteristic and common autopsy finding. Contrary to this, only 14 cases of clinical panhypopituitarism have been reported. Recently we...confirmed six patients with panhypopituitarism by high resolution sella computed tomo-,raphy(CT) and combined anterior pituitary stimulation lest(CAPS I

[Clinical presentation of different severities of hemorrhagic fever with renal syndrome: how to recognise it].

Science.gov (United States)

Lausević, Mirjana; Lausević, Zeljko; Stojimirović, Biljana

2012-07-01

Besides viral serotype, HLA haplotype and cytokine genes polymorphism are associated with clinical presentation of hemorrhagic fever with renal syndrome. Since these analyses are unavailable in routine clinical practice, the aim of this study was to assess clinical, laboratory and radiographic findings associated with clinical presentation of disease severity. A total of 30 patients (27 men and 3 women), average age 40 +/- 14.9 years, treated for hemorrhagic fever with renal syndrome from January 1, 1999 to December 31, 2009 in Clinical Center of Serbia, were included in the study. Nine patients (30%) had mild, 14 (46.7%) moderate and 7 (23.3%) severe form of the disease; 24 (800%) recovered, 6 (20%) died in the acute phase of the illness, and 19 patients (63.3%) required hemodialysis. The average titer of antiviral antibodies in patients infected with Belgrade serotype virus were significantly higher in those with severe clinical presentation. Hypotension, anuria, macrohaematuria, pulmonary infiltration, pleural effusion, hepatomegalia and positive meningeal signs were more frequent in the patients with severe form of the disease. Statistically significant differences between groups with mild, moderate and severe clinical picture were found in serum total protein, albumin, calcium, glutamate pyruvate and glutamate oxaloacetate transaminase on admittance; serum creatinine and phosphorus concentration on day 14 and day 21; serum sodium and calciums on day 14; hemoglobine concentration on day 21. A statistically significant correlation was found between clinical presentation of the disease severity and platelet count, white blood cell count, hemoglobine concentration, serum calcium and serum transaminases on admittance. Multivariate analysis identified variables' combinations associated with clinical presentation of the disease. Our study confirmed that we can distinguish patients who will manifest different severities of the disease on the basis of careful

Clinical presentation of different severities of hemorrhagic fever with renal syndrome: How to recognize it

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Laušević Mirjana

2012-01-01

Full Text Available Background/Aim. Besides viral serotype, HLA haplotype and cytokine genes polymorphism are associated with clinical presentation of hemorrhagic fever with renal syndrome. Since these analyses are unavailable in routine clinical practice, the aim of this study was to assess clinical, laboratory and radiographic findings associated with clinical presentation of disease severity. Methods. A total of 30 patients (27 men and 3 women, average age 40 ± 14.9 years, treated for hemorrhagic fever with renal syndrome from January 1, 1999 to December 31, 2009 in Clinical Center of Serbia, were included in the study. Nine patients (30% had mild, 14 (46.7% moderate and 7 (23.3% severe form of the disease; 24 (80% recovered, 6 (20% died in the acute phase of the illness, and 19 patients (63.3% required hemodialysis. Results. The average titer of antiviral antibodies in patients infected with Belgrade serotype virus were significantly higher in those with severe clinical presentation. Hypotension, anuria, macrohaematuria, pulmonary infiltration, pleural effusion, hepatomegalia and positive meningeal signs were more frequent in the patients with severe form of the disease. Statistically significant differences between groups with mild, moderate and severe clinical picture were found in serum total protein, albumin, calcium, glutamate pyruvate and glutamate oxaloacetate transaminase on admittance; serum creatinine and phosphorus concentration on day 14 and day 21; serum sodium and calciums on day 14; hemoglobine concentration on day 21. A statistically significant correlation was found between clinical presentation of the disease severity and platelet count, white blood cell count, hemoglobine concentration, serum calcium and serum transaminases on admittance. Multivariate analysis identified variables` combinations associated with clinical presentation of the disease. Conclusion. Our study confirmed that we can distinguish patients who will manifest different

A epidemia de dengue/dengue hemorrágico no município do Rio de Janeiro, 2001/2002 The epidemic of dengue and hemorrhagic dengue fever in the city of Rio de Janeiro, 2001/2002

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Clarisse Guimarães Casali

2004-08-01

Full Text Available O objetivo deste estudo foi avaliar a ocorrência dos principais sinais e sintomas dos casos de dengue clássico e dengue hemorrágico na epidemia de 2001-2002 do município do Rio de Janeiro. Foram analisados os 155.242 casos notificados ao Sistema de Informações de Agravos de Notificação, desde janeiro/2001, até junho/2002; deste total, excluindo-se os ignorados, 81.327 casos foram classificados como dengue clássico e 958 como dengue hemorrágico, com um total de 54 óbitos. Avaliaram-se as variáveis referentes à sintomatologia da doença. Manifestações gerais como febre, cefaléia, prostração, mialgia, náuseas e dor retro-orbitária tiveram alta incidência tanto no dengue clássico como no dengue hemorrágico. Por outro lado, manifestações hemorrágicas e algumas de maior gravidade como choque, hemorragia digestiva, petéquias, epistaxe, dor abdominal e derrame pleural, estiveram significativamente associadas ao dengue hemorrágico. Além disso, a evolução do quadro clínico para o óbito foi 34,8 vezes maior no dengue hemorrágico que no dengue clássico (OR=34,8; IC 19,7-61,3.The following study was intended to evaluate the occurrence of typical signs and symptoms in the cases of classic dengue and hemorrhagic dengue fever, during the 2001-2002 epidemic in the city of Rio de Janeiro. The authors reviewed 155,242 cases notified to the Information System of Notification Diseases, from January/2001 to June/2002: 81,327 cases were classified as classic dengue and 958 as hemorrhagic dengue fever, with a total of 60 deaths. Common symptoms, such as fever, headache, prostration, myalgia, nausea and retro-orbital pain, had a high incidence in both classic and hemorrhagic dengue fever. On the other hand, hemorrhagic signs and other signs of severe disease, such as shock, gastrointestinal bleeding, petechiae, epistaxis, abdominal pain and pleural effusion, were strongly associated to hemorrhagic dengue fever. Besides, the occurrence

On the mathematical analysis of Ebola hemorrhagic fever: deathly infection disease in West African countries.

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Atangana, Abdon; Goufo, Emile Franc Doungmo

2014-01-01

For a given West African country, we constructed a model describing the spread of the deathly disease called Ebola hemorrhagic fever. The model was first constructed using the classical derivative and then converted to the generalized version using the beta-derivative. We studied in detail the endemic equilibrium points and provided the Eigen values associated using the Jacobian method. We furthered our investigation by solving the model numerically using an iteration method. The simulations were done in terms of time and beta. The study showed that, for small portion of infected individuals, the whole country could die out in a very short period of time in case there is not good prevention.

Structural basis for receptor recognition by New World hemorrhagic fever arenaviruses

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Abraham, Jonathan; Corbett, Kevin D.; Farzan, Michael; Choe, Hyeryun; Harrison, Stephen C. (Harvard-Med)

2010-08-18

New World hemorrhagic fever arenaviruses are rodent-borne agents that cause severe human disease. The GP1 subunit of the surface glycoprotein mediates cell attachment through transferrin receptor 1 (TfR1). We report the structure of Machupo virus (MACV) GP1 bound with human TfR1. Atomic details of the GP1-TfR1 interface clarify the importance of TfR1 residues implicated in New World arenavirus host specificity. Analysis of sequence variation among New World arenavirus GP1s and their host-species receptors, in light of the molecular structure, indicates determinants of viral zoonotic transmission. Infectivities of pseudoviruses in cells expressing mutated TfR1 confirm that contacts at the tip of the TfR1 apical domain determine the capacity of human TfR1 to mediate infection by particular New World arenaviruses. We propose that New World arenaviruses that are pathogenic to humans fortuitously acquired affinity for human TfR1 during adaptation to TfR1 of their natural hosts.

Potential impacts of climate variability on dengue hemorrhagic fever in Honduras, 2010.

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Zambrano, L I; Sevilla, C; Reyes-García, S Z; Sierra, M; Kafati, R; Rodriguez-Morales, A J; Mattar, S

2012-12-01

Climate change and variability are affecting human health and disease direct or indirectly through many mechanisms. Dengue is one of those diseases that is strongly influenced by climate variability; however its study in Central America has been poorly approached. In this study, we assessed potential associations between macroclimatic and microclimatic variation and dengue hemorrhagic fever (DHF) cases in the main hospital of Honduras during 2010. In this year, 3,353 cases of DHF were reported in the Hospital Escuela, Tegucigalpa. Climatic periods marked a difference of 158% in the mean incidence of cases, from El Niño weeks (-99% of cases below the mean incidence) to La Niña months (+59% of cases above it) (pHonduras. However, it is necessary to extend these studies in this and other countries in the Central America region, because these models can be applied for surveillance as well as for prediction of dengue.

[Actual vitamin and main foodstuffs consumption by recovered patients suffered from hemorrhagic fever with renal syndrome].

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Kasanova, G M; Tutel'ian, A V

2011-01-01

Actual consumption of vitamins A, E, beta-carotene, ascorbic acid, thiamin, pyridoxine and main foodstuffs by recovered patients suffered from hemorrhagic fever with renal syndrome has been given. Frequency analysis of foodstuffs consumption was used to study actual nourishment of recovered patients. Surplus consumption of fat mainly due to the use of saturated fatty acids, deficiency of poly unsaturated fatty acids, surplus sugar consumption and predominance of proteins of animal origin over proteins of vegetable origin in ration has been revealed. Deficiency of water soluble vitamins equals to 41,6-78,7% of all examined patients, deficiency of fat water soluble vitamins is lower (21,4-38,3%).

A Nonfatal Case of Dobrava Hantavirus Hemorrhagic Fever with Renal Syndrome Combined with Hantavirus Cardiopulmonary Syndrome

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Shemsedin Dreshaj

2018-01-01

Full Text Available Among hantaviruses (HTNV, 22 are known as pathogenic for humans. HTNV can cause two clinical entities: hemorrhagic fever with renal syndrome (HFRS and hantavirus pulmonary syndrome or hantavirus cardiopulmonary syndrome (HCPS. In most countries of Eastern Europe as well as in Kosovo, HTNV infection is presented mainly as HFRS. Here, we report a 20-year-old man with HFRS and HCPS caused by Dobrava hantavirus strain, successfully treated in Intensive Care Unit of Infectious Diseases Clinic, University Clinical Center of Kosovo. In HFRS endemic areas, patients with acute respiratory distress syndrome need to be evaluated for Dobrava hantavirus strain as a possible causative agent.

PLASMA LEAKAGE PROFILES OF DENGUE HEMORRHAGIC FEVER PATIENTS IN RSUD DR. SOETOMO, SURABAYA, EAST JAVA, INDONESIA JANUARY – JUNE 2014

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Ferdian Rizaliansyah

2017-04-01

Full Text Available Plasma leakage is one crucial point of dengue hemorrhagic fever (DHF that differentiates it from dengue fever (DF. DHF has to meet 4 criteria which are 2 – 7 days of acute fever, hemorrhagic manifestation, thrombocytopenia (≤100.000 cells/mm3 and evidence of plasma leakage. Plasma leakage consists of increasing hematocrit ≥20%, hypoalbuminemia or evidence of pleural effusion or ascites. Often doctors only base their DHF diagnosis on the presence of thrombocytopenia. This study analyzed the presence of plasma leakage between adult and pediatric patients with a DHF diagnosis in RSUD Dr. Soetomo in order to make the diagnosis and healthcare services better in the future. This was a retrospective study which used medical records of DHF patients admitted from January to June 2014. 78 cases were included, 24 adult patients (31% and 54 pediatric patients (69%. 29/78 (37% patients had no evidence of plasma leakage. No adult patients had ascites whereas 11/54 (20% pediatric patients presented with ascites. No adult patients had pleural effusion whereas 25/54 (53% pediatric patients did. Most adult patients that had serum albumin checked had normal albumin levels (12/14 [86%] while only 14/28 (52% pediatric patients had normal albumin level. 5/22 (23% adult patients versus 32/53 (60% pediatric patients showed hematocrit increments ≥20%. Patients admitted with dengue virus infection may currently be often misclassified as DHF because there are no plasma leakage manifestation in some patients.. There are significant differences in plasma leakage manifestations between adult and pediatric patients which poses a theory that pediatric patients are more susceptible to have plasma leakage manifestations than adult patients.

Spread of yellow fever virus outbreak in Angola and the Democratic Republic of the Congo 2015-16: a modelling study.

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Kraemer, Moritz U G; Faria, Nuno R; Reiner, Robert C; Golding, Nick; Nikolay, Birgit; Stasse, Stephanie; Johansson, Michael A; Salje, Henrik; Faye, Ousmane; Wint, G R William; Niedrig, Matthias; Shearer, Freya M; Hill, Sarah C; Thompson, Robin N; Bisanzio, Donal; Taveira, Nuno; Nax, Heinrich H; Pradelski, Bary S R; Nsoesie, Elaine O; Murphy, Nicholas R; Bogoch, Isaac I; Khan, Kamran; Brownstein, John S; Tatem, Andrew J; de Oliveira, Tulio; Smith, David L; Sall, Amadou A; Pybus, Oliver G; Hay, Simon I; Cauchemez, Simon

2017-03-01

Since late 2015, an epidemic of yellow fever has caused more than 7334 suspected cases in Angola and the Democratic Republic of the Congo, including 393 deaths. We sought to understand the spatial spread of this outbreak to optimise the use of the limited available vaccine stock. We jointly analysed datasets describing the epidemic of yellow fever, vector suitability, human demography, and mobility in central Africa to understand and predict the spread of yellow fever virus. We used a standard logistic model to infer the district-specific yellow fever virus infection risk during the course of the epidemic in the region. The early spread of yellow fever virus was characterised by fast exponential growth (doubling time of 5-7 days) and fast spatial expansion (49 districts reported cases after only 3 months) from Luanda, the capital of Angola. Early invasion was positively correlated with high population density (Pearson's r 0·52, 95% CI 0·34-0·66). The further away locations were from Luanda, the later the date of invasion (Pearson's r 0·60, 95% CI 0·52-0·66). In a Cox model, we noted that districts with higher population densities also had higher risks of sustained transmission (the hazard ratio for cases ceasing was 0·74, 95% CI 0·13-0·92 per log-unit increase in the population size of a district). A model that captured human mobility and vector suitability successfully discriminated districts with high risk of invasion from others with a lower risk (area under the curve 0·94, 95% CI 0·92-0·97). If at the start of the epidemic, sufficient vaccines had been available to target 50 out of 313 districts in the area, our model would have correctly identified 27 (84%) of the 32 districts that were eventually affected. Our findings show the contributions of ecological and demographic factors to the ongoing spread of the yellow fever outbreak and provide estimates of the areas that could be prioritised for vaccination, although other constraints such as vaccine

Lassa fever – full recovery without ribavarin treatment: a case report ...

African Journals Online (AJOL)

Her close contacts showed no evidence of Lassa virus infection. Conclusion: This report adds to the literature on the natural history of Lassa fever; and that individuals may survive Lassa fever with conservative management of symptoms of the disease and its complications. Keywords: Lassa fever; viral hemorrhagic fever, ...

Could peak proteinuria determine whether patient with dengue fever develop dengue hemorrhagic/dengue shock syndrome? - A prospective cohort study

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Suhail Sufi M

2011-08-01

Full Text Available Abstract Background Worldwide there is a need to develop simple effective predictors that can distinguish whether a patient will progress from dengue fever (DF to life threatening dengue hemorrhagic (DHF or dengue shock syndrome (DSS. We explored whether proteinuria could be used as such a marker. Methods We included patients admitted to hospital with suspected dengue fever. Starting at enrollment until discharge, each patient's daily spot urine protein creatinine ratio (UPCR was measured. We classified those with confirmed dengue infection as DF or DHF (including DSS based on WHO criteria. Peak and day of onset of proteinuria was compared between both groups. Results Compared to those with DF, patients with DHF had significantly higher median peak proteinuria levels (0.56 versus 0.08 g/day; p Conclusions Peak UPCR could potentially predict DHF in patients with dengue requiring close monitoring and treatment.

African Journal of Infectious Diseases - Vol 10, No 1 (2016)

African Journals Online (AJOL)

Review of past and present Ebola hemorrhagic fever outbreaks in the Democratic Republic of Congo 1976 -2014 · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Auralie Kasangye Kangoy, Guy Mutangala Muloye, Patrick Mawupemor Avevor, Li Shixue, 38-42.

Fever with Rashes.

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Soman, Letha

2018-07-01

Fever with rashes is one of the commonest clinical problems a general practitioner or pediatrician has to face in day-to-day clinical practice. It can be a mild viral illness or a life-threatening illness like meningococcemia or Dengue hemorrhagic fever or it can be one with a lifelong consequence like Kawasaki disease. It is very important to arrive at a clinical diagnosis as early as possible with the minimum investigational facilities. The common causes associated with fever and rashes are infections, viral followed by other infections. There can be so many non-infectious causes also for fever and rashes like auto immune diseases, drug allergies etc. The type of rashes, their appearance in relation to the fever and pattern of spread to different parts of body and the disappearance, all will help in making a diagnosis. Often the diagnosis is clinical. In certain situations laboratory work up becomes essential.

Acute hemorrhagic encephalitis: An unusual presentation of dengue viral infection

International Nuclear Information System (INIS)

Nadarajah, Jeyaseelan; Madhusudhan, Kumble Seetharama; Yadav, Ajay Kumar; Gupta, Arun Kumar; Vikram, Naval Kumar

2015-01-01

Dengue is a common viral infection worldwide with presentation varying from clinically silent infection to dengue fever, dengue hemorrhagic fever, and severe fulminant dengue shock syndrome. Neurological manifestation usually results from multisystem dysfunction secondary to vascular leak. Presentation as hemorrhagic encephalitis is very rare. Here we present the case of a 13-year-old female admitted with generalized tonic clonic seizures. Plain computed tomography (CT) scan of head revealed hypodensities in bilateral deep gray matter nuclei and right posterior parietal lobe without any hemorrhage. Cerebrospinal fluid (CSF) and serology were positive for IgM and IgG antibodies to dengue viral antigen. Contrast-enhanced magnetic resonance imaging (MRI) revealed multifocal T2 and fluid attenuated inversion recovery (FLAIR) hyperintensities in bilateral cerebral parenchyma including basal ganglia. No hemorrhage was seen. She was managed with steroids. As her clinical condition deteriorated, after being stable for 2 days, repeat MRI was done which revealed development of hemorrhage within the lesions, and diagnosis of acute hemorrhagic encephalitis of dengue viral etiology was made

Existing and potential infection risk zones of yellow fever worldwide: a modelling analysis

OpenAIRE

Shearer, Freya M; Longbottom, Joshua; Browne, Annie J; Pigott, David M; Brady, Oliver J; Kraemer, Moritz U G; Marinho, Fatima; Yactayo, Sergio; de Araújo, Valdelaine E M; da Nóbrega, Aglaêr A; Fullman, Nancy; Ray, Sarah E; Mosser, Jonathan F; Stanaway, Jeffrey D; Lim, Stephen S

2018-01-01

Summary: Background: Yellow fever cases are under-reported and the exact distribution of the disease is unknown. An effective vaccine is available but more information is needed about which populations within risk zones should be targeted to implement interventions. Substantial outbreaks of yellow fever in Angola, Democratic Republic of the Congo, and Brazil, coupled with the global expansion of the range of its main urban vector, Aedes aegypti, suggest that yellow fever has the propensity t...

Intracranial Hemorrhage

Science.gov (United States)

2011-01-01

Intracranial hemorrhage is a life-threatening condition, the outcome of which can be improved by intensive care. Intracranial hemorrhage may be spontaneous, precipitated by an underlying vascular malformation, induced by trauma, or related to therapeutic anticoagulation. The goals of critical care are to assess the proximate cause, minimize the risks of hemorrhage expansion through blood pressure control and correction of coagulopathy, and obliterate vascular lesions with a high risk of acute rebleeding. Simple bedside scales and interpretation of computed tomography scans assess the severity of neurological injury. Myocardial stunning and pulmonary edema related to neurological injury should be anticipated, and can usually be managed. Fever (often not from infection) is common and can be effectively treated, although therapeutic cooling has not been shown to improve outcomes after intracranial hemorrhage. Most functional and cognitive recovery takes place weeks to months after discharge; expected levels of functional independence (no disability, disability but independence with a device, dependence) may guide conversations with patient representatives. Goals of care impact mortality, with do-not-resuscitate status increasing the predicted mortality for any level of severity of intraparenchymal hemorrhage. Future directions include refining the use of bedside neuromonitoring (electroencephalogram, invasive monitors), novel approaches to reduce intracranial hemorrhage expansion, minimizing vasospasm, and refining the assessment of quality of life to guide rehabilitation and therapy. PMID:22167847

Studies of Reservoir Hosts for Marburg virus

DEFF Research Database (Denmark)

Swanepoel, Robert; Smit, Sheilagh B; Rollin, Pierre E

2007-01-01

To determine reservoir hosts for Marburg virus (MARV), we examined the fauna of a mine in northeastern Democratic Republic of the Congo. The mine was associated with a protracted outbreak of Marburg hemorrhagic fever during 1998-2000. We found MARV nucleic acid in 12 bats, comprising 3.0%-3.6% of...

A serological survey of Crimean-Congo haemorrhagic fever in animals in the Sharkia Governorate of Egypt

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Amr Murad

2008-09-01

Full Text Available A surveillance survey was conducted over a period of 12 months between September 2004 and August 2005 by the Tropical Medicine Department of Zagazig University in collaboration with Naval Medical Research Unit No. 3 (NAMRU-3, Egypt, to evaluate the role of ruminants as a reservoir host for Crimean-Congo haemorrhagic fever virus (CCHFV. A total of 1 022 serum samples from 313 cattle, 264 water buffalo (Bubalus bubalis, 270 sheep and 175 goats were included in the survey. All samples were collected from the Sharkia Governorate of Egypt and were examined for anti-CCHFV IgG. Of the total of 1 022 samples examined, 32 (3.13% were positive to IgG ELISA. Out of 270 sheep examined, 17 (6.30% were confirmed to have anti-CCHFV IgG with the highest titre recorded at 1:800. However, CCHFV-specific IgG-positive cases among the cattle, buffalo and goats were 3.83%, 0.38% and 1.14%, respectively. Positive cases in age group B (=2 years old were significantly higher (p<0.001 than those in age group A (<2 years old (5.7% versus 1.6%. Belbis City was found to have the highest number of positive cases compared to all other localities (p<0.001.

Rat bite fever in a pet lover.

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Cunningham, B B; Paller, A S; Katz, B Z

1998-02-01

Rat-bite fever is an uncommon bacterial illness resulting from infection with Streptobacillus moniliformis that is often transmitted by the bite of a rat. The cutaneous findings in rat-bite fever are nonspecific but have been described as maculopapular or petechial. We describe a 9-year-old girl with acrally distributed hemorrhagic pustules, fever, and arthralgias. Diagnosis was delayed because of difficulty in identifying the pathologic organism. She was successfully treated with 10 days of ceftriaxone.

Pharmacotherapy of Ebola hemorrhagic fever: a brief review of current status and future perspectives.

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Olszanecki, Rafał; Gawlik, Grzegorz

2014-01-01

The 2014 outbreak clearly showed that Ebola viruses (EBOV) remain a substantial threat for public health. The mainstay of management of patients with Ebola disease is isolation of patients and use of strict barrier nursing procedures; the present treatment strategies are mainly symptomatic and supportive (fluid resuscitation, antypyretics, antidiarrheal drugs). Currently, there is no approved therapy for Ebola hemorrhagic fever (EHF), however several advanced treatment options were tested in animal models (on non-human primates or rodents). They include use of both symptomatic (e.g. use of tissue factor inhibitors - rhNAPc2, rhAPC - to abolish coagulopathy) and specific antiviral approaches: e.g. monoclonal anti EBOV antibodies (ZMapp, MB-003), phosphorodiamidate morpholino oligomers (PMOs), liposomes containing siRNA (LNP-siRNA:TKM-Ebola) and small molecule inhibitors (e.g. BCX4430, favipiravir). The scope of this article is to briefly review the most promising therapeutics for EHF, based on the data coming from rare clinical reports, studies on animals and results from in vitro models.

Interim Report on Multiple Sequence Alignments and TaqMan Signature Mapping to Phylogenetic Trees

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Gardner, S; Jaing, C

2012-03-27

The goal of this project is to develop forensic genotyping assays for select agent viruses, addressing a significant capability gap for the viral bioforensics and law enforcement community. We used a multipronged approach combining bioinformatics analysis, PCR-enriched samples, microarrays and TaqMan assays to develop high resolution and cost effective genotyping methods for strain level forensic discrimination of viruses. We have leveraged substantial experience and efficiency gained through year 1 on software development, SNP discovery, TaqMan signature design and phylogenetic signature mapping to scale up the development of forensics signatures in year 2. In this report, we have summarized the Taqman signature development for South American hemorrhagic fever viruses, tick-borne encephalitis viruses and henipaviruses, Old World Arenaviruses, filoviruses, Crimean-Congo hemorrhagic fever virus, Rift Valley fever virus and Japanese encephalitis virus.

Rift Valley Fever.

Science.gov (United States)

Hartman, Amy

2017-06-01

Rift Valley fever (RVF) is a severe veterinary disease of livestock that also causes moderate to severe illness in people. The life cycle of RVF is complex and involves mosquitoes, livestock, people, and the environment. RVF virus is transmitted from either mosquitoes or farm animals to humans, but is generally not transmitted from person to person. People can develop different diseases after infection, including febrile illness, ocular disease, hemorrhagic fever, or encephalitis. There is a significant risk for emergence of RVF into new locations, which would affect human health and livestock industries. Copyright © 2017 Elsevier Inc. All rights reserved.

Prevention of vector transmitted diseases with clove oil insect repellent.

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Shapiro, Rochel

2012-08-01

Vector repellent is one element in the prevention of vector-borne diseases. Families that neglect protecting their children against vectors risk their children contracting illnesses such as West Nile virus, eastern equine encephalitis, Lyme disease, malaria, dengue hemorrhagic fever, yellow fever, babesiosis, Crimean-Congo hemorrhagic fever, Rocky Mountain spotted fever, Southern tick-associated rash illness, ehrlichiosis, tick-borne relapsing fever, tularemia, and other insect and arthropod related diseases (CDC, 2011). Identification of families at risk includes screening of the underlying basis for reluctance to apply insect repellent. Nurses and physicians can participate in a positive role by assisting families to determine the proper prophylaxis by recommending insect repellent choices that are economical, safe, and easy to use. A holistic alternative might include the suggestion of clove oil in cases where families might have trepidations regarding the use of DEET on children. This article will explore the safety and effectiveness of clove oil and its use as an insect repellent. Copyright © 2012 Elsevier Inc. All rights reserved.

Dengue fever: a Wikipedia clinical review.

Science.gov (United States)

Heilman, James M; De Wolff, Jacob; Beards, Graham M; Basden, Brian J

2014-01-01

Dengue fever, also known as breakbone fever, is a mosquito-borne infectious tropical disease caused by the dengue virus. Symptoms include fever, headache, muscle and joint pains, and a characteristic skin rash that is similar to measles. In a small proportion of cases, the disease develops into life-threatening dengue hemorrhagic fever, which results in bleeding, thrombocytopenia, and leakage of blood plasma, or into dengue shock syndrome, in which dangerously low blood pressure occurs. Treatment of acute dengue fever is supportive, with either oral or intravenous rehydration for mild or moderate disease and use of intravenous fluids and blood transfusion for more severe cases. Along with attempts to eliminate the mosquito vector, work is ongoing to develop a vaccine and medications targeted directly at the virus.

Detecting Ebola with limited laboratory access in the Democratic Republic of Congo: evaluation of a clinical passive surveillance reporting system.

Science.gov (United States)

Ashbaugh, Hayley R; Kuang, Brandon; Gadoth, Adva; Alfonso, Vivian H; Mukadi, Patrick; Doshi, Reena H; Hoff, Nicole A; Sinai, Cyrus; Mossoko, Mathias; Kebela, Benoit Ilunga; Muyembe, Jean-Jacques; Wemakoy, Emile Okitolonda; Rimoin, Anne W

2017-09-01

Ebola virus disease (EVD) can be clinically severe and highly fatal, making surveillance efforts for early disease detection of paramount importance. In areas with limited access to laboratory testing, the Integrated Disease Surveillance and Response (IDSR) strategy in the Democratic Republic of Congo (DRC) may be a vital tool in improving outbreak response. Using DRC IDSR data from the nation's four EVD outbreak periods from 2007-2014, we assessed trends of Viral Hemorrhagic Fever (VHF) and EVD differential diagnoses reportable through IDSR. With official case counts from active surveillance of EVD outbreaks, we assessed accuracy of reporting through the IDSR passive surveillance system. Although the active and passive surveillance represent distinct sets of data, the two were correlated, suggesting that passive surveillance based only on clinical evaluation may be a useful predictor of true cases prior to laboratory confirmation. There were 438 suspect VHF cases reported through the IDSR system and 416 EVD cases officially recorded across the outbreaks examined. Although collected prior to official active surveillance cases, case reporting through the IDSR during the 2007, 2008 and 2012 outbreaks coincided with official EVD epidemic curves. Additionally, all outbreak areas experienced increases in suspected cases for both malaria and typhoid fever during EVD outbreaks, underscoring the importance of training health care workers in recognising EVD differential diagnoses and the potential for co-morbidities. © 2017 John Wiley & Sons Ltd.

Intracerebral hemorrhage complicating viral hepatitis A | Belfquih ...

African Journals Online (AJOL)

HVA IgM. Eight 8 weeks after, she developed hemorrhagic syndrome coupled with fever associated and persistent jaundice. The blood count showed aregenerative pancytopenia secondary to aplastic anemia confirmed by bone marrow biopsy.

Some clinical and laboratory parameters of hemorrhagic fever with renal failure syndrome against the background correction of hyperhomocysteinemia

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G. R. Syrtlanova

2013-01-01

Full Text Available The aim of the research was to curry out correction of hyperhomocysteinemia in patients with hemorrhagic fever with renal failure syndrome (HFRS and evaluate some clinical and laboratory parameters. The results of examining 91 men patients with HFRS at the age of 18 till 50 years old are presented. The vitamin complex «Angiovit» was used for hyperhomocysteinemia correction. The correction of hyperhomocysteinemia using the vitamin complex in all the three considered forms (mid, severs, complicated there are statistically significant decreases of homocysteine, the duration of oliguric stage and the concentration of creatinine in oliguric and diuretic stages in patients with HFRS compared with the group of patients having the generally basically therapy.

Role Of Adhesion Molecules Vcam-1 And Ve-Cadherin In Endothelium Dysfunction Development At Hemorrhagic Fever With Renal Syndrome

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А.А. Baygildina

2009-12-01

Full Text Available The research goal is to determine the changes in concentration of both sVCAM-1 and VE-cadherin in blood serum of patients suffered from hemorrhagic fever with renal syndrome (HFRS. 87 patients aged 15-65 were examined. Concentrations of both sVCAM-1 and VE- cadherin in blood serum by means of "Bender MedSystems" (Austria ELISA test were determined. It was shown that in both medium severe and severe forms of HFRS statistically the significant rise of sVCAM-1 concentration in blood with high indices in oliguric period took place. Complicated form was characterized by high indices of sVCAM-1 level in fever period, extremely decreasing in concentration in oliguric period and tendency to normalizing in clinical convalescence period. VE-cadherin level in blood was predominantly lower than control in all the observed groups with the exception of fever period in group with medium severe disease form. Negative correlation of normal intensity between adhesion molecules levels in blood was revealed. In conclusion it is necessary to point out that high VCAM-1 expression by endotheliocytes evidences the development of an adhesion form of endothelial dysfunction, low VE-cadherin production in a base for development of angiogenic form of endothelial dysfunction and changes in expression of these adhesion molecules that have adaptive metabolic response to macroorganism of HFRS pathogenic action

Spatial analysis of hemorrhagic fever with renal syndrome in China

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Yang Hong

2006-04-01

Full Text Available Abstract Background Hemorrhagic fever with renal syndrome (HFRS is endemic in many provinces with high incidence in mainland China, although integrated intervention measures including rodent control, environment management and vaccination have been implemented for over ten years. In this study, we conducted a geographic information system (GIS-based spatial analysis on distribution of HFRS cases for the whole country with an objective to inform priority areas for public health planning and resource allocation. Methods Annualized average incidence at a county level was calculated using HFRS cases reported during 1994–1998 in mainland China. GIS-based spatial analyses were conducted to detect spatial autocorrelation and clusters of HFRS incidence at the county level throughout the country. Results Spatial distribution of HFRS cases in mainland China from 1994 to 1998 was mapped at county level in the aspects of crude incidence, excess hazard and spatial smoothed incidence. The spatial distribution of HFRS cases was nonrandom and clustered with a Moran's I = 0.5044 (p = 0.001. Spatial cluster analyses suggested that 26 and 39 areas were at increased risks of HFRS (p Conclusion The application of GIS, together with spatial statistical techniques, provide a means to quantify explicit HFRS risks and to further identify environmental factors responsible for the increasing disease risks. We demonstrate a new perspective of integrating such spatial analysis tools into the epidemiologic study and risk assessment of HFRS.

Localised transmission hotspots of a typhoid fever outbreak in the Democratic Republic of Congo.

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Ali, Engy; Bergh, Rafael Van Den; D'hondt, Rob; Kuma-Kuma, Donat; Weggheleire, Anja De; Baudot, Yves; Lambert, Vincent; Hunter, Paul; Zachariah, Rony; Maes, Peter

2017-01-01

In a semi-urban setting in the Democratic Republic of Congo, this study aims to understand the dynamic of a typhoid fever (TF) outbreak and to assess: a) the existence of hot spots for TF transmission and b) the difference between typhoid cases identified within those hot spots and the general population in relation to socio-demographic characteristics, sanitation practice, and sources of drinking water. This was a retrospective analysis of TF outbreaks in 2011 in Kikwit, DRC using microbiological analysis of water sources and a structured interview questionnaire. There were a total of 1430 reported TF cases. The outbreak's epidemic curve shows earliest and highest peak attack rates (AR) in three military camps located in Kikwit (Ebeya 3.2%; Ngubu 3.0%; and Nsinga 2.2%) compared to an average peak AR of 0.6% in other affected areas. A total 320 cases from the military camps and the high burden health areas were interviewed. Typhoid cases in the military camps shared a latrine with more than one family (P<0.02). All tap water sources in both the military camps and general population were found to be highly contaminated with faecal coliforms. The role of military camps in Kikwit as early hotspots of TF transmission was likely associated with lower sanitary and hygiene conditions. The proximity of camps to the general population might have been responsible for disseminating TF to the general population. Mapping of cases during an outbreak could be crucial to identify hot spots for transmission and institute corrective measures.

Acute infectious purpura fulminans due to probable spotted fever

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A Kundavaram

2014-01-01

Full Text Available Purpura fulminans (PF is associated with several infections, most notably with meningococcus, staphylococcus, and streptococcus infections. However, there are few reports of association of this entity with spotted fever from India. We report the case of a 55-year-old man who presented with fever, headache, and myalgia. On the seventh day of fever he developed nonblanching purple hemorrhagic purpura on the trunk and most prominently on the extremities consistent with purpura fulminans. Immunofluorescent assay confirmed the diagnosis of spotted fever. PF though common with rocky mountain spotted fever (RMSF is rarely seen in association with Indian tick typhus, the usual cause of spotted fever in India.

Browse Title Index

African Journals Online (AJOL)

Items 101 - 126 of 126 ... Vol 10, No 1 (2016), Review of past and present Ebola hemorrhagic fever outbreaks in the Democratic Republic of Congo 1976 -2014, Abstract PDF ... Vol 10, No 2 (2016), The evaluation of domestic ducks as potential reservoir of avian influenza virus in post HPAI H5N1 outbreak area, Sunyani ...

Fatal dengue hemorrhagic fever in adults: emphasizing the evolutionary pre-fatal clinical and laboratory manifestations.

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Ing-Kit Lee

Full Text Available BACKGROUND: A better description of the clinical and laboratory manifestations of fatal patients with dengue hemorrhagic fever (DHF is important in alerting clinicians of severe dengue and improving management. METHODS AND FINDINGS: Of 309 adults with DHF, 10 fatal patients and 299 survivors (controls were retrospectively analyzed. Regarding causes of fatality, massive gastrointestinal (GI bleeding was found in 4 patients, dengue shock syndrome (DSS alone in 2; DSS/subarachnoid hemorrhage, Klebsiella pneumoniae meningitis/bacteremia, ventilator associated pneumonia, and massive GI bleeding/Enterococcus faecalis bacteremia each in one. Fatal patients were found to have significantly higher frequencies of early altered consciousness (≤24 h after hospitalization, hypothermia, GI bleeding/massive GI bleeding, DSS, concurrent bacteremia with/without shock, pulmonary edema, renal/hepatic failure, and subarachnoid hemorrhage. Among those experienced early altered consciousness, massive GI bleeding alone/with uremia/with E. faecalis bacteremia, and K. pneumoniae meningitis/bacteremia were each found in one patient. Significantly higher proportion of bandemia from initial (arrival laboratory data in fatal patients as compared to controls, and higher proportion of pre-fatal leukocytosis and lower pre-fatal platelet count as compared to initial laboratory data of fatal patients were found. Massive GI bleeding (33.3% and bacteremia (25% were the major causes of pre-fatal leukocytosis in the deceased patients; 33.3% of the patients with pre-fatal profound thrombocytopenia (<20,000/µL, and 50% of the patients with pre-fatal prothrombin time (PT prolongation experienced massive GI bleeding. CONCLUSIONS: Our report highlights causes of fatality other than DSS in patients with severe dengue, and suggested hypothermia, leukocytosis and bandemia may be warning signs of severe dengue. Clinicians should be alert to the potential development of massive GI bleeding

Effect of dexamethasone in primary intracerebral hemorrhage in the south west of iran

International Nuclear Information System (INIS)

Sharafadinzadeh, N.; Baghebanian, S.M.; Pipelzadeh, M.; Moravej, A. A.; Ghanavatiz, P.

2008-01-01

Previous study revealed the value of dexamethasone in the treatment of vasogenic edema associated with brain tumor and abscess. However there are poor documented studies about its usefulness in primary intracerebral hemorrhage. In this study we evaluated dexamethasone effects in primary intracerebral hemorrhage. In a double blind randomized placebo-controlled clinical trial we evaluated 200 intracerebral hemorrhage cases between 40 to 80 years old whom were admitted at Golestan Hospital (Ahwaz, IR) between March 2002 and March 2003. They were divided in two groups dexamethasone (N=100) and placebo (N=100). Then mortality, GI bleeding, fever, electrolytes disturbances, hypertension and hyperglycemic status were analyzed in two groups. Ethical considerations were employed and subjects were followed by appropriate statistical methods for 21 days to assess the major outcomes. Mortality was much higher in the dexamethasone group; Dexamethasone group (49.3%) and placebo (23.4%) and also fever was higher seen in the dexamethasone group; dexamethasone group (40.2%) and placebo group (24.7%) but there was not any significant statistical difference between two groups as regards other complications. Dexamethasone is widely used for cerebral edema associated conditions but in this study we saw that it's complications in intracerebral hemorrhage such as increasing fever and mortality are significantly higher. Hence it use for treatment of primary intracerebral hemorrhage should be reconsidered. (author)

Meta-Analysis of High-Throughput Datasets Reveals Cellular Responses Following Hemorrhagic Fever Virus Infection

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Gavin C. Bowick

2011-05-01

Full Text Available The continuing use of high-throughput assays to investigate cellular responses to infection is providing a large repository of information. Due to the large number of differentially expressed transcripts, often running into the thousands, the majority of these data have not been thoroughly investigated. Advances in techniques for the downstream analysis of high-throughput datasets are providing additional methods for the generation of additional hypotheses for further investigation. The large number of experimental observations, combined with databases that correlate particular genes and proteins with canonical pathways, functions and diseases, allows for the bioinformatic exploration of functional networks that may be implicated in replication or pathogenesis. Herein, we provide an example of how analysis of published high-throughput datasets of cellular responses to hemorrhagic fever virus infection can generate additional functional data. We describe enrichment of genes involved in metabolism, post-translational modification and cardiac damage; potential roles for specific transcription factors and a conserved involvement of a pathway based around cyclooxygenase-2. We believe that these types of analyses can provide virologists with additional hypotheses for continued investigation.

Ixodes ricinus as vector and reservoir of Borrelia burgdorferi in an urban environment

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Rajković Dragana V.

2005-01-01

Full Text Available As specific arthropods, ticks in urban environments transmit the agents of dangerous contagious diseases endangering human and animal health. They are vectors of numerous infective agents that cause serious diseases of animals such as babesiosis and ehrlichiosis. Tick populations maintain and transmit an increas­ing number of different infective agents. In regard to the human population, they transmit the agents of tick encephalitis, Omsk hemorrhagic disease, Crim-Congo hemorrhagic disease, Kyasa-nur forest fever, ixodid fever, Q fever, Rocky Mountain spotted fever, tularemia, Siberian tick typhus and Lyme disease the last of which according to acarological references has become the dominant zoonosis in over 140 of the world's countries. In urban environments ticks represent problem both for their epidemiological significance and as organisms whose presence disturbs people during their work and rest. In Europe, the two most fre­quent species and Ixodes ricinus and Ixodes persulcatus. Both species have a wide spectrum of hosts.

Localised transmission hotspots of a typhoid fever outbreak in the ...

African Journals Online (AJOL)

Introduction: in a semi-urban setting in the Democratic Republic of Congo, this study aims to understand the dynamic of a typhoid fever (TF) outbreak and to assess: a) the existence of hot spots for TF transmission and b) the difference between typhoid cases identified within those hot spots and the general population in ...

Hospital Preparations for Viral Hemorrhagic Fever Patients and Experience Gained from Admission of an Ebola Patient.

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Haverkort, J J Mark; Minderhoud, A L C Ben; Wind, Jelte D D; Leenen, Luke P H; Hoepelman, Andy I M; Ellerbroek, Pauline M

2016-02-01

The Major Incident Hospital of the University Medical Centre of Utrecht has a longstanding history of preparing for the management of highly pathogenic and infectious organisms. An assessment of the hospital's preparations for an outbreak of viral hemorrhagic fever and its experience during admission of a patient with Ebola virus disease showed that the use of the buddy system, frequent training, and information sessions for staff and their relatives greatly increased the sense of safety and motivation among staff. Differing procedures among ambulance services limited the number of services used for transporting patients. Waste management was the greatest concern, and destruction of waste had to be outsourced. The admission of an Ebola patient proceeded without incident but led to considerable demands on staff. The maximum time allowed for wearing personal protective equipment was 45 minutes to ensure safety, and an additional 20 minutes was needed for recovery.

Outbreak of viral hemorrhagic fever caused by dengue virus type 3 in Al-Mukalla, Yemen.

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Madani, Tariq A; Abuelzein, El-Tayeb M E; Al-Bar, Hussein M S; Azhar, Esam I; Kao, Moujahed; Alshoeb, Haj O; Bamoosa, Alabd R

2013-03-14

Investigations were conducted by the authors to explore an outbreak of viral hemorrhagic fever (VHF) reported in 2010 from Al-Mukalla city, the capital of Hadramout in Yemen. From 15-17 June 2010, the outbreak investigation period, specimens were obtained within 7 days after onset of illness of 18 acutely ill patients hospitalized with VHF and 15 household asymptomatic contacts of 6 acute cases. Additionally, 189 stored sera taken from acutely ill patients with suspected VHF hospitalized in the preceding 12 months were obtained from the Ministry of Health of Yemen. Thus, a total of 222 human specimens were collected; 207 specimens from acute cases and 15 specimens from contacts. All samples were tested with RT-PCR for dengue (DENV), Alkhumra (ALKV), Rift Valley Fever (RVFV), Yellow Fever (YFV), and Chikungunya (CHIKV) viruses. Samples were also tested for DENV IgM, IgG, and NS1-antigen. Medical records of patients were reviewed and demographic, clinical, and laboratory data was collected. Of 207 patients tested, 181 (87.4%) patients were confirmed to have acute dengue with positive dengue NS1-antigen (97 patients, 46.9%) and/or IgM (163 patients, 78.7%). Of the 181 patients with confirmed dengue, 100 (55.2%) patients were IgG-positive. DENV RNA was detected in 2 (1%) patients with acute symptoms; both samples were molecularly typed as DENV type 3. No other VHF viruses were detected. For the 15 contacts tested, RT-PCR tests for the five viruses were negative, one contact was dengue IgM positive, and another one was dengue IgG positive. Of the 181 confirmed dengue patients, 120 (66.3%) patients were males and the median age was 24 years. The most common manifestations included fever (100%), headache (94.5%), backache (93.4%), malaise (88.4%), arthralgia (85.1%), myalgia (82.3%), bone pain (77.9%), and leukopenia (76.2%). Two (1.1%) patients died. DENV-3 was confirmed to be the cause of an outbreak of VHF in Al-Mukalla. It is important to use both IgM and NS1-antigen

Outbreak of viral hemorrhagic fever caused by dengue virus type 3 in Al-Mukalla, Yemen

Science.gov (United States)

2013-01-01

Background Investigations were conducted by the authors to explore an outbreak of viral hemorrhagic fever (VHF) reported in 2010 from Al-Mukalla city, the capital of Hadramout in Yemen. Methods From 15–17 June 2010, the outbreak investigation period, specimens were obtained within 7 days after onset of illness of 18 acutely ill patients hospitalized with VHF and 15 household asymptomatic contacts of 6 acute cases. Additionally, 189 stored sera taken from acutely ill patients with suspected VHF hospitalized in the preceding 12 months were obtained from the Ministry of Health of Yemen. Thus, a total of 222 human specimens were collected; 207 specimens from acute cases and 15 specimens from contacts. All samples were tested with RT-PCR for dengue (DENV), Alkhumra (ALKV), Rift Valley Fever (RVFV), Yellow Fever (YFV), and Chikungunya (CHIKV) viruses. Samples were also tested for DENV IgM, IgG, and NS1-antigen. Medical records of patients were reviewed and demographic, clinical, and laboratory data was collected. Results Of 207 patients tested, 181 (87.4%) patients were confirmed to have acute dengue with positive dengue NS1-antigen (97 patients, 46.9%) and/or IgM (163 patients, 78.7%). Of the 181 patients with confirmed dengue, 100 (55.2%) patients were IgG-positive. DENV RNA was detected in 2 (1%) patients with acute symptoms; both samples were molecularly typed as DENV type 3. No other VHF viruses were detected. For the 15 contacts tested, RT-PCR tests for the five viruses were negative, one contact was dengue IgM positive, and another one was dengue IgG positive. Of the 181 confirmed dengue patients, 120 (66.3%) patients were males and the median age was 24 years. The most common manifestations included fever (100%), headache (94.5%), backache (93.4%), malaise (88.4%), arthralgia (85.1%), myalgia (82.3%), bone pain (77.9%), and leukopenia (76.2%). Two (1.1%) patients died. Conclusions DENV-3 was confirmed to be the cause of an outbreak of VHF in Al

Filgrastim as a Rescue Therapy for Persistent Neutropenia in a Case of Dengue Hemorrhagic Fever with Acute Respiratory Distress Syndrome and Myocarditis

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Desh Deepak

2011-01-01

Full Text Available Pathogenesis of dengue involves suppression of immune system leading to development of characteristic presentation of haematological picture of thrombocytopenia and leucopenia. Sometimes, this suppression in immune response is responsible for deterioration in clinical status of the patient in spite of all specific and supportive therapy. Certain drugs like steroids are used for rescue therapy in conditions like sepsis. We present a novel use of filgrastim as a rescue therapy in a patient with dengue hemorrhagic fever (DHF with acute respiratory distress syndrome (ARDS, myocarditis, and febrile neutropenia and not responding to standard management.

Herpes Simplex Encephalitis Complicated by Cerebral Hemorrhage during Acyclovir Therapy.

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Harada, Yukinori; Hara, Yuuta

2017-01-01

Herpes simplex encephalitis (HSE) can be complicated by adverse events in the acute phase. We herein present the case of a 71-year-old woman with HSE complicated by cerebral hemorrhage. She presented with acute deterioration of consciousness and fever and was diagnosed with HSE based on the detection of herpes simplex virus-1 in the cerebrospinal fluid by a polymerase chain reaction. The cerebral hemorrhage developed during acyclovir therapy; however, its diagnosis was delayed for 2 days. After the conservative treatment of the cerebral hemorrhage, the patient made a near-complete recovery. Cerebral hemorrhage should be considered as an acute-phase complication of HSE.

Ebola Viral Hemorrhagic Disease Outbreak in West Africa- Lessons ...

African Journals Online (AJOL)

... to contain the Ebola epidemic. Key words: Ebola, viral hemorrhagic fever, West Africa, lessons, Uganda .... the corresponding surveillance systems for detecting priority diseases. ... A major outbreak of Yellow Fe- ver was reported in five ...

Dengue fever: diagnosis and treatment.

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Wiwanitkit, Viroj

2010-07-01

Dengue fever is a common tropical infection. This acute febrile illness can be a deadly infection in cases of severe manifestation, causing dengue hemorrhagic shock. In this brief article, I will summarize and discuss the diagnosis and treatment of this disease. For diagnosis of dengue, most tropical doctors make use of presumptive diagnosis; however, the definite diagnosis should be based on immunodiagnosis or viral study. Focusing on treatment, symptomatic and supportive treatment is the main therapeutic approach. The role of antiviral drugs in the treatment of dengue fever has been limited, but is currently widely studied.

Animal Models for the Study of Rodent-Borne Hemorrhagic Fever Viruses: Arenaviruses and Hantaviruses

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Joseph W. Golden

2015-01-01

Full Text Available Human pathogenic hantaviruses and arenaviruses are maintained in nature by persistent infection of rodent carrier populations. Several members of these virus groups can cause significant disease in humans that is generically termed viral hemorrhagic fever (HF and is characterized as a febrile illness with an increased propensity to cause acute inflammation. Human interaction with rodent carrier populations leads to infection. Arenaviruses are also viewed as potential biological weapons threat agents. There is an increased interest in studying these viruses in animal models to gain a deeper understating not only of viral pathogenesis, but also for the evaluation of medical countermeasures (MCM to mitigate disease threats. In this review, we examine current knowledge regarding animal models employed in the study of these viruses. We include analysis of infection models in natural reservoirs and also discuss the impact of strain heterogeneity on the susceptibility of animals to infection. This information should provide a comprehensive reference for those interested in the study of arenaviruses and hantaviruses not only for MCM development but also in the study of viral pathogenesis and the biology of these viruses in their natural reservoirs.

[Ebola hemorrhagic fever: Properties of the pathogen and development of vaccines and chemotherapeutic agents].

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Kiselev, O I; Vasin, A V; Shevyryova, M P; Deeva, E G; Sivak, K V; Egorov, V V; Tsvetkov, V B; Egorov, A Yu; Romanovskaya-Romanko, E A; Stepanova, L A; Komissarov, A B; Tsybalova, L M; Ignatjev, G M

2015-01-01

Ebola hemorrhagic fever (EHF) epidemic currently ongoing in West Africa is not the first among numerous epidemics in the continent. Yet it seems to be the worst EHF epidemic outbreak caused by Ebola virus Zaire since 1976 as regards its extremely large scale and rapid spread in the population. Experiments to study the agent have continued for more than 20 years. The EHF virus has a relatively simple genome with seven genes and additional reading frame resulting from RNA editing. While being of a relatively low genetic capacity, the virus can be ranked as a standard for pathogenicity with the ability to evade the host immune response in uttermost perfection. The EHF virus has similarities with retroviruses, but belongs to (-)RNA viruses of a nonretroviral origin. Genetic elements of the virus, NIRV, were detected in animal and human genomes. EHF virus glycoprotein (GP) is a class I fusion protein and shows more similarities than distinctions in tertiary structure with SIV and HIV gp41 proteins and even influenza virus hemagglutinin. EHF is an unusual infectious disease, and studying the molecular basis of its pathogenesis may contribute to new findings in therapy of severe conditions leading to a fatal outcome.

T Cells and Pathogenesis of Hantavirus Cardiopulmonary Syndrome and Hemorrhagic Fever with Renal Syndrome

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Francis A. Ennis

2011-07-01

Full Text Available We previously hypothesized that increased capillary permeability observed in both hantavirus cardiopulmonary syndrome (HCPS and hemorrhagic fever with renal syndrome (HFRS may be caused by hantavirus-specific cytotoxic T cells attacking endothelial cells presenting viral antigens on their surface based on clinical observations and in vitro experiments. In HCPS, hantavirus-specific T cell responses positively correlated with disease severity. In HFRS, in one report, contrary to HCPS, T cell responses negatively correlated with disease severity, but in another report the number of regulatory T cells, which are thought to suppress T cell responses, negatively correlated with disease severity. In rat experiments, in which hantavirus causes persistent infection, depletion of regulatory T cells helped infected rats clear virus without inducing immunopathology. These seemingly contradictory findings may suggest delicate balance in T cell responses between protection and immunopathogenesis. Both too strong and too weak T cell responses may lead to severe disease. It is important to clarify the role of T cells in these diseases for better treatment (whether to suppress T cell functions and protection (vaccine design which may need to take into account viral factors and the influence of HLA on T cell responses.

Pathogenesis of lober intracerebral hemorrhage related to cerebral amyloid angiopathy

International Nuclear Information System (INIS)

Sakai, Naoto; Namba, Hiroki; Miura, Katsutoshi; Baba, Satoshi; Isoda, Haruo; Yokoyama, Tetsuo

2010-01-01

Cerebral amyloid angiopathy (CAA) is an important cause of lober intracerebral hemorrhage in the elderly. Although leptomeningeal and cortical arteries with the deposition of the amyloid β-protein (Aβ) have been thought to rupture in CAA, the pathogenesis of CAA-related hemorrhage still remains obscure. We studied 10 cases of CAA according to the Boston criteria from April 2006 to July 2009 in Omaezaki Municipal Hospital. Based on clinical data, we examined the primary site of hemorrhage and hypothesized the mechanisms of bleeding. Intracerebral hematoma evacuation was performed to alleviate neurological deteriolation in 2 patients and to make diagnosis in 3 patients. The surgical specimens were pathologically examined. The characteristic MR images of CAA related hemorrhage were characterized by microbleeds, superficial siderosis, subpial or subarachnoid hemorrhage, subcortical hemorrhage and lober intracerebral hemorrhage. Chronological images obtained in 1 patient revealed that lober intracerebral hemorrhage developed from microbleed with subpial hemorrhage without subarachnoid hemorrhage in one side of the cortex in the affected facing cerebral sulci. Operative findings showed subpial and subarachnoid hemorrhages around the cortical veins on the affected cerebral sulci in all cases. Abnormal fragile vessels existed in one side of the cortex of the affected sulci but not in the other side of the cortex. Complete hamatoma evacuation was performed in 4 cases. The surgical specimens of the hematoma and the adjacent brain parenchyma were pathologically examined by tissue staining with hematoxylin-eosin and Congo red. Many vessels in subpial, subcortical and subarachnoid space along the cerebral sulci were deposited with Aβ. From these findings, we speculated that the primary hemorrhage related to CAA occurred from the cortical arteries with Aβ deposition in the subpial space along the cerebral sulci and formed a lober intracerebral hematoma. Subarachnoid

The pathogenesis of Ebola hemorrhagic fever.

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Takada, A; Kawaoka, Y

2001-10-01

Ebola virus causes lethal hemorrhagic disease in humans, yet there are still no satisfactory biological explanations to account for its extreme virulence. This review focuses on recent findings relevant to understanding the pathogenesis of Ebola virus infection and developing vaccines and effective therapy. The available data suggest that the envelope glycoprotein and the interaction of some viral proteins with the immune system are likely to play important roles in the extraordinary pathogenicity of this virus. There are also indications that genetically engineered vaccines, including plasmid DNA and viral vectors expressing Ebola virus proteins, and passive transfer of neutralizing antibodies could be feasible options for the control of Ebola virus-associated disease.

Pathogenesis of Rift Valley Fever in Rhesus Monkeys: Role of Interferon Response

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1990-01-01

hemorrhagic fever characterized by epistaxis, petechial to purpuric cutaneous lesions, anorexia, and vomiting prior to death. The 14 remaining monkeys survived...DMI, FILE Copy Arch Virol (1990) 110: 195-212 Amhivesirology ( by Springer-Verlag 1990 00 N Pathogenesis of Rift Valley fever in rhesus monkeys: (NI...inoculated intravenously with Rift Valley fever (RVF) virus presented clinical disease syndromes similar to human cases of RVF. All 17 infected monkeys

RELATIONSHIP BETWEEN KNOWLEDGE OF VECTOR WITH HOUSEHOLD INSECTICIDE USAGE BEHAVIOR IN DENGUE HEMORRHAGIC FEVER ENDEMIC AREAS IN BALI PROVINCE

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Diana Andriyani Pratamawati

2014-06-01

Full Text Available Bali Province has a case fatality rate (CFR of Dengue Hemorrhagic Fever (DHF 56.16 per100,000 populations in 2011. Data of Riskesdas 2010 showed that anti mosquito (householdinsecticides was the most widely used by people to prevent vector borne diseases. This studyaimed to describe behavior by using household insecticides to prevent DHF and determinewhether this behavior was based on dengue vector knowledge. This research was a descriptivestudy using survey methods. Unit analysis was households in DHF endemic area in DenpasarCity, Gianyar and Badung Regency which had highest dengue cases until August 2011. Resultsshowed that 54.5% of the 88 respondents has high level in dengue vector knowledge. Mostrespondents (59.1% has good category in household insecticide usage behavior. Kendall taucorrelation test (t showed no significant relation between knowledge of dengue vectors withhousehold insecticide usage behavior for dengue vector control (t = 0,076, p value= 0,479.Keywords: Knowledge, Vector, Dengue Hemorrhagic Fever, HouseholdInsecticides Provinsi Bali memiliki case fatality rate (CFR Demam Berdarah Dengue (DBD 56,16 per100.000 penduduk pada tahun 2011. Data Riskesdas 2010 menunjukkan bahwa obat antinyamuk (insektisida rumah tangga merupakan cara yang paling banyak digunakan olehmasyarakat untuk mencegah penyakit tular vektor. Studi ini bertujuan untuk mendeskripsikanperilaku dalam menggunakan insektisida rumah tangga untuk mencegah DBDserta mengetahuiapakah perilaku ini didasari oleh pengetahuanmengenai vektor DBD. Penelitian ini merupakanstudi deskriptif dengan menggunakan metode survei. Unit analisis adalah rumah tangga didaerah endemis DBD di Kota Denpasar, Kabupaten Gianyar, dan Kabupaten Badung yangmemiliki kasus DBD tertinggi hingga bulan Agustus tahun 2011. Hasil penelitianmenunjukkan bahwa 54,5% dari 88 responden memiliki tingkat pengetahuan yang tinggitentang vektor DBD. Sebagian besar responden (59,1% memiliki perilaku

Virus and Infections 2010 - BIT's first world congress.

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Garkavenko, Olga

2010-10-01

The World Congress of Virus and Infections, held in Busan, South Korea, included topics reviewing the field of zoonoses. This conference report highlights selected presentations on surveillance, epidemiology and measures for the control and prevention of zoonotic diseases. Topics discussed include human factors influencing zoonoses, the molecular epidemiology of Crimean-Congo hemorrhagic fever, the emerging Nipah virus, and the re-emergence of cowpox virus.

Risk Factors Associated with Ebola and Marburg Viruses Seroprevalence in Blood Donors in the Republic of Congo.

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Nanikaly Moyen

Full Text Available Ebola and Marburg viruses (family Filoviridae, genera Ebolavirus and Marburgvirus cause haemorrhagic fevers in humans, often associated with high mortality rates. The presence of antibodies to Ebola virus (EBOV and Marburg virus (MARV has been reported in some African countries in individuals without a history of haemorrhagic fever. In this study, we present a MARV and EBOV seroprevalence study conducted amongst blood donors in the Republic of Congo and the analysis of risk factors for contact with EBOV.In 2011, we conducted a MARV and EBOV seroprevalence study amongst 809 blood donors recruited in rural (75; 9.3% and urban (734; 90.7% areas of the Republic of Congo. Serum titres of IgG antibodies to MARV and EBOV were assessed by indirect double-immunofluorescence microscopy. MARV seroprevalence was 0.5% (4 in 809 without any identified risk factors. Prevalence of IgG to EBOV was 2.5%, peaking at 4% in rural areas and in Pointe Noire. Independent risk factors identified by multivariate analysis were contact with bats and exposure to birds.This MARV and EBOV serological survey performed in the Republic of Congo identifies a probable role for environmental determinants of exposure to EBOV. It highlights the requirement for extending our understanding of the ecological and epidemiological risk of bats (previously identified as a potential ecological reservoir and birds as vectors of EBOV to humans, and characterising the protection potentially afforded by EBOV-specific antibodies as detected in blood donors.

Clinico-laboratory spectrum of dengue viral infection and risk factors associated with dengue hemorrhagic fever: a retrospective study.

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Mallhi, Tauqeer Hussain; Khan, Amer Hayat; Adnan, Azreen Syazril; Sarriff, Azmi; Khan, Yusra Habib; Jummaat, Fauziah

2015-09-30

The incidence of dengue is rising steadily in Malaysia since the first major outbreak in 1973. Despite aggressive measures taken by the relevant authorities, Malaysia is still facing worsening dengue crisis over the past few years. There is an urgent need to evaluate dengue cases for better understanding of clinic-laboratory spectrum in order to combat this disease. A retrospective analysis of dengue patients admitted to a tertiary care teaching hospital during the period of six years (2008 - 2013) was performed. Patient's demographics, clinical and laboratory findings were recorded via structured data collection form. Patients were categorized into dengue fever (DF) and dengue hemorrhagic fever (DHF). Appropriate statistical methods were used to compare these two groups in order to determine difference in clinico-laboratory characteristics and to identify independent risk factors of DHF. A total 667 dengue patients (30.69 ± 16.13 years; Male: 56.7 %) were reviewed. Typical manifestations of dengue like fever, myalgia, arthralgia, headache, vomiting, abdominal pain and skin rash were observed in more than 40 % patients. DHF was observed in 79 (11.8 %) cases. Skin rash, dehydration, shortness of breath, pleural effusion and thick gall bladder were more significantly (P  40 years (OR: 4.1, P hospitalization (OR: 2.3, P = 0.037) as independent predictors of DHF. Overall mortality was 1.2 % in our study. Current study demonstrated that DF and DHF present significantly different clinico-laboratory profile. Older age, secondary infection, diabetes mellitus, lethargy, thick gallbladder and delayed hospitalization significantly predict DHF. Prior knowledge of expected clinical profile and predictors of DHF/DSS development would provide information to identify individuals at higher risk and on the other hand, give sufficient time to clinicians for reducing dengue related morbidity and mortality.

A Study on Plasma Renin Activity in Korean Hemorrhagic Fever

International Nuclear Information System (INIS)

Kim, Suhng Gwon; Cho, Bo Yun; Lee, Jung Sang; Koh, Won Soon; Lee, Mun Ho; Kim, Won Dong; Yun, Hong Jin

1976-01-01

To evaluate the possible pathophysiologic role of renin in acute renal failure observed in Korean hemorrhagic fever (KHF), the author measured the basal plasma renin activity (PRA) and the stimulated PRA by radioimmunoassay for angiotensin I in 15 normal controls and 42 KHF patients who are admitted in Seoul National University Hospital and Nation Army Hospital from Jan. 1975 to Jan. 1976. The results obtained were as follows:The mean basal PRA in normal control group was 2.9±2.16 ng/ml/hr in the patients during the oliguric phase of KHF, the mean basal PRA was 4.7±2.13 ng/ml/hr, and there was statistically significant increase compared to the normal control. In the patients during the diuretic phase of KHF, the mean basal PRA was 3.4±2.09 ng/ml/hr, and there was statistically significant decrease compared to the oliguric phase of KHF. In normal control group, the mean basal PRA was 2.9±2.16 ng/ml/hr. And the PRA 1 hour after the administration of Lasix 40 mg intravenously (stimulated PRA) was 5.3±2.20 ng/ml/hr and there was statistically significant increase compared to basal level. In oliguric phase of KHF, the mean basal PRA was 4.6±2.01 ng/ml/hr. And stimulated PRA was 4.4±2.34 ng/ml/hr and there was no significant changes. In diuretic phase of KHF, the mean basal PR was 3.3±1.86 ng/ml/hr. And stimulated PRA was 5.2±2.58 ng/ml/hr and there was statistically significant increase compared to basal level. There were statistically no significant correlations between basal PRA and stimulated PRA and serum creatinine. BUN, urine volume and peritoneal dialysis.

Acute hemorrhagic edema of infancy: report of three cases.

Science.gov (United States)

Emerich, Paulo Sergio; Prebianchi, Patricia Almeida; Motta, Luciene Lage da; Lucas, Elton Almeida; Ferreira, Leonardo Mello

2011-01-01

Acute Hemorrhagic Edema of Infancy is an infrequent leukocytoclastic vasculitis which occurs almost exclusively in children between 4 months and 2 years of age. It is clinically characterized by the triad fever, purpuric lesions on the face, auricular pinna and extremities, and edema. Although the cutaneous findings are dramatic and of rapid onset, the prognosis is favorable, with spontaneous resolution within 1 to 3 weeks. Three cases are described in which clinical and histopathological findings are characteristic of acute hemorrhagic edema of infancy.

Fundus Findings in Dengue Fever: A Case Report

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Berna Şahan

2015-10-01

Full Text Available Dengue fever is a flavivirus infection transmitted through infected mosquitoes, and is endemic in Southeast Asia, Central and South America, the Pacific, Africa and the Eastern Mediterranean region. A 41-year-old male patient had visual impairment after travelling to Thailand, which is one of the endemic areas. Cotton wool spots were observed on fundus examination. Fundus fluorescein angiography showed minimal vascular leakage from areas near the cotton wool spots and dot hemorrhages in the macula. Dengue fever should be considered in patients with visual complaints who traveled to endemic areas of dengue fever. (Turk J Ophthalmol 2015; 45: 223-225

Distribution of Soft Ticks and Their Natural Infection with Borrelia in a Focus of Relapsing Fever in Iran

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Z Aghighi

2007-11-01

Full Text Available Tick-borne diseases such as relapsing fever and Crimean-Congo Hemorrhagic Fever (CCHF are of public health impor¬tance in Iran. There are 471 reported cases of relapsing fever in 2003, according to the Ministry of Health of Iran.The num¬ber of cases has been increased in recent years. Its distribution is more or less prevalent in different parts of Iran. The aim of this study was to find out the fauna and natural infection of soft ticks with Borrelia in Qazvin Province, during their sea¬sonal activity. The province covers 15821 km² between 48-45 to 50-50 east of Greenwich Meridian of longitude and 35-37 to 36-45 north latitude of the equator. For this purpose a field study was carried out in the region. A total of 54 villages from 19 districts were selected ran¬domly and ticks were collected from their habitats according to the standard method. A total of 3197 Argasidae ticks were collected from human dwellings, poultry and animal shelters. They belonged to Argas and Or¬nithodoros genera which 36.8% were Argas persicus, 4% A. reflexus, 6.4% O. canestrini, 45.5% O. lahorensis and 7.3% O. tholozani. It should be noted that 12 ticks of O. erraticus were collected from 12 rodents borrows. We found that 8.82 % of O. tholozani ticks were infected with Borrelia persica and half of the O. erraticus were infected with Borrelia microti. All the people who are in¬volved with veterinary activities should be aware of disease transmission by the ticks. In the endemic area of the disease tick control is recommended.

"Congo" red: out of Africa?

Science.gov (United States)

Steensma, D P

2001-02-01

Congo red is the essential histologic stain for demonstrating the presence of amyloidosis in fixed tissues. To the best of my knowledge, nothing has been written about why the stain is named "Congo." To understand the etymology and history of the Congo red histologic stain. Primary sources were consulted extensively, including 19th-century corporate documents, newspapers, legal briefs, patents, memoirs, and scientific papers. Sources were obtained from multiple university libraries and German corporate archives. To Europeans in 1885, the word Congo evoked exotic images of far-off central Africa known as The Dark Continent. The African Congo was also a political flashpoint during the Age of Colonialism. "Congo" red was introduced in Berlin in 1885 as the first of the economically lucrative direct textile dyes. A patent on Congo red was filed by the AGFA Corporation of Berlin 3 weeks after the conclusion of the well-publicized Berlin West Africa Conference. During these important diplomatic talks, German Chancellor Otto von Bismarck presided over a discussion of free trade issues in the Congo River basin. A challenge to AGFA's Congo red patent led to a precedent-setting decision in intellectual property law. The Congo red stain was named "Congo" for marketing purposes by a German textile dyestuff company in 1885, reflecting geopolitical current events of that time.

Tick in the outer ear canal: Two case reports

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Özalkan Özkan

2013-01-01

Full Text Available Serious systemic diseases such as Crimean Congo Hemorrhagic Fever, Lyme Disease, tularemia, typhus and Q fever can be transmitted by ticks. An 8-year-old boy and a 34-year-old woman were brought to our clinic with ear pains. No symptoms such as fever, headache or lethargy to suggest CCHF were present. The patients both lived in rural areas and were engaged in farming. Full blood count, liver and kidney function tests and serum electrolytes were within normal limits at laboratory tests. Prothrombin time, partial thromboplastin time and INR were normal. The tick was grasped with alligator forceps and removed from the outer ear in one piece with the help of 0-degree rigid otoendoscopy.

Accelerating vaccine development for African swine fever virus ...

International Development Research Centre (IDRC) Digital Library (Canada)

Photo: IDRC / Bartay The challenge African swine fever (ASF) is a highly infectious hemorrhagic viral disease that wipes out entire herds of infected pigs. ASF is widespread in at least half of sub-Saharan Africa, and threatens food security due to devastating economic losses.

Emergence of Lassa Fever Disease in Northern Togo: Report of Two Cases in Oti District in 2016

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Akouda Akessiwe Patassi

2017-01-01

Full Text Available Background. Lassa fever belongs to the group of potentially fatal hemorrhagic fevers, never reported in Togo. The aim of this paper is to report the first two cases of Lassa fever infection in Togo. Case Presentation. The two first Lassa fever cases occurred in two expatriate’s health professionals working in Togo for more than two years. The symptoms appeared among two health professionals of a clinic located in Oti district in the north of the country. The absence of clinical improvement after antimalarial treatment and the worsening of clinical symptoms led to the medical evacuation. The delayed diagnosis of the first case led to a fatal outcome. The second case recovered under ribavirin treatment. Conclusion. The emergence of this hemorrhagic fever confirms the existence of Lassa fever virus in Togo. After a period of intensive Ebola virus transmission from 2013 to 2015, this is an additional call for the establishment and enhancement of infection prevention and control measures in the health care setting in West Africa.

Molecular Diagnostics of Hemorrhagic Fever with Renal Syndrome during a Dobrava Virus Infection Outbreak in the European Part of Russia ▿

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Dzagurova, Tamara K.; Klempa, Boris; Tkachenko, Evgeniy A.; Slyusareva, Galina P.; Morozov, Vyacheslav G.; Auste, Brita; Kruger, Detlev H.

2009-01-01

A large outbreak of hemorrhagic fever with renal syndrome (HFRS) occurred in the winter of 2006-2007 in a region southeast of Moscow in Central European Russia. Of the 422 patients with HFRS investigated in this study, 58 patients were found to be infected by Puumala virus, whereas as many as 364 were infected by Dobrava-Belgrade virus (DOBV). Early serum samples from 10 DOBV-infected patients were used for nucleic acid amplification, which was successful for 5 patients. Molecular analyses demonstrated that the causative hantavirus belongs to the DOBV-Aa genetic lineage, which is carried by the striped field mouse (Apodemus agrarius) as the natural reservoir host. Neutralization assays with convalescent-phase sera from these patients confirmed infection by DOBV-Aa; related viruses, such as the Dobrava-Slovenia virus (DOBV-Af) and the Dobrava-Sochi virus (DOBV-Ap), were neutralized at lower efficiencies. The clinical courses of the 205 patients enrolled in the study were found to be mostly mild to moderate; however, an unexpectedly high fraction (27%) of patients exhibited severe illness. One patient died from kidney failure and showed symptoms of generalized subcutaneous hemorrhage. The results provide molecular, serodiagnostic, and clinical evidence that DOBV-Aa is a common pathogen in East Europe that causes large outbreaks of HFRS. PMID:19828747

Prevention of Dengue Fever: An Exploratory School-Community Intervention Involving Students Empowered as Change Agents

Science.gov (United States)

Jayawardene, Wasantha P.; Lohrmann, David K.; YoussefAgha, Ahmed H.; Nilwala, Dayani C.

2011-01-01

Background: Dengue fever and dengue hemorrhagic fever (DF/DHF) are epidemic and endemic in tropical and subtropical countries including Sri Lanka. Numerous structural and community interventions have been shown to be effective in interrupting the life cycle of mosquitoes that transmit DF/DHF; however, these interventions are not always implemented…

A successful management of dengue fever in pregnancy: Report of two cases

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Singh N

2008-01-01

Full Text Available In the most recent outbreak of degue fever in India, we encountered at least seven cases of fever with thrombocytopenia in pregnancy but only two were seropositive for dengue. In one of the cases there was postpartum hemorrhage while in the other case there was perinatal transmission to the neonate requiring platelet transfusions. The diagnostic difficulties in pregnancy and the management are discussed.

Single-particle cryo-electron microscopy of Rift Valley fever virus

OpenAIRE

Sherman, Michael B.; Freiberg, Alexander N.; Holbrook, Michael R.; Watowich, Stanley J.

2009-01-01

Rift Valley fever virus (RVFV; Bunyaviridae; Phlebovirus) is an emerging human veterinary pathogen causing acute hepatitis in ruminants and has the potential to Single-particle cryo-EM reconstruction of RVFV MP-12 hemorrhagic fever in humans. We report a three-dimensional reconstruction of RVFV vaccine strain MP-12 (RVFV MP-12) by cryo-electron microcopy using icosahedral symmetry of individual virions. Although the genomic core of RVFV MP-12 is apparently poorly ordered, the glycoproteins on...

VECTOR RESISTANCE STATUS OF DENGUE HEMORRHAGIC FEVER (Aedes aegypti IN THE SIDOREJO DISTRICT SALATIGA CITY AGAINST TEMEPHOS (ORGANOPHOSPHATES

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Ary Oktsari Yanti S

2014-06-01

Full Text Available One of the efforts to control the incidence of Dengue Hemorrhagic Fever (DHF is contrled thedengue vector larvae using larvasida. The most widely larvasida used to control larvae Ae.aegypti is temephos. In Indonesia 1% temephos (abate 1SG has been used since 1976, and since1980 has been used for the eradication program ofAe. aegypti larvae. The purpose of this studyis to determine the resistance status of vectors of dengue hemorrhagic fever (Ae. aegypti ofendemic, sporadic, and potentially in Sub District Sidorejo Salatiga City to temephos(organofosfat. This research was conducted using experimental research design (TrueExperiment, posttcst design with control groups (posttest-only Control Group Design. Thepopulation of the research were larvae of Ae. aegypti collected from the study area. Samples testlarvae were used of Ae. aegypti third and early fourth instars larvae which were maintenance ofthe first generation. The result showed that the mortality percentages of Ae. aegypti larvaeof endemic, sporadic and potential administratives against temephos using WHO standardconcentration (0,625; 0,125; 0,025 mg/1 indicates the mortality of Ae. aegypti larvae by 100%Based on the status resistance criteria, Ae. aegypti larvae from endemic, sporadic, and potentialadministratives of Sidorejo Sub-District, Salatiga City is still susceptible to temephos.Keywords : Status of resistance, Aedes aegypti. TemephosSalah satu upaya menurunkan Demam Berdarah Dengue (DBD adalah melaluipengcndalian jentik vektor DBD dengan larvasida. Larvasida yang digunakan untukmengcndalikan jentik Ae. aegypti adalah temephos. Temephos 1% (abate ISG sudah programdi Indonesia sejak 1976, scjak 1980 telah digunakan secara massal untuk programpemberantasan jentik Ae. aegypti. Tujuan penelitian ini adalah untuk mengetahui status resistensivektor demam berdarah dengue Ae. aegypti di kclurahan endemis, sporadis, dan potensialKecamatan Sidorejo Kota Salatiga terhadap temephos

Current status of Crimean-Congo haemorrhagic fever in the World Health Organization Eastern Mediterranean Region: issues, challenges, and future directions.

Science.gov (United States)

Al-Abri, Seif S; Abaidani, Idris Al; Fazlalipour, Mehdi; Mostafavi, Ehsan; Leblebicioglu, Hakan; Pshenichnaya, Natalia; Memish, Ziad A; Hewson, Roger; Petersen, Eskild; Mala, Peter; Nhu Nguyen, Tran Minh; Rahman Malik, Mamunur; Formenty, Pierre; Jeffries, Rosanna

2017-05-01

Crimean-Congo haemorrhagic fever (CCHF) is the most widespread, tick-borne viral disease affecting humans. The disease is endemic in many regions, such as Africa, Asia, Eastern and Southern Europe, and Central Asia. Recently, the incidence of CCHF has increased rapidly in the countries of the World Health Organization Eastern Mediterranean Region (WHO EMR), with sporadic human cases and outbreaks of CCHF being reported from a number of countries in the region. Despite the rapidly growing incidence of the disease, there are currently no accurate data on the burden of the disease in the region due to the different surveillance systems used for CCHF in these countries. In an effort to increase our understanding of the epidemiology and risk factors for the transmission of the CCHF virus (CCHFV; a Nairovirus of the family Bunyaviridae) in the WHO EMR, and to identify the current knowledge gaps that are hindering effective control interventions, a sub-regional meeting was organized in Muscat, Oman, from December 7 to 9, 2015. This article summarizes the current knowledge of the disease in the region, identifies the knowledge gaps that present challenges for the prevention and control of CCHFV, and details a strategic framework for research and development activities that would be necessary to curb the ongoing and new threats posed by CCHFV. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Current status of Crimean-Congo haemorrhagic fever in the World Health Organization Eastern Mediterranean Region: issues, challenges, and future directions

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Seif S. Al-Abri

2017-05-01

Full Text Available Crimean-Congo haemorrhagic fever (CCHF is the most widespread, tick-borne viral disease affecting humans. The disease is endemic in many regions, such as Africa, Asia, Eastern and Southern Europe, and Central Asia. Recently, the incidence of CCHF has increased rapidly in the countries of the World Health Organization Eastern Mediterranean Region (WHO EMR, with sporadic human cases and outbreaks of CCHF being reported from a number of countries in the region. Despite the rapidly growing incidence of the disease, there are currently no accurate data on the burden of the disease in the region due to the different surveillance systems used for CCHF in these countries. In an effort to increase our understanding of the epidemiology and risk factors for the transmission of the CCHF virus (CCHFV; a Nairovirus of the family Bunyaviridae in the WHO EMR, and to identify the current knowledge gaps that are hindering effective control interventions, a sub-regional meeting was organized in Muscat, Oman, from December 7 to 9, 2015. This article summarizes the current knowledge of the disease in the region, identifies the knowledge gaps that present challenges for the prevention and control of CCHFV, and details a strategic framework for research and development activities that would be necessary to curb the ongoing and new threats posed by CCHFV.

Dengue Hemorrhagic Fever at 60 Years: Early Evolution of Concepts of Causation and Treatment.

Science.gov (United States)

Halstead, Scott B; Cohen, Sanford N

2015-09-01

During the decade of the 1960s, the epidemiology of a new dengue disease, dengue hemorrhagic fever and dengue shock syndrome (DHF/DSS), was described by collaborative research performed by Thai scientists from many institutions and by workers at the U.S. Army's SEATO Medical Research Laboratory in Bangkok, Thailand. Careful clinical and physiological studies provided the initial description of DSS. DSS cases were caused by each of the four dengue viruses (DENV) and not chikungunya (CHIK) virus or DENV 5 and 6, were associated with a secondary-type dengue antibody response in children over the age of 1 year, were associated with a primary antibody response in infants less than 1 year old whose mothers had neutralizing antibodies to all four DENV, were associated more frequently with secondary DENV 2 infections than those due to DENV 1 and 3, and were more common in females than males over the age of 3 years. Robust laboratory methods for growth and recovery of DENV in tissue cultures were introduced. In addition, life-saving principles of fluid and plasma protein resuscitation of hypovolemia were described. Most epidemiological observations made during the decade of the 1960s have been confirmed in the succeeding 45 years. Much contemporary research on pathogenesis fails to address the two distinct immunological antecedents of DHF/DSS. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Molecular-genetic risk assessement of determining angiotensin-converting enzyme hyperactivity in hemorrhagic fever with renal syndrome

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Ildar R. Minniakhmetov

2012-09-01

Full Text Available The present study was designed to investigate changes in angiotensin-converting enzyme (ACE blood activity and angiotensin II type 1 receptor gene polymorphism as a possible disease predictor in hemorrhagic fever with renal syndrome (HFRS. Four hundred and nine patients (346 males and 63 females with HFRS serologic confirmation were enrolled in the study. Their age ranged from 15 to 65 years. ACE blood activity was assessed kinetically using the Bühlmann (Switzerland kit. Peripheral blood genomic DNA was isolated by a phenol-chloroform extraction. The genotyping of DNA loci was done using a polymerase chain reaction of DNA synthesis. Statistically, ACE blood activity was significantly higher throughout the entire HFRS course with diverse severity apart from the feverish phase of moderate-to-severe uncomplicated disease forms. *A1166 and *C1166 alleles, *A1166/*A1166 and *C1166/*C1166 genotypes of angiotensin II type 1 receptor gene were not associated with HFRS severity. The results of this study indicate that high ACE activity has not adaptive characteristics due to abnormalities in angiotensin II reception. It is an adequate metabolic response of the body to endotheliotropic virus activity.

Gestion participative du sanctuaire de gorilles de plaine de l'ouest (Gorilla gorilla gorilla de Lossi en République du Congo- Brazzaville: première analyse de résultats et des contraintes

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Mbété, RA.

2007-01-01

Full Text Available Participative Management of the Sanctuary of Western Lowland Gorillas (Gorilla gorilla gorilla of Lossi in Republic of Congo-Brazzaville: Preliminary Results and Constraints Analysis. The gorilla sanctuary of Lossi experiments the synergy between scientific research and nature conservation. Three partners are involved in a management participative process. These partners include the Republic of Congo, the local community of Lossi and the European programme on the forest ecosystems in Central Africa. An investigation was carried out on the sanctuary of Lossi in 2003, in order to study in situ the effects generated by the participative management and to identify the constraints linked to the participative approach. The work of primatologists allowed the habituation of the gorillas to the human presence and opened eyesight tourism of western lowland gorillas. A camp for tourists and the access road to the sanctuary have been constructed. The tourism generated jobs in favour of the local population which is also a take-partner of contracts on road repairing. The income from the tourism allowed the construction of a health centre. However, the works of researchers and tourism activities failed during the outbreaks of the Ebola hemorrhagic fever and during the three civil war episodes. The consolidation and the long term of this process of co-management of natural resources of Lossi remains the establishment of a management that should include conservation, rural development and scientific research, with equitably in the distribution of gain between the partnerses.

Transborder cooperation on the protection, surveillance and control of endemic diseases

International Nuclear Information System (INIS)

Encho, S.; Doganov, B.; Kamenov, G.; Anelov, K.; Kalvachev, Z.; Rusev, A.; Dimova, J.

2009-01-01

This paper discuss some concern and challenges regards the Bulgarian-Greek transborder cooperation with respect the protection, surveillance and control of some endemic for this transborder region diseases like: Q-fever, Brucellosis, Lyme disease, Crimean-Congo hemorrhagic fever and Marseilles fever. The study examines transborder activities, including a background for the infection diseases state for the period 2004-2007, the problems of training and equipment of the specialists for sampling and identification of these diseases, development of strategy and conception for control of spreading of the infectious agents in 4 bulgarian regions / Blagoevgrad, Haskovo, Smoljan and Kardjeli/ and in the corresponding regions in Greece - Seres, Drama, Ksanti and Evro. Additionally, there is presented the role of local governmental representatives to manage these transnational border issues.(author)

A Different Approach to Assess Oxidative Stress in Dengue Hemorrhagic Fever Patients Through The Calculation of Oxidative Stress Index

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Edi Hartoyo

2017-09-01

Full Text Available The objectives of this study were to determine the involvement of Oxidative Stress (OS in the pathogenesis of dengue hemorrhagic fever (DHF through the analysis of oxidative stress Index (OSI. The levels of malondialdehyde (MDA, superoxide dismutase (SOD and catalase (CAT activity, and OSI were measured in 61 child dengue patients and (aged 6 months–18 years with three different stages of DHF, i.e stage I, II, and III. The results show that the levels of MDA, SOD and CAT activity, and OSI significantly different between the group. The all parameters that investigated in this present study seems higher MDA level and OSI in the higher grade of DHF, except for SOD and CAT activity. From this result, it can be concluded that oxidative stress pathways might be involved in the pathomechanism of DHF and OSI might be used as a biomarker for OS and the severity in DHF patients.

Low adiposity during early infancy is associated with a low risk for developing dengue hemorrhagic fever: a preliminary model.

Science.gov (United States)

Libraty, Daniel H; Zhang, Lei; Woda, Marcia; Giaya, Kris; Kathivu, Chido Loveness; Acosta, Luz P; Tallo, Veronica; Segubre-Mercado, Edelwisa; Bautista, Analisa; Obcena, AnaMae; Brion, Job D; Capeding, Rosario Z

2014-01-01

Dengue virus (DENV) infections range from asymptomatic or mild illness to a severe and potentially life threatening disease, dengue hemorrhagic fever (DHF). DHF occurs in primary DENV infections during early infancy. A prospective clinical study of DENV infections during infancy was conducted in San Pablo, Philippines. We found that infants who developed DHF with a primary DENV infection had higher WHO weight-for-age z scores before and at the time of infection compared to infants with primary DENV infections who did not develop DHF. In addition, TLR 7/8-stimulated tumor necrosis factor-α (TNF-α) production from myeloid-derived cells was higher among well-nourished infants. Leptin augmented TLR 7/8-mediated TNF-α production in monocytes and decreased intracellular cAMP levels. Circulating leptin levels were elevated during early infancy and correlated with WHO weight-for-age z scores. Our data support a plausible hypothesis as to why well-nourished infants are at risk for developing DHF with their first DENV infection.

Epidemic dengue and dengue hemorrhagic fever at the Texas-Mexico border: results of a household-based seroepidemiologic survey, December 2005.

Science.gov (United States)

Ramos, Mary M; Mohammed, Hamish; Zielinski-Gutierrez, Emily; Hayden, Mary H; Lopez, Jose Luis Robles; Fournier, Marta; Trujillo, Alfredo Rodríguez; Burton, Roy; Brunkard, Joan M; Anaya-Lopez, Luis; Banicki, Allison Abell; Morales, Pablo Kuri; Smith, Brian; Muñoz, Jorge L; Waterman, Stephen H

2008-03-01

A dengue-2 epidemic causing dengue hemorrhagic fever (DHF) occurred in the contiguous border cities of Matamoros, Tamaulipas (Mexico), and Brownsville, TX, in 2005. In December, we conducted a household-based epidemiologic survey to determine the incidence and seroprevalence of dengue infection among Matamoros and Brownsville residents and to identify risk factors associated with infection. Antibodies to dengue were measured in 273 individuals. The estimated incidence of recent dengue infection was 32% and 4% among Matamoros and Brownsville participants, respectively. The estimated prevalence of past dengue infection was 77% and 39% among Matamoros and Brownsville participants, respectively. The Breteau index was 28 in Matamoros and 16 in Brownsville, reflecting an abundant winter population of Aedes mosquitoes. Discarded waste tires and buckets were the two largest categories of infested containers found in both cities. Our results underscore the risk for epidemic dengue and DHF in the Texas-Mexico border region.

Inhibition of Interferon Induction and Action by the Nairovirus Nairobi Sheep Disease Virus/Ganjam Virus

OpenAIRE

Holzer, Barbara; Bakshi, Siddharth; Bridgen, Anne; Baron, Michael D.

2011-01-01

The Nairoviruses are an important group of tick-borne viruses that includes pathogens of man (Crimean Congo hemorrhagic fever virus) and livestock animals (Dugbe virus, Nairobi sheep disease virus (NSDV)). NSDV is found in large parts of East Africa and the Indian subcontinent (where it is known as Ganjam virus). We have investigated the ability of NSDV to antagonise the induction and actions of interferon. Both pathogenic and apathogenic isolates could actively inhibit the induction of type ...

An Outbreak of Ebola Virus Disease in the Lassa Fever Zone.

Science.gov (United States)

Goba, Augustine; Khan, S Humarr; Fonnie, Mbalu; Fullah, Mohamed; Moigboi, Alex; Kovoma, Alice; Sinnah, Vandi; Yoko, Nancy; Rogers, Hawa; Safai, Siddiki; Momoh, Mambu; Koroma, Veronica; Kamara, Fatima K; Konowu, Edwin; Yillah, Mohamed; French, Issa; Mustapha, Ibraham; Kanneh, Franklyn; Foday, Momoh; McCarthy, Helena; Kallon, Tiangay; Kallon, Mustupha; Naiebu, Jenneh; Sellu, Josephine; Jalloh, Abdul A; Gbakie, Michael; Kanneh, Lansana; Massaly, James L B; Kargbo, David; Kargbo, Brima; Vandi, Mohamed; Gbetuwa, Momoh; Gevao, Sahr M; Sandi, John D; Jalloh, Simbirie C; Grant, Donald S; Blyden, Sylvia O; Crozier, Ian; Schieffelin, John S; McLellan, Susan L; Jacob, Shevin T; Boisen, Matt L; Hartnett, Jessica N; Cross, Robert W; Branco, Luis M; Andersen, Kristian G; Yozwiak, Nathan L; Gire, Stephen K; Tariyal, Ridhi; Park, Daniel J; Haislip, Allyson M; Bishop, Christopher M; Melnik, Lilia I; Gallaher, William R; Wimley, William C; He, Jing; Shaffer, Jeffrey G; Sullivan, Brian M; Grillo, Sonia; Oman, Scott; Garry, Courtney E; Edwards, Donna R; McCormick, Stephanie J; Elliott, Deborah H; Rouelle, Julie A; Kannadka, Chandrika B; Reyna, Ashley A; Bradley, Benjamin T; Yu, Haini; Yenni, Rachael E; Hastie, Kathryn M; Geisbert, Joan B; Kulakosky, Peter C; Wilson, Russell B; Oldstone, Michael B A; Pitts, Kelly R; Henderson, Lee A; Robinson, James E; Geisbert, Thomas W; Saphire, Erica Ollmann; Happi, Christian T; Asogun, Danny A; Sabeti, Pardis C; Garry, Robert F

2016-10-15

 Kenema Government Hospital (KGH) has developed an advanced clinical and laboratory research capacity to manage the threat of Lassa fever, a viral hemorrhagic fever (VHF). The 2013-2016 Ebola virus (EBOV) disease (EVD) outbreak is the first to have occurred in an area close to a facility with established clinical and laboratory capacity for study of VHFs.  Because of its proximity to the epicenter of the EVD outbreak, which began in Guinea in March 2014, the KGH Lassa fever Team mobilized to establish EBOV surveillance and diagnostic capabilities.  Augustine Goba, director of the KGH Lassa laboratory, diagnosed the first documented case of EVD in Sierra Leone, on 25 May 2014. Thereafter, KGH received and cared for numbers of patients with EVD that quickly overwhelmed the capacity for safe management. Numerous healthcare workers contracted and lost their lives to EVD. The vast majority of subsequent EVD cases in West Africa can be traced back to a single transmission chain that includes this first diagnosed case.  Responding to the challenges of confronting 2 hemorrhagic fever viruses will require continued investments in the development of countermeasures (vaccines, therapeutic agents, and diagnostic assays), infrastructure, and human resources. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Geographical distribution and surveillance of Crimean-Congo hemorrhagic fever in Iran

DEFF Research Database (Denmark)

Chinikar, Sadegh; Ghiasi, Seyed Mojtaba; Moradi, Maryam

2010-01-01

. Since 2000, we have shown the disease to be prevalent in 23 out of 30 provinces of Iran. Among those, Sistan-va-Baluchistan, Isfahan, Fars, Tehran, Khorasan, and Khuzestan demonstrated the highest infection, respectively. Notably, Sistan-va-Baluchistan province, southeast of Iran, has the highest...... of the disease has ranged variably in different provinces of Iran. More pathogenesis and phylogenetic studies should therefore be investigated to clarify these differences....

Hemorrhage listerial encephalitis in a patient with systemic lupus erythematosis: A case report

Energy Technology Data Exchange (ETDEWEB)

Lee, Hyun Gyu; Lee, Ji Young; Lee, Young Jun; Kim, Young Seo; Kim, Hyun Young; Sung, Won Jae [Hanyang University Hospital, Hanyang University College of Medicine, Seoul (Korea, Republic of)

2017-05-15

A 31-year-old female with systemic lupus erythematosus (SLE) presented with fever, headache, seizures and mental status changes. Brain MRI showed T2 hyperintense lesions in the cerebellum and frontal white matter and a lesion in the cerebellum exhibited hemorrhagic changes and peripheral ring enhancement. The MRI features of listerial encephalitis are difficult to differentiate from those of neuropsychiatric SLE and various other diseases. Here, we report a case of hemorrhagic listerial encephalitis in a patient with SLE.

Bilateral acute visual loss from Rathke's cleft cyst apoplexy in a patient with dengue fever

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Ana Cláudia De Franco Suzuki

2014-10-01

Full Text Available Hemorrhagic complications of optic pathway diseases are extremely rare causes of acute visual loss associated with dengue fever. In this paper we report a patient presenting with dengue fever and bilateral acute visual loss caused by chiasmal compression due to Rathke's cleft cyst apoplexy. Considering the importance of early diagnosis and treatment to visual recovery, apoplexy of sellar and suprasellar tumors should be considered in the differential diagnosis of patients with acute visual loss and dengue fever.

Existing and potential infection risk zones of yellow fever worldwide: a modelling analysis

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Freya M Shearer, BSc

2018-03-01

Full Text Available Summary: Background: Yellow fever cases are under-reported and the exact distribution of the disease is unknown. An effective vaccine is available but more information is needed about which populations within risk zones should be targeted to implement interventions. Substantial outbreaks of yellow fever in Angola, Democratic Republic of the Congo, and Brazil, coupled with the global expansion of the range of its main urban vector, Aedes aegypti, suggest that yellow fever has the propensity to spread further internationally. The aim of this study was to estimate the disease's contemporary distribution and potential for spread into new areas to help inform optimal control and prevention strategies. Methods: We assembled 1155 geographical records of yellow fever virus infection in people from 1970 to 2016. We used a Poisson point process boosted regression tree model that explicitly incorporated environmental and biological explanatory covariates, vaccination coverage, and spatial variability in disease reporting rates to predict the relative risk of apparent yellow fever virus infection at a 5 × 5 km resolution across all risk zones (47 countries across the Americas and Africa. We also used the fitted model to predict the receptivity of areas outside at-risk zones to the introduction or reintroduction of yellow fever transmission. By use of previously published estimates of annual national case numbers, we used the model to map subnational variation in incidence of yellow fever across at-risk countries and to estimate the number of cases averted by vaccination worldwide. Findings: Substantial international and subnational spatial variation exists in relative risk and incidence of yellow fever as well as varied success of vaccination in reducing incidence in several high-risk regions, including Brazil, Cameroon, and Togo. Areas with the highest predicted average annual case numbers include large parts of Nigeria, the Democratic Republic of the

Low adiposity during early infancy is associated with a low risk for developing dengue hemorrhagic fever: a preliminary model.

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Daniel H Libraty

Full Text Available Dengue virus (DENV infections range from asymptomatic or mild illness to a severe and potentially life threatening disease, dengue hemorrhagic fever (DHF. DHF occurs in primary DENV infections during early infancy. A prospective clinical study of DENV infections during infancy was conducted in San Pablo, Philippines. We found that infants who developed DHF with a primary DENV infection had higher WHO weight-for-age z scores before and at the time of infection compared to infants with primary DENV infections who did not develop DHF. In addition, TLR 7/8-stimulated tumor necrosis factor-α (TNF-α production from myeloid-derived cells was higher among well-nourished infants. Leptin augmented TLR 7/8-mediated TNF-α production in monocytes and decreased intracellular cAMP levels. Circulating leptin levels were elevated during early infancy and correlated with WHO weight-for-age z scores. Our data support a plausible hypothesis as to why well-nourished infants are at risk for developing DHF with their first DENV infection.

Sensitive and specific detection of Crimean-Congo Hemorrhagic Fever Virus (CCHFV)—Specific IgM and IgG antibodies in human sera using recombinant CCHFV nucleoprotein as antigen in μ-capture and IgG immune complex (IC) ELISA tests

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Emmerich, Petra; Mika, Angela; von Possel, Ronald; Rackow, Anne; Liu, Yang; Schmitz, Herbert; Sherifi, Kurtesh; Halili, Barie; Jakupi, Xhevat; Berisha, Lindita; Ahmeti, Salih

2018-01-01

As the most widespread tick-borne arbovirus causing infections in numerous countries in Asia, Africa and Europe, Crimean-Congo Hemorrhagic Fever Virus (CCHFV, family Nairoviridae) was included in the WHO priority list of emerging pathogens needing urgent Research & Development attention. To ensure preparedness for potential future outbreak scenarios, reliable diagnostic tools for identification of acute cases as well as for performance of seroprevalence studies are necessary. Here, the CCHFV ortholog of the major bunyavirus antigen, the nucleoprotein (NP), was recombinantly expressed in E.coli, purified and directly labeled with horseradish peroxidase (HRP). Employing this antigen, two serological tests, a μ-capture ELISA for the detection of CCHFV-specific IgM antibodies (BLACKBOX CCHFV IgM) and an IgG immune complex (IC) ELISA for the detection of CCHFV-specific IgG antibodies (BLACKBOX CCHFV IgG), were developed. Test performance was evaluated and compared with both in-house gold standard testing by IgM/IgG indirect immunofluorescence (IIF) and commercially available ELISA tests (VectoCrimean-CHF-IgM/IgG, Vector-Best, Russia) using a serum panel comprising paired samples collected in Kosovo during the years 2013–2016 from 15 patients with an acute, RT-PCR-confirmed CCHFV infection, and 12 follow-up sera of the same patients collected approximately one year after having overcome the infection. Reliably detecting IgM antibodies in all acute phase sera collected later than day 4 after onset of symptoms, both IgM ELISAs displayed excellent diagnostic and analytical sensitivity (100%, 95% confidence interval (CI): 85.2%–100.0%). While both IgG ELISAs readily detected the high IgG titers present in convalescent patients approximately one year after having overcome the infection (sensitivity 100%, 95% CI: 73.5%–100.0%), the newly developed BLACKBOX CCHFV IgG ELISA was superior to the commercial IgG ELISA in detecting the rising IgG titers during the acute phase

Acute Compressive Ulnar Neuropathy in a Patient of Dengue Fever: An Unusual Presentation

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Anil K Mehtani

2013-04-01

Full Text Available Introduction: Dengue haemorrhagic fever is known for its haemorrhagic and neurologic complications. Neurologic complications are caused by three mechanism namely neurotropism, systemic complications causing encephalopathy and postinfectious immune-mediated mechanisms. However acute compressive neuropathy due to haemorrhage is not frequent and we could find no literature describing this Case Report: We report a case of acute compressive ulnar neuropathy due to peri neural hematoma, following an attempt at intravenous cannulation in the cubital fossa in a patient of dengue haemorrhagic fever with thrombocytopenia. Immediate fasciotomy and removal of haematoma was performed to relieve the symptoms. Conclusion: Compression neuropathies can be seen in dengue hemorrhagic fever and removal of compressing hematoma relieves symptoms. Keywords: Dengue haemmorrhagic fever; coagulopathy; peri neural haematoma.

Acute hemorrhagic edema of infancy

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Sultan Ecer Menteş

2009-03-01

Full Text Available Acute hemorrhagic edema of infancy is a rare form of leukocytoclastic vasculitis. Mostly it appears under three years of age and is characterized by purpuric skin lesions, fever and edema. A three years-old boy, who has cough and coryzea was admitted to our clinic for fever and red spots on legs and arms. In physical examination; ecimotic skin lesions on right ear, face, arms, dorsal of the hands, buttocks, legs and dorsal of the feet were found. In the laboratory tests acute phase reactants were elevated and blood coagulation tests were in normal range. Hepatit A,B,C and TORCH markers were negative. Punch biopsy obtained from gluteal area showed leukositoclastic vasculity. Focal fibrinogen accumulation was detected by immun fluorescent microscopy. Regression on lesions was not observed despite supportive therapy, so prednisolone (1 mg/kg/day therapy was started. On the third day of the steroid therapy, complete recovery was achived.

Calcium Regulation of Hemorrhagic Fever Virus Budding: Mechanistic Implications for Host-Oriented Therapeutic Intervention.

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Ziying Han

2015-10-01

Full Text Available Hemorrhagic fever viruses, including the filoviruses (Ebola and Marburg and arenaviruses (Lassa and Junín viruses, are serious human pathogens for which there are currently no FDA approved therapeutics or vaccines. Importantly, transmission of these viruses, and specifically late steps of budding, critically depend upon host cell machinery. Consequently, strategies which target these mechanisms represent potential targets for broad spectrum host oriented therapeutics. An important cellular signal implicated previously in EBOV budding is calcium. Indeed, host cell calcium signals are increasingly being recognized to play a role in steps of entry, replication, and transmission for a range of viruses, but if and how filoviruses and arenaviruses mobilize calcium and the precise stage of virus transmission regulated by calcium have not been defined. Here we demonstrate that expression of matrix proteins from both filoviruses and arenaviruses triggers an increase in host cytoplasmic Ca2+ concentration by a mechanism that requires host Orai1 channels. Furthermore, we demonstrate that Orai1 regulates both VLP and infectious filovirus and arenavirus production and spread. Notably, suppression of the protein that triggers Orai activation (Stromal Interaction Molecule 1, STIM1 and genetic inactivation or pharmacological blockade of Orai1 channels inhibits VLP and infectious virus egress. These findings are highly significant as they expand our understanding of host mechanisms that may broadly control enveloped RNA virus budding, and they establish Orai and STIM1 as novel targets for broad-spectrum host-oriented therapeutics to combat these emerging BSL-4 pathogens and potentially other enveloped RNA viruses that bud via similar mechanisms.

Clinical and epidemiological features of hemorrhagic fever with renal syndrome course in Perm region

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M. V. Ivanova

2011-01-01

Full Text Available The results of retrospective analysis of hemorrhagic fever with renal syndrome (HFRS incidence in the Perm region for 1995–2009 are shown in the article. There are highly active natural foci of infection on the territory of the region, mainly in the subzone of mixed coniferous-deciduous forests. Factors supporting the morbidity are high numbers of small mammals, in particular, the bank vole, with a large circulation of the HFRS virus and active population visit of natural foci in summer-autumn period. Analysis of clinical features of HFRS in 338 patients living in the Perm region, revealed some peculiarities of its course. Among surveyed contingent men (72,4% prevailed. Most of the patients (80,4% were of working age (16 to 60 years. More frequently mild and moderate forms (92,8% of HFRS were observed. A typical picture of the disease with the development of all specific syndromes occurred mainly in patients with severe and moderate forms. Mild cases occurred blurry in the absence of pathognomonic symptoms. Notable was the frequent lesion of liver, with the development of acute anicteric hepatitis (51,2%. Among the complications dominated: pneumonia (4,7% and acute renal  ailure (4,4%. Manifestations of DIC syndrome with recurrent bleeding were registered in 0,6% of patients, toxic shock – at 0,3%. Case fatality rate was 0,6%.

Advanced Vaccine Candidates for Lassa Fever

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Igor S. Lukashevich

2012-10-01

Full Text Available Lassa virus (LASV is the most prominent human pathogen of the Arenaviridae. The virus is transmitted to humans by a rodent reservoir, Mastomys natalensis, and is capable of causing lethal Lassa Fever (LF. LASV has the highest human impact of any of the viral hemorrhagic fevers (with the exception of Dengue Fever with an estimated several hundred thousand infections annually, resulting in thousands of deaths in Western Africa. The sizeable disease burden, numerous imported cases of LF in non-endemic countries, and the possibility that LASV can be used as an agent of biological warfare make a strong case for vaccine development. Presently there is no licensed vaccine against LF or approved treatment. Recently, several promising vaccine candidates have been developed which can potentially target different groups at risk. The purpose of this manuscript is to review the LASV pathogenesis and immune mechanisms involved in protection. The current status of pre-clinical development of the advanced vaccine candidates that have been tested in non-human primates will be discussed. Major scientific, manufacturing, and regulatory challenges will also be considered.

Application of Gis in Temporal and Spatial Analyses of Dengue Fever Outbreak : Case of Rio de Janeiro, Brazil

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Achu, Denis

2009-01-01

Since Dengue fever (DF) and its related forms, Dengue Hemorrhagic fever (DHF) and Dengue Shock Syndrome (DSS) have become important health concerns worldwide, it is also imperative to develop methods which will help in the analysis of the incidences. Dengue fever cases are growing in number as it also invades widely, affecting larger number of countries and crossing climatic boundaries. Considering that the disease as of now has neither an effective vaccine nor a cure, monitoring in order to ...

Yellow Fever Remains a Potential Threat to Public Health.

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Vasconcelos, Pedro F C; Monath, Thomas P

2016-08-01

Yellow fever (YF) remains a serious public health threat in endemic countries. The recent re-emergence in Africa, initiating in Angola and spreading to Democratic Republic of Congo and Uganda, with imported cases in China and Kenya is of concern. There is such a shortage of YF vaccine in the world that the World Health Organization has proposed the use of reduced doses (1/5) during emergencies. In this short communication, we discuss these and other problems including the risk of spread of YF to areas free of YF for decades or never before affected by this arbovirus disease.

Hyalomma ticks on northward migrating birds in southern Spain: Implications for the risk of entry of Crimean-Congo haemorrhagic fever virus to Great Britain.

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England, Marion E; Phipps, Paul; Medlock, Jolyon M; Atkinson, Peter M; Atkinson, Barry; Hewson, Roger; Gale, Paul

2016-06-01

Crimean-Congo haemorrhagic fever virus (CCHFV) is a zoonotic virus transmitted by Hyalomma ticks, the immature stages of which may be carried by migratory birds. In this study, a total of 12 Hyalomma ticks were recovered from five of 228 migratory birds trapped in Spring, 2012 in southern Spain along the East Atlantic flyway. All collected ticks tested negative for CCHFV. While most birds had zero Hyalomma ticks, two individuals had four and five ticks each and the statistical distribution of Hyalomma tick counts per bird is over-dispersed compared to the Poisson distribution, demonstrating the need for intensive sampling studies to avoid underestimating the total number of ticks. Rates of tick exchange on migratory birds during their northwards migration will affect the probability that a Hyalomma tick entering Great Britain is positive for CCHFV. Drawing on published data, evidence is presented that the latitude of a European country affects the probability of entry of Hyalomma ticks on wild birds. Further data on Hyalomma infestation rates and tick exchange rates are required along the East Atlantic flyway to further our understanding of the origin of Hyalomma ticks (i.e., Africa or southern Europe) and hence the probability of entry of CCHFV into GB. © 2016 The Society for Vector Ecology.

YouTube videos as a source of medical information during the Ebola hemorrhagic fever epidemic.

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Nagpal, Sajan Jiv Singh; Karimianpour, Ahmadreza; Mukhija, Dhruvika; Mohan, Diwakar; Brateanu, Andrei

2015-01-01

The content and quality of medical information available on video sharing websites such as YouTube is not known. We analyzed the source and quality of medical information about Ebola hemorrhagic fever (EHF) disseminated on YouTube and the video characteristics that influence viewer behavior. An inquiry for the search term 'Ebola' was made on YouTube. The first 100 results were arranged in decreasing order of "relevance" using the default YouTube algorithm. Videos 1-50 and 51-100 were allocated to a high relevance (HR), and a low relevance (LR) video group, respectively. Multivariable logistic regression models were used to assess the predictors of a video being included in the HR vs. LR groups. Fourteen videos were excluded because they were parodies, songs or stand-up comedies (n = 11), not in English (n = 2) or a remaining part of a previous video (n = 1). Two scales, the video information and quality and index and the medical information and content index (MICI) assessed the overall quality, and the medical content of the videos, respectively. There were no videos from hospitals or academic medical centers. Videos in the HR group had a higher median number of views (186,705 vs. 43,796, p YouTube videos presenting clinical symptoms of infectious diseases during epidemics are more likely to be included in the HR group and influence viewers behavior.

Lassa virus-like particles displaying all major immunological determinants as a vaccine candidate for Lassa hemorrhagic fever

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Cashman Kathleen A

2010-10-01

virion, electron microscopy analysis demonstrated that LASV VLP appeared structurally similar to native virions, with pleiomorphic distribution in size and shape. LASV VLP that displayed GPC or GPC+NP were immunogenic in mice, and generated a significant IgG response to individual viral proteins over the course of three immunizations, in the absence of adjuvants. Furthermore, sera from convalescent Lassa fever patients recognized VLP in ELISA format, thus affirming the presence of native epitopes displayed by the recombinant pseudoparticles. Conclusions These results established that modular LASV VLP can be generated displaying high levels of immunogenic viral proteins, and that small laboratory scale mammalian expression systems are capable of producing multi-milligram quantities of pseudoparticles. These VLP are structurally and morphologically similar to native LASV virions, but lack replicative functions, and thus can be safely generated in low biosafety level settings. LASV VLP were immunogenic in mice in the absence of adjuvants, with mature IgG responses developing within a few weeks after the first immunization. These studies highlight the relevance of a VLP platform for designing an optimal vaccine candidate against Lassa hemorrhagic fever, and warrant further investigation in lethal challenge animal models to establish their protective potential.

Existing and potential infection risk zones of yellow fever worldwide: a modelling analysis.

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Shearer, Freya M; Longbottom, Joshua; Browne, Annie J; Pigott, David M; Brady, Oliver J; Kraemer, Moritz U G; Marinho, Fatima; Yactayo, Sergio; de Araújo, Valdelaine E M; da Nóbrega, Aglaêr A; Fullman, Nancy; Ray, Sarah E; Mosser, Jonathan F; Stanaway, Jeffrey D; Lim, Stephen S; Reiner, Robert C; Moyes, Catherine L; Hay, Simon I; Golding, Nick

2018-03-01

Yellow fever cases are under-reported and the exact distribution of the disease is unknown. An effective vaccine is available but more information is needed about which populations within risk zones should be targeted to implement interventions. Substantial outbreaks of yellow fever in Angola, Democratic Republic of the Congo, and Brazil, coupled with the global expansion of the range of its main urban vector, Aedes aegypti, suggest that yellow fever has the propensity to spread further internationally. The aim of this study was to estimate the disease's contemporary distribution and potential for spread into new areas to help inform optimal control and prevention strategies. We assembled 1155 geographical records of yellow fever virus infection in people from 1970 to 2016. We used a Poisson point process boosted regression tree model that explicitly incorporated environmental and biological explanatory covariates, vaccination coverage, and spatial variability in disease reporting rates to predict the relative risk of apparent yellow fever virus infection at a 5 × 5 km resolution across all risk zones (47 countries across the Americas and Africa). We also used the fitted model to predict the receptivity of areas outside at-risk zones to the introduction or reintroduction of yellow fever transmission. By use of previously published estimates of annual national case numbers, we used the model to map subnational variation in incidence of yellow fever across at-risk countries and to estimate the number of cases averted by vaccination worldwide. Substantial international and subnational spatial variation exists in relative risk and incidence of yellow fever as well as varied success of vaccination in reducing incidence in several high-risk regions, including Brazil, Cameroon, and Togo. Areas with the highest predicted average annual case numbers include large parts of Nigeria, the Democratic Republic of the Congo, and South Sudan, where vaccination coverage in 2016

[Ixodid ticks in the mountainous part of the Crimea].

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Markeshin, S Ia; Evstaf'ev, I L; Kovin, V V; Evstratov, Iu V

1992-01-01

About a hundred of patients with tick-borne encephalitis (TBE) were recorded over the latest decade in the Crimea, and 60 TBE virus strains were isolated from the ticks collected on the peninsula. The results of studies carried out in 1986-1990 helped define the borders of 4 local natural foci of TBE, study their acarifauna, detect the principal TBE vector--Ixodes ricinus (with a mean virophority of 0.6%), and distinguish two foci with a combination of TBE and Crimean-Congo hemorrhagic fever.

Spatiotemporal transmission dynamics of hemorrhagic fever with renal syndrome in China, 2005-2012.

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Wen-Yi Zhang

2014-11-01

Full Text Available Hemorrhagic fever with renal syndrome (HFRS is a rodent-borne disease caused by many serotypes of hantaviruses. In China, HFRS has been recognized as a severe public health problem with 90% of the total reported cases in the world. This study describes the spatiotemporal dynamics of HFRS cases in China and identifies the regions, time, and populations at highest risk, which could help the planning and implementation of key preventative measures.Data on all reported HFRS cases at the county level from January 2005 to December 2012 were collected from Chinese Center for Disease Control and Prevention. Geographic Information System-based spatiotemporal analyses including Local Indicators of Spatial Association and Kulldorff's space-time scan statistic were performed to detect local high-risk space-time clusters of HFRS in China. In addition, cases from high-risk and low-risk counties were compared to identify significant demographic differences.A total of 100,868 cases were reported during 2005-2012 in mainland China. There were significant variations in the spatiotemporal dynamics of HFRS. HFRS cases occurred most frequently in June, November, and December. There was a significant positive spatial autocorrelation of HFRS incidence during the study periods, with Moran's I values ranging from 0.46 to 0.56 (P<0.05. Several distinct HFRS cluster areas were identified, mainly concentrated in northeastern, central, and eastern of China. Compared with cases from low-risk areas, a higher proportion of cases were younger, non-farmer, and floating residents in high-risk counties.This study identified significant space-time clusters of HFRS in China during 2005-2012 indicating that preventative strategies for HFRS should be particularly focused on the northeastern, central, and eastern of China to achieve the most cost-effective outcomes.

Modeled Forecasts of Dengue Fever in San Juan, PR Using NASA Satellite Enhanced Weather Forecasts

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Morin, Cory; Quattrochi, Dale; Zavodsky, Bradley; Case, Jonathan

2015-01-01

Dengue virus is transmitted between humans and mosquitoes of the genus Aedes and causes approximately 96 million cases of disease (dengue fever) each year (Bhatet al. 2013). Symptoms of dengue fever include fever, headache, nausea, vomiting, and eye, muscle and joint pain (CDC). More sever manifestations such as abdominal pain, bleeding from nose and gums, vomiting of blood, and clammy skin occur in rare cases of dengue hemorrhagic fever (CDC). Dengue fever occurs throughout tropical and sub-tropical regions worldwide, however, the geographical range and size of epidemics is increasing. Weather and climate are drivers of dengue virus transmission dynamics (Morin et al. 2013) by affecting mosquito proliferation and the virus extrinsic incubation period (i.e. required time for the virus to replicate and disseminate within the mosquito before it can retransmit the virus).

[Microbiological surveillance: viral hemorrhagic fever in Central African Republic: current serological data in man].

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Nakounné, E; Selekon, B; Morvan, J

2000-01-01

An investigation was conducted between 1994 and 1997 in forested areas of the Central African Republic (CAR) to determine the seroprevalence of IgG antibodies against several haemorrhagic fever viruses present in the region. Sera were obtained from 1762 individuals in two groups (Pygmy and Bantu locuted populations) living in 4 forested areas in the south of the country. Sera were tested for IgG antibodies against Ebola, Marburg, Rift Valley fever (RVF), Yellow fever (YF) and Hantaviruses by enzyme immunoassay (EIA), and against Lassa virus by immunofluorescent assay. The prevalence of IgG antibodies was 5.9% for Ebola, 2% for Marburg, 6.9% pour RVF, 6.5% for YF, 2% for Hantaan. No antibodies were detected against Lassa, Seoul, Puumala and Thottapalayam viruses. No IgM antibodies were detected against RVF and YF viruses. The distribution of antibodies appears to be related to tropical rain forest areas. This study indicates that several haemorrhagic fever viruses are endemic in forested areas of the CAR and could emerge due to environmental modification.

La epidemiología del dengue y del dengue hemorrágico en Santiago de Cuba, 1997 The epidemiology of dengue and dengue hemorrhagic fever in Santiago de Cuba, 1997

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Luis Valdés

1999-07-01

Full Text Available En 1977, Cuba informó de su primera epidemia de dengue, durante la cual se registraron más de 500 000 casos de fiebre del dengue causados por el serotipo 1 del virus. En 1981, se produjo una gran epidemia de dengue hemorrágico causada por el serotipo 2. Esa vez se notificaron 344 203 casos en total, 10 312 casos clínicos de dengue hemorrágico y 158 defunciones, de las cuales 101 correspondieron a niños. Por medio de una búsqueda activa con confirmación de laboratorio, en el municipio de Santiago de Cuba de la provincia del mismo nombre se detectó precozmente en enero de 1997 la reintroducción del dengue, específicamente del virus del tipo 2, genotipo Jamaica. En este trabajo se presentan los aspectos epidemiológicos de mayor interés referentes a esa epidemia. Se notificaron 3 012 casos confirmados por serología, 205 clasificados como fiebre hemorrágica del dengue/síndrome de choque del dengue, de los cuales 12 fallecieron (todos adultos. La infección secundaria por virus del dengue fue uno de los principales factores de riesgo en el desarrollo de dengue hemorrágico y 98% de los casos, así como 92% de los fallecidos, manifestaron una respuesta de tipo secundario. Por primera vez se observó la posibilidad de contraer dengue hemorrágico en personas con una infección secundaria de 16 a 20 años después de la primera infección. Pertenecer a la raza blanca fue otro factor de riesgo de importancia, tal como se había observado desde la epidemia de 1981. En la última epidemia se demostró que la llamada “alerta de fiebre” no es útil para la detección temprana de una epidemia. Las medidas tomadas por las autoridades sanitarias del país evitaron la extensión de la epidemia a otros municipios que estaban infestados por Aedes aegypti.A dengue epidemic that Cuba reported in 1997 registered more than 500 000 cases of dengue fever produced by viral serotype 1. In 1981, there was an epidemic of dengue hemorrhagic fever produced by

Collective immunity of the population from endemic zones of hemorrhagic fever with renal syndrome in Kosovo.

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Muçaj, Sefedin; Kabashi, Serbeze; Ahmeti, Salih; Dedushaj, Isuf; Ramadani, Naser; Avsic-Zupanc, Tatjana

2009-01-01

Hemorrhagic fever with renal syndrome (HFRS), also known as mice fever is an acute viral zoonosis and it appears in the natural focus after the human contact with Hantaan virus infected mice. The objective (purpose) of this study was to investigate the prevalence of specific antibodies in HFRS, in convalescent persons (collective immunity in endemic hearths). In this project we applied the epidemiological method of studying with retrospective-perspective, the serological method for determination and detecting antibodies from the persons of epidemical focus and statistical methods. The disease diagnosis is based on the epidemiological, clinical and serological records. The collected samples have been sent to referral laboratory in Medical Faculty-Institute of Microbiology Ljubljana for laboratory confirmation. From the results we came to conclusion that in the territory of Republic of Kosovo, the HFRS is still a serious health, economic and biological problem. The lethality rate from HFRS in 1986 was 15.4%, 1986-89 10.8%, from 1995-2006 8.70%. The lowest rates of morbidity, mortality and lethality of HFRS compared with the previous periods of time, prove collective immunity growth in Dukagjini valley. For collective immunity research and to conduct the persistence of antibodies for viral corresponding (relative) antigen, after the disease, the samples were collected in the time period of May-June 2008, with 203 persons that were tested with serological method IIF (Indirect immune fluorescence) from which 187 cases (92.1%) resulted sero-negative and 16 cases (7.9%) resulted sero-positive with HFRS. This proves the collective immunity increase for HFRS. From 13 recovered patients previously diagnosed with HFRS (1986-1989-1995), levels of antibodies were screened in 2008 with IIF. Out of 13 persons, positive antibodies were found in 10 cases, while 3 cases were negative for antibodies (HTN, PUU, and DOB). After 13, 19 and 22 years HTN, PUU and DOB antibodies persisted

Spatial analysis of hemorrhagic fever with renal syndrome in Zibo City, China, 2009-2012.

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Feng Cui

Full Text Available BACKGROUND: Hemorrhagic fever with renal syndrome (HFRS is highly endemic in mainland China, where human cases account for 90% of the total global cases. Zibo City is one of the most serious affected areas in Shandong Province China with the HFRS incidence increasing sharply from 2009 to 2012. However, the hotspots of HFRS in Zibo remained unclear. Thus, a spatial analysis was conducted with the aim to explore the spatial, spatial-temporal and seasonal patterns of HFRS in Zibo from 2009 to 2012, and to provide guidance for formulating regional prevention and control strategies. METHODS: The study was based on the reported cases of HFRS from the National Notifiable Disease Surveillance System. Annualized incidence maps and seasonal incidence maps were produced to analyze the spatial and seasonal distribution of HFRS in Zibo City. Then spatial scan statistics and space-time scan statistics were conducted to identify clusters of HFRS. RESULTS: There were 200 cases reported in Zibo City during the 4-year study period. One most likely cluster and one secondary cluster for high incidence of HFRS were identified by the space-time analysis. And the most likely cluster was found to exist at Yiyuan County in October to December 2012. The human infections in the fall and winter reflected a seasonal characteristic pattern of Hantaan virus (HTNV transmission. The secondary cluster was detected at the center of Zibo in May to June 2009, presenting a seasonal characteristic of Seoul virus (SEOV transmission. CONCLUSION: To control and prevent HFRS in Zibo city, the comprehensive preventive strategy should be implemented in the southern areas of Zibo in autumn and in the northern areas of Zibo in spring.

Dobrava virus carried by the yellow-necked field mouse Apodemus flavicollis, causing hemorrhagic fever with renal syndrome in Romania.

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Panculescu-Gatej, Raluca Ioana; Sirbu, Anca; Dinu, Sorin; Waldstrom, Maria; Heyman, Paul; Murariu, Dimitru; Petrescu, Angela; Szmal, Camelia; Oprisan, Gabriela; Lundkvist, Ake; Ceianu, Cornelia S

2014-05-01

Hemorrhagic fever with renal syndrome (HFRS) has been confirmed by serological methods during recent years in Romania. In the present study, focus-reduction neutralization tests (FRNT) confirmed Dobrava hantavirus (DOBV) as the causative agent in some HFRS cases, but could not distinguish between DOBV and Saaremaa virus (SAAV) infections in other cases. DOBV was detected by a DOBV-specific TaqMan assay in sera of nine patients out of 22 tested. Partial sequences of the M genomic segment of DOBV were obtained from sera of three patients and revealed the circulation of two DOBV lineages in Romania. Investigation of rodents trapped in Romania found three DOBV-positive Apodemus flavicollis out of 83 rodents tested. Two different DOBV lineages were also detected in A. flavicollis as determined from partial sequences of the M and S genomic segments. Sequences of DOBV in A. flavicollis were either identical or closely related to the sequences obtained from the HFRS patients. The DOBV strains circulating in Romania clustered in two monophyletic groups, together with strains from Slovenia and the north of Greece. This is the first evidence for the circulation of DOBV in wild rodents and for a DOBV etiology of HFRS in Romania.

Diversity, Replication, Pathogenicity and Cell Biology of Crimean Congo Hemorrhagic Fever Virus

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2010-10-01

1990. Hen egg white lysozyme expressed in, and secreted from, Aspergillus niger is correctly processed and folded. Biotechnology (New York) 8:741–745. 7...in bunyavirus-infected cells. J. Virol. 41:643–648. 18. Garry, C. E., and R. F. Garry. 2004. Proteomics computational analyses suggest that the...2005). Proteomic identification of proteins conjugated to ISG15 in mouse and human cells. Biochem. Biophys. Res. Commun. 336, 496–506. Haas, A.L

Impact of Climate on the incidence of Dengue Haemorrhagic fever in Semarang City

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Khairunisa, Ummi; Endah Wahyuningsih, Nur; Suhartono; Hapsari

2018-05-01

Dengue Haemorrhagic Fever (DHF) is one of major health problems in Indonesia. DHF is a caused by the dengue virus and potentially deadly infection spread by some mosquitos. The mosquito Aedes aegypti is the main species that spreads this disease. The incidence rate of dengue haemorrhagic fever was still increased in 2011 to 2015 in Indonesia. Dengue viruses and their mosquito vectors are sensitive to their environment. Temperature, rainfall and humidity have well-define roles in the transmission cycle. Therefore changes in these conditions may contribute to increasing incidence. The aim of this study was to analyze the relationship between climate factors and the incidence rate of dengue hemorrhagic fever in Semarang City. The type of research was analytic with cross sectional study. The sample used is the climate data from Meteorology, Climatology and Geophysics Agency (BMKG) and the number of dengue cases from Health Office in Semarang City from 2011 to 2016. Data were analyzed using Pearson trials with α=0,05. Base on this study here air temperature and relative humidity were moderate correlation with negative direction on air temperature (p = 0,000 and r = -0, 429), weakly correlation with positive direction on rainfall (p = 0,014 and r = 0,288) and humidity (p=0,001 and r = 0,382) with dengue hemorrhagic fever incidence in Semarang City. The conclusions of this study there were correlation between climate (air temperature, rainfall, and relative humidity) and DHF in Semarang City in 2011-2016.

Effects of Climate and Rodent Factors on Hemorrhagic Fever with Renal Syndrome in Chongqing, China, 1997-2008.

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Yuntao Bai

Full Text Available China has the highest global incidence of hemorrhagic fever with renal syndrome (HFRS, constituting 90% of the cases in the world. Chongqing, located in the Three Gorges Reservoir Region, has been experiencing differences in the occurrence of HFRS from 1997 to 2008. The current study was designed to explore the effects of climate and rodent factors on the transmission of HFRS in Chongqing. Data on monthly HFRS cases, rodent strains, and climatic factors were collected from 1997 to 2008. Spatio-temporal analysis indicated that most HFRS cases were clustered in central Chongqing and that the incidence of HFRS decreased from 1997 to 2008. Poisson regression models showed that temperature (with lagged months of 0 and 5 and rainfall (with 2 lagged months were key climatic factors contributing to the transmission of HFRS. A zero-inflated negative binomial model revealed that rodent density was also significantly associated with the occurrence of HFRS in the Changshou district. The monthly trend in HFRS incidence was positively associated with rodent density and rainfall and negatively associated with temperature. Possible mechanisms are proposed through which construction of the dam influenced the incidence of HFRS in Chongqing. The findings of this study may contribute to the development of early warning systems for the control and prevention of HFRS in the Three Gorges Reservoir Region.

THROMBOCYTOPENIA IN DENGUE HAEMORRHAGIC FEVER

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I Wayan Putu Sutirta-Yasa

2013-04-01

Full Text Available The incidence and geographical distribution of dengue has gradually increased during the past decade. Today, dengue is considered one of the most important arthropod-borne viral diseasases in humans in term of morbidity and mortality. Dengue infection   a potential life-threatening dengue hemorrhagic fever (DHF / dengue shock syndrome(DSS, characterized by thrombocytopenia and increased vascular permiability. Thrombocytopenia causes bleeding, but in   DHF patients with thrombocytopenia do not always develop bleeding manifestation. The pathogenesis of thrombocytopenia are not cleared. Multiple factors  may be involved in the machanisms leading to thrombocytopenia in DHF/DSS patients.

The petroleum economy of the Congo

International Nuclear Information System (INIS)

Gualbert-Brice Massengo, Ph.D.

2005-01-01

The author aims to explain the petroleum phenomena in Congo as a contribution to the truth. The Congo petroleum experience can be seen as a lesson for the next generations and for the other african countries. The Congo Brazzaville, a little country by its population and well equipped in natural and human resources, is become meanwhile a non security area for its inhabitants because of a decreasing economy and a continuous political crisis. (A.L.B.)

Country Presentation Congo

International Nuclear Information System (INIS)

Mwata, P.K.; SAKI, A.; KAZADI, J.

2010-01-01

Illicit trafficking of radioactive minerals, precious metals and nuclear materials is generally expanded practice in some parts of the Democratic Republic of Congo. The phenomenon took place early in 1990 and amplified from 1998. The main causes of this practice are political instability that led to general poverty among population and the lack of legal framework governing the exploitation of minerals. Nuclear Illicit trafficking in Congo concerns radioactive mineral sand precious metals in eastern and southern parts of the country. The unfavorable political environment that took place in Congo in the 1990s resulted in local manpower and mine workers immigrating to neighboring countries. A great fraction of these new jobless started exploiting abandoned mines residues searching for Cu, Co and Au for survival. First cases of illicit exploitation of uranium minerals were reported very soon after rock sliding that occurred in 2004 on Shinkolobwe site in Katanga region. This uncontrolled mineral exploitation got worse when several mining companies were licensed by GECAMINES company to explore, exploit, purchase minerals from individuals and export raw materials and concentrates.

Serological Assays Based on Recombinant Viral Proteins for the Diagnosis of Arenavirus Hemorrhagic Fevers

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Masayuki Saijo

2012-10-01

Full Text Available The family Arenaviridae, genus Arenavirus, consists of two phylogenetically independent groups: Old World (OW and New World (NW complexes. The Lassa and Lujo viruses in the OW complex and the Guanarito, Junin, Machupo, Sabia, and Chapare viruses in the NW complex cause viral hemorrhagic fever (VHF in humans, leading to serious public health concerns. These viruses are also considered potential bioterrorism agents. Therefore, it is of great importance to detect these pathogens rapidly and specifically in order to minimize the risk and scale of arenavirus outbreaks. However, these arenaviruses are classified as BSL-4 pathogens, thus making it difficult to develop diagnostic techniques for these virus infections in institutes without BSL-4 facilities. To overcome these difficulties, antibody detection systems in the form of an enzyme-linked immunosorbent assay (ELISA and an indirect immunofluorescence assay were developed using recombinant nucleoproteins (rNPs derived from these viruses. Furthermore, several antigen-detection assays were developed. For example, novel monoclonal antibodies (mAbs to the rNPs of Lassa and Junin viruses were generated. Sandwich antigen-capture (Ag-capture ELISAs using these mAbs as capture antibodies were developed and confirmed to be sensitive and specific for detecting the respective arenavirus NPs. These rNP-based assays were proposed to be useful not only for an etiological diagnosis of VHFs, but also for seroepidemiological studies on VHFs. We recently developed arenavirus neutralization assays using vesicular stomatitis virus (VSV-based pseudotypes bearing arenavirus recombinant glycoproteins. The goal of this article is to review the recent advances in developing laboratory diagnostic assays based on recombinant viral proteins for the diagnosis of VHFs and epidemiological studies on the VHFs caused by arenaviruses.

Fatal yellow fever in a traveler returning from Venezuela, 1999.

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2000-04-14

On September 28, 1999, a previously healthy 48-year-old man from California sought care at a local emergency department (ED) and was hospitalized with a 2-day history of fever (102 F [38.9 C]), chills, headache, photophobia, diffuse myalgias, joint pains, nausea, vomiting, constipation, upper abdominal discomfort, and general weakness. On September 26, he had returned from a 10-day trip to Venezuela. On September 29, an infectious disease physician from the ED contacted the Marin County Health Department (MCHD) about the patient's symptoms; MCHD reported his illness to the California Department of Health Services (CDHS) as a suspected case of viral hemorrhagic fever. This report describes the investigation of the case.

Severe Dengue Fever Outbreak in Taiwan.

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Wang, Sheng-Fan; Wang, Wen-Hung; Chang, Ko; Chen, Yen-Hsu; Tseng, Sung-Pin; Yen, Chia-Hung; Wu, Deng-Chyang; Chen, Yi-Ming Arthur

2016-01-01

Dengue fever (DF) is a vector-borne disease caused by dengue viruses (DENVs). Epidemic dengue occurs intermittently in Taiwan. In 2014, Taiwan experienced its largest DF outbreak. There were 15,732 DF cases reported. There were a total of 136 dengue hemorrhagic fever (DHF) cases, of which 20 resulted in death. Most DF cases were reported in southern Taiwan. A total of 15,043 (96%) cases were from Kaohsiung, a modern city in southern Taiwan. This report reviews DF epidemics in Taiwan during 2005-2014. The correlation between DF and DHF along with temperature and precipitation were conjointly examined. We conclude that most dengue epidemics in Taiwan resulted from imported DF cases. Results indicate three main factors that may have been associated with this DF outbreak in Kaohsiung: an underground pipeline explosion combined with subsequent rainfall and higher temperature. These factors may have enhanced mosquito breeding activity, facilitating DENV transmission. © The American Society of Tropical Medicine and Hygiene.

[Hemorrhagic dengue and vertical transmission to the newborn: a case report and literature review].

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Morgan-Ortiz, Fred; Rodríguez-Lugo, Silvia Mirelle; León-Gil, María del Socorro; Gaxiola-Villa, Marisela; Martínez-Félix, Nora Selene; Lara-Avila, Leticia

2014-06-01

To describe the case of a patient with term pregnancy and infection with hemorrhagic dengue and vertical transmission to the newborn. Thirty-two year old patient with pregnancy at 38 weeks was admitted with fever 2 days earlier (38 degrees C). During her stay she continued with fever of 39 degrees C and platelets of 85,000/mm3. Serology for dengue NS1 antigen was reported positive. Labor was induced getting a new-born, male, 3,220 g, who breathed and cried at birth. During the postpartum period continued with fever, malaise, retro-ocular pain, generalized rash in upper and lower limbs, bleeding gums and petechial on the soft palate and thrombocytopenia of 5,000/mm3, later. At 8 days of stay, platelet concentration increased to 42,000/mm3 without requiring platelet concentrates and she was discharged after ten days in hospital with platelets of 94,000/mm3. The 4th day of extra-uterine live (EUL), neonate shows generalized rash over the trunk; The 5th day starts with 38 degrees C fever and thrombocytopenia (78,000/mm3). Dengue serological tests reported positive for Ag NS1 and negative for Abs IgM and IgG. Neonate was admitted to NICU, he continued with a decrease in platelet of 14,000/mm3- and ecchymotic areas by pressure and veno-punction sites. Four platelet concentrates were transfused. At 10th day of EUL platelet count was reported with 387,000/mm3. In an endemic area, such as Sinaloa state, in a pregnant woman with fever and thrombocytopenia, we should be alert to possibility of a DV infection and its complications. Although rare, such as this case, infection can be transmitted to fetus (vertical transmission) and produce a primary congenital dengue, even in its severe hemorrhagic types.

Evaluation of surveillance of dengue fever cases in the public health centre of Putat Jaya based on attribute surveillance

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Zumaroh Zumaroh

2015-01-01

Full Text Available Dengue Hemorrhagic Fever (DHF is a public health problem in the village of Putat Jaya which is an endemic area. Surveilans activity in DHF control program is the most important activity in controlling and monitoring disease progression. The program is expected to achieve incidence rate 55/100.000 population. This study aimed to evaluate the implementation of case surveilans in health centre of putat jaya based on attribute surveillance. Attribute surveillance is an indicator that describes the characteristics of the surveillance system. This research was an evaluation research with descriptive study design. As informants were clinic staff who deal specifically with cases of dengue hemorrhagic fever and laboratory workers. The techniques of data collection by interviews and document study. The variables of this study were simplicity, flexibility, acceptability, sensitivity, positive predictive value, representativeness, timeliness, data quality and data stability. It could be seen from Incidence Rate in 2013 has reached 133/100.00 population. The activity of surveilance in the village of Putat Jaya reviewed from disease contol program management was not succeed into decrease incidence rate of DHF. Therefore, dengue control programs in health centers Putat Jaya need to do cross-sector cooperation and cross-program cooperation, strengthening the case reporting system by way increasing in the utilization of information and communication technology electromedia. Keywords: case surveillance, dengue hemorrhagic fever, evaluation, attribute surveillance, Putat Jaya

Serum Cytokine Profiles Differentiating Hemorrhagic Fever with Renal Syndrome and Hantavirus Pulmonary Syndrome

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Svetlana F. Khaiboullina

2017-05-01

Full Text Available Hantavirus infection is an acute zoonosis that clinically manifests in two primary forms, hemorrhagic fever with renal syndrome (HFRS and hantavirus pulmonary syndrome (HPS. HFRS is endemic in Europe and Russia, where the mild form of the disease is prevalent in the Tatarstan region. HPS is endemic in Argentina, as well as other countries of North and South American. HFRS and HPS are usually acquired via the upper respiratory tract by inhalation of virus-contaminated aerosol. Although the pathogenesis of HFRS and HPS remains largely unknown, postmortem tissue studies have identified endothelial cells as the primary target of infection. Importantly, cell damage due to virus replication, or subsequent tissue repair, has not been documented. Since no single factor has been identified that explains the complexity of HFRS or HPS pathogenesis, it has been suggested that a cytokine storm may play a crucial role in the manifestation of both diseases. In order to identify potential serological markers that distinguish HFRS and HPS, serum samples collected during early and late phases of the disease were analyzed for 48 analytes using multiplex magnetic bead-based assays. Overall, serum cytokine profiles associated with HPS revealed a more pro-inflammatory milieu as compared to HFRS. Furthermore, HPS was strictly characterized by the upregulation of cytokine levels, in contrast to HFRS where cases were distinguished by a dichotomy in serum cytokine levels. The severe form of hantavirus zoonosis, HPS, was characterized by the upregulation of a higher number of cytokines than HFRS (40 vs 21. In general, our analysis indicates that, although HPS and HFRS share many characteristic features, there are distinct cytokine profiles for these diseases. These profiles suggest a strong activation of an innate immune and inflammatory responses are associated with HPS, relative to HFRS, as well as a robust activation of Th1-type immune responses. Finally, the results

CLINICAL AND LABORATORY PROFILE OF DENGUE FEVER

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Farhan Fazal

2015-02-01

Full Text Available AIM: Dengue is a major health problem in many parts of India and Gulbarga (North Karnataka was previously not a known endemic area f or dengue. Infection with dengue virus can cause a spectrum of three clinical syndromes , classic dengue fever (DF , dengue hemorrhagic fever (DHF and dengue shock syndrome (DSS. The present study was undertaken to determine the disease profile of dengue virus infection in hospitalized patients. METHODS AND MATERIAL: One hundred patients admitted in Basaveshwar Teaching and General hospital with fever more than 38.5 degree Celsius and IgM dengue positive were selected. They were followed from the onset of fever to twelve days or till they are recovered according to WHO discharge criteria whichever is earlier. They underwent relevant investigations to identify specific organ dysfunction and categorize them into the spectrum of Dengue fever in accordance to W HO criteria . RESULTS: Out of 100 cases in this study 70 cases belongs to DF , 23 cases to DHF and 7 cases to DSS based on WHO criteria. All the cases had fever (100%. Other common symptoms noted were myalgia (61% , joint pain (54% , headache (66% , vomitin g (55% , pain abdomen (48% , rash (41% , hepatomegaly (20% , bleeding (21% and shock (8%. Hess test was positive in 24% patients. Low platelet count of less than 100 , 000/cu mm according to WHO criteria was present in 73% patients. Deranged liver functio n test and renal parameters were seen in 26 and 8 patients respectively . Mortality documented was 7 patients due to delayed presentation. The average duration of hospital stay was 4.65 days. CONCLUSION: Dengue fever was a more common manifestation than DHF or DSS. During aepidemic , dengue should be strongly considered on the differential diagnosis of any patient with fever. The treatment of dengue is mainly fluid management and supportive. Early recognition and management of alarm symptoms is the key to bet ter outcome

Evaluation of Intraventricular Hemorrhage in Pediatric Intracerebral hemorrhage

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Kleinman, Jonathan T; Beslow, Lauren A; Engelmann, Kyle; Smith, Sabrina E; Licht, Daniel J; Ichord, Rebecca N; Jordan, Lori C

2012-01-01

Previous studies of pediatric intracerebral hemorrhage have investigated isolated intraparenchymal hemorrhage. We investigated whether detailed assessment of intraventricular hemorrhage enhanced outcome prediction after intracerebral hemorrhage. We prospectively enrolled 46 children, full-term to 17 years, median age 2.7 years with spontaneous intraparenchymal hemorrhage and/or intraventricular hemorrhage. Outcome was assessed with the King’s Outcome Scale for Childhood Head Injury. Twenty-six (57%) had intraparenchymal hemorrhage, 10 (22%) had pure intraventricular hemorrhage, and 10 (22%) had both. There were 2 deaths, both with intraparenchymal hemorrhage + intraventricular hemorrhage volume ≥4% of total brain volume. Presence of intraventricular hemorrhage was not associated with poor outcome, but hydrocephalus showed a trend (p=0.09) toward poor outcome. In receiver operating characteristic curve analysis, combined intraparenchymal hemorrhage + intraventricular hemorrhage volume also showed a trend toward better outcome prediction than intraparenchymal hemorrhage volume alone. Although not an independent outcome predictor, future studies should assess intraventricular hemorrhage qualitatively and quantitatively. PMID:22068828

Lassa hemorrhagic fever in a late term pregnancy from northern sierra leone with a positive maternal outcome: case report

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Bangura James J

2011-08-01

Full Text Available Abstract Lassa fever (LF is a devastating viral disease prevalent in West Africa. Efforts to take on this public health crisis have been hindered by lack of infrastructure and rapid field deployable diagnosis in areas where the disease is prevalent. Recent capacity building at the Kenema Government Hospital Lassa Fever Ward (KGH LFW in Sierra Leone has lead to a major turning point in the diagnosis, treatment and study of LF. Herein we present the first comprehensive rapid diagnosis and real time characterization of an acute hemorrhagic LF case at KGH LFW. This case report focuses on a third trimester pregnant Sierra Leonean woman from the historically non-endemic Northern district of Tonkolili who survived the illness despite fetal demise. Employed in this study were newly developed recombinant LASV Antigen Rapid Test cassettes and dipstick lateral flow immunoassays (LFI that enabled the diagnosis of LF within twenty minutes of sample collection. Deregulation of overall homeostasis, significant hepatic and renal system involvement, and immunity profiles were extensively characterized during the course of hospitalization. Rapid diagnosis, prompt treatment with a full course of intravenous (IV ribavirin, IV fluids management, and real time monitoring of clinical parameters resulted in a positive maternal outcome despite admission to the LFW seven days post onset of symptoms, fetal demise, and a natural still birth delivery. These studies solidify the growing rapid diagnostic, treatment, and surveillance capabilities at the KGH LF Laboratory, and the potential to significantly improve the current high mortality rate caused by LF. As a result of the growing capacity, we were also able to isolate Lassa virus (LASV RNA from the patient and perform Sanger sequencing where we found significant genetic divergence from commonly circulating Sierra Leonean strains, showing potential for the discovery of a newly emerged LASV strain with expanded geographic

Dengue Hemorrhagic Fever Tranmission Risk Level on Three Local Health Center in Three Endemic District in South Sulawesi Province, Indonesia

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Dicky Andiarsa

2017-12-01

Full Text Available Abstrak. Penelitian ini bertujuan untuk menentukan tingkat risiko penularan DBD di wilayah endemis DBD di Kabupaten Bone, Kota Palopo dan Kota Makassar Provinsi Sulawesi Selatan. Penelitian dilaksanakan Bulan Mei-Juni 2015 pada rumah tangga secara sistematik sampling sebanyak 100 rumah pada setiap wilayah kerja puskesmas endemis DBD tertinggi di Kab. Bone (Watampone, Kota Palopo (Wara dan Kota Makassar (Mangasa Provinsi Sulawesi Selatan. Data dianalisis untuk menunjukkan indikator surveilans larva (HI, CI, dan BI dan density figure. Data disajikan dengan jumlah larva berdasarkan jenis kontainer, persentase dan distribusi kontainer. Nilai ABJ ketiga puskesmas termasuk rendah Watampone: 53%, Wara: 54%, Mangasa: 68%. Persentase CI (angka container larva tertinggi adalah Puskesmas Watampone (17, 78%, selanjutnya Wara (17,71% dan Mangasa (15,47%. Berdasarkan perhitungan HI, CI dan BI, density figure dari ketiga kabupaten pada kategori sedang hingga tinggi dan Maya index menunjukkan tingkat risiko penularan DBD sedang. Hasil menunjukkan bahwa Density figure pada kontainer rumah tangga yang diperiksa sedang hingga tinggi. Kampanye pencegahan DBD yang kuat, deteksi kasus dari rumah ke rumah dan upaya persuasif yang mengedukasi mengenai hal ini penting dilakukan untuk meningkatkan kesadaran masyarakat agar ikut berpartisipasi dan lebih waspada terhadap DBD.Kata Kunci: DBD, larva, Aedes aegypti, kontainer, Maya IndeksAbstract. The aim of this research is to determine of transmission risk level of Dengue Hemorrhagic Fever (DHF endemic area in District of Bone, Municipal of Palopo, and Municipal of Makassar, South Sulawesi province. Study held in May-June 2015 to 100 households by systematically sampling method in three highest local healthcare center work area in each endemic in District of Bone (Watampone, Municipal of Palopo (Wara, and Municipal of Makassar (Mangasa, South Sulawesi Province. Data analyzed to show the indicators of DHF surveillance (House

Emerging arboviral human diseases in Southern Europe.

Science.gov (United States)

Papa, Anna

2017-08-01

Southern Europe is characterized by unique landscape and climate which attract tourists, but also arthropod vectors, some of them carrying pathogens. Among several arboviral diseases that emerged in the region during the last decade, West Nile fever accounted for high number of human cases and fatalities, while Crimean-Congo hemorrhagic fever expanded its geographic distribution, and is considered as a real threat for Europe. Viruses evolve rapidly and acquire mutations making themselves stronger and naive populations more vulnerable. In an effort to tackle efficiently the emerging arboviral diseases, preparedness and strategic surveillance are needed for the early detection of the pathogen and containment and mitigation of probable outbreaks. In this review, the main human arboviral diseases that emerged in Southern Europe are described. © 2017 Wiley Periodicals, Inc.

The Significance of Prolonged and Saddleback Fever in Hospitalised Adult Dengue.

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Deborah Hl Ng

Full Text Available Dengue fever is gaining importance in Singapore with an increase in the number of cases and mortality in recent years. Although prolonged and saddleback fever have been reported in dengue fever, there are no specific studies on their significance in dengue. This study aims to examine the prevalence of prolonged and saddleback fever in dengue as well as their associations with dengue severity. A total of 2843 polymerase-chain reaction (PCR confirmed dengue patients admitted to Tan Tock Seng Hospital from 2004 to 2008 were included in the study. Sixty-nine percent of them were male with a median age of 34 years. Prolonged fever (fever > 7 days duration was present in 572 (20.1% of patients. Dengue hemorrhagic fever (DHF, dengue shock syndrome (DSS and severe dengue (SD were significantly more likely to occur in patients with prolonged fever. Mucosal bleeding, anorexia, diarrhea, abdominal pain, nausea or vomiting, lethargy, rash, clinical fluid accumulation, hepatomegaly, nosocomial infection, leukopenia, higher neutrophil count, higher hematocrit, higher alanine transaminase (ALT and aspartate transaminase (AST, higher creatinine, lower protein and prolonged activated partial thromboplastin time (APTT were significantly associated with prolonged fever but not platelet count or prothrombin time (PT. Saddleback fever was present in 165 (5.8%. Although DHF and SD were more likely to occur in patients in those with saddleback fever, DSS was not. Compared with prolonged fever, saddleback fever did not show many significant associations except for diarrhea, abdominal pain, clinical fluid accumulation, hematocrit and platelet change, and lower systolic blood pressure. This study demonstrates that prolonged fever may be associated with various warning signs and more severe forms of dengue (SD, DSS, DHF, while saddleback fever showed associations with DHF and SD but not DSS. The presence of prolonged or saddleback fever in dengue patients should therefore

A Correlation of the Platelet Count with D-Dimer Levels as an Indicator for Component Therapy in Children with Dengue Hemorrhagic Fever.

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Sridhar, Arthi; Sunil Kumar, B M; Rau, Aarathi; Rau, A T K

2017-06-01

Dengue Fever (DF) may evolve into two life threatening forms-Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS). DHF is associated with increased vascular permeability and plasma leakage causing thrombocytopenia and loss of clotting factors into the third space and may result in bleeding initially due to thrombocytopenia and later due to disseminated intravascular coagulation (DIC), often as a terminal event. Prompt recognition and treatment of minor bleeds in DF children with incipient DIC with component therapy may be associated with improved survival while failure to do so is usually catastrophic. A sensitive marker for early DIC is the presence of D-dimer (DD) in the blood. To determine the correlation between the severity of thrombocytopenia and early DIC in children with DHF. The impact of additional factors like age and shock will also be evaluated. Case control prospective study of 60 DHF sero -positive children (1-15 years) with thrombocytopenia. After clinical evaluation they were divided into two equal groups based on the degree of thrombocytopenia (more than/less than 30,000/mm 3 ). PT/APTT and DD levels were estimated in all children of both groups and statistical correlation was done. There was no significant difference in the DD levels between the two groups. However, children in either group, presenting with clinical features of shock and thrombocytopenia had significantly higher DD levels. Empirical component therapy in children with DHF based purely on their low platelet counts may not be justified. However, in DHF children with thrombocytopenia and features of shock, aggressive component therapy may prevent subsequent bleeding and may be justified.

Hemorrhagic fever with renal syndrome: clinical, pathogenetic and therapeutic aspects

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Vera F. Pavelkina

2017-09-01

Full Text Available Introduction: The republic of Mordovia (RM is an active natural focus of hemorrhagic fever with renal syndrome (HFRS. The incidence of HFRS ranges from 10 to 40 cases per 100 000 people, i.e. exceeds the average Russian rate. The relevance of HFRS is determined by the involvement of many organs and systems in the pathological process. The intoxication syndrome (IS takes a leading place in the pathogenesis of the disease. The development of IS is associated with both the phenomenon of viremia, and the accumulation of endogenous toxins in the body. Despite the large number of recommendations, the problem of IS correction is not completely solved. Antiviral drugs are not applicable in connection with a short period of viremia. Therefore, the basis of treatment is pathogenetic therapy. The purpose of research is to study the clinical, epidemiological and therapeutic aspects of the medium degree HFRS. Materials and Methods: In the course of the study, the patients of two groups were examined: the first group (comparison group, 35 patients received basal therapy; the second group (primary group, 25 patients received a dropwise preparation of remaxol (400 ml for 7 days intravenously. The control group consisted of 30 healthy people of a similar age group. The clinical features of the disease in the Republic of Mordovia, as well as objective indicators were observed. Urea, creatinine, alanine aminotransferase (ALT, aspartate aminotransferase (AST, medium-weight molecules (MWM, circulating immune complexes (CIC, total, effective concentration and binding capacity of albumin (TCA, ECA, BCA, and toxicity index (TI were studied. Results: The infection was mainly in rural areas (78.3 %. Despite the c yclicity of the course, there was no clearly defined period of oliguria in the HFRS clinic (in 22 %, polyuria in 27 % of cases. Hepatomegaly is combined with a change in functional liver samples. The pathological changes indicate the presence of IS, which

Plug-assisted retrograde transvenous obliteration for the treatment of gastric variceal hemorrhage

International Nuclear Information System (INIS)

Chang, Min Yung; Kim, Man Deuk; Shin, Won Seon; Shin, Min Woo; Kim, Gyoung Min; Won, Jong Yun; Park, Sung Il; Lee, Do Yun; Kim, Tae Hwan

2016-01-01

To evaluate the feasibility, safety, and clinical outcomes of plug-assisted retrograde transvenous obliteration (PARTO) to treat gastric variceal hemorrhage in patients with portal hypertension. From May 2012 to June 2014, 19 patients (11 men and 8 women, median age; 61, with history of gastric variceal hemorrhage; 17, active bleeding; 2) who underwent PARTO using a vascular plug and a gelfoam pledget were retrospectively analyzed. Clinical and laboratory data were examined to evaluate primary (technical and clinical success, complications) and secondary (worsening of esophageal varix [EV], change in liver function) end points. Median follow-up duration was 11 months, from 6.5 to 18 months. The Wilcoxon signed-rank test was used to compare laboratory data before and after the procedure. Technical success (complete occlusion of the efferent shunt and complete filling of gastric varix [GV] with a gelfoam slurry) was achieved in 18 of 19 (94.7%) patients. The embolic materials could not reach the GV in 1 patient who had endoscopic glue injection before our procedure. The clinical success rate (no recurrence of gastric variceal bleeding) was the same because the technically failed patient showed recurrent bleeding later. Acute complications included fever (n = 2), fever and hypotension (n = 2; one diagnosed adrenal insufficiency), and transient microscopic hematuria (n = 3). Ten patients underwent follow-up endoscopy; all exhibited GV improvement, except 2 without endoscopic change. Five patients exhibited aggravated EV, and 2 of them had a bleeding event. Laboratory findings were significantly improved after PARTO. PARTO is technically feasible, safe, and effective for gastric variceal hemorrhage in patients with portal hypertension

Plug-assisted retrograde transvenous obliteration for the treatment of gastric variceal hemorrhage

Energy Technology Data Exchange (ETDEWEB)

Chang, Min Yung; Kim, Man Deuk; Shin, Won Seon; Shin, Min Woo; Kim, Gyoung Min; Won, Jong Yun; Park, Sung Il; Lee, Do Yun [Dept. of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Tae Hwan [Dept. of Radiology, National Health Insurance Serivce Ilsan Hospital, Goyang (Korea, Republic of)

2016-04-15

To evaluate the feasibility, safety, and clinical outcomes of plug-assisted retrograde transvenous obliteration (PARTO) to treat gastric variceal hemorrhage in patients with portal hypertension. From May 2012 to June 2014, 19 patients (11 men and 8 women, median age; 61, with history of gastric variceal hemorrhage; 17, active bleeding; 2) who underwent PARTO using a vascular plug and a gelfoam pledget were retrospectively analyzed. Clinical and laboratory data were examined to evaluate primary (technical and clinical success, complications) and secondary (worsening of esophageal varix [EV], change in liver function) end points. Median follow-up duration was 11 months, from 6.5 to 18 months. The Wilcoxon signed-rank test was used to compare laboratory data before and after the procedure. Technical success (complete occlusion of the efferent shunt and complete filling of gastric varix [GV] with a gelfoam slurry) was achieved in 18 of 19 (94.7%) patients. The embolic materials could not reach the GV in 1 patient who had endoscopic glue injection before our procedure. The clinical success rate (no recurrence of gastric variceal bleeding) was the same because the technically failed patient showed recurrent bleeding later. Acute complications included fever (n = 2), fever and hypotension (n = 2; one diagnosed adrenal insufficiency), and transient microscopic hematuria (n = 3). Ten patients underwent follow-up endoscopy; all exhibited GV improvement, except 2 without endoscopic change. Five patients exhibited aggravated EV, and 2 of them had a bleeding event. Laboratory findings were significantly improved after PARTO. PARTO is technically feasible, safe, and effective for gastric variceal hemorrhage in patients with portal hypertension.

Arthropod-borne viral infections associated with a fever outbreak in the northern province of Sudan.

Science.gov (United States)

Watts, D M; el-Tigani, A; Botros, B A; Salib, A W; Olson, J G; McCarthy, M; Ksiazek, T G

1994-08-01

An outbreak of acute febrile illness occurred during August and September 1989 in the Northern Province of Sudan coinciding with a high population density of phlebotomine sandflies. An investigation was conducted to determine whether arboviruses were associated with human illness during this outbreak. Sera were obtained from 185 febrile individuals and tested for IgG and IgM antibody to selected arboviruses by enzyme immunoassay (EIA). The prevalence of IgG antibody was 59% for West Nile (WN), 53% for Sandfly Fever Sicilian (SFS), 32% for Sandfly Fever Naples (SFN), 39% for Yellow Fever (YF), 24% for dengue-2 (DEN-2), 23% for Rift Valley Fever (RVF), 12% for Chikungunya (CHIK) and 5% for Crimean-Congo haemorrhagic Fever (CCHF) viruses. Antibody prevalences tended to increase with age for WN and YF viruses. Antibody rates were about the same for males and females for most of the viruses tested. The prevalence of IgM antibody to SFN was 24% and reciprocal IgM titre exceeded 12,800 for some individuals suggesting that this virus was the cause of recent infection. The prevalence of IgM antibody for the other viruses did not exceed 5%. The study indicated that several arboviruses were endemic and some of them may have caused human disease in the Northern Province of Sudan.

Congo red and protein aggregation in neurodegenerative diseases.

Science.gov (United States)

Frid, Petrea; Anisimov, Sergey V; Popovic, Natalija

2007-01-01

Congo red is a commonly used histological dye for amyloid detection. The specificity of this staining results from Congo red's affinity for binding to fibril proteins enriched in beta-sheet conformation. Unexpectedly, recent investigations indicate that the dye also possesses the capacity to interfere with processes of protein misfolding and aggregation, stabilizing native protein monomers or partially folded intermediates, while reducing concentration of more toxic protein oligomers. Inhibitory effects of Congo red upon amyloid toxicity may also range from blockade of channel formation and interference with glycosaminoglycans binding or immune functions, to the modulation of gene expression. Particularly, Congo red exhibits ameliorative effect in models of neurodegenerative disorders, such as Alzheimer's, Parkinson's, Huntington's and prion diseases. Another interesting application of Congo red analogues is the development of imaging probes. Based on their small molecular size and penetrability through blood-brain barrier, Congo red congeners can be used for both antemortem and in vivo visualization and quantification of brain amyloids. Therefore, understanding mechanisms involved in dye-amyloidal fibril binding and inhibition of aggregation will provide instructive guides for the design of future compounds, potentially useful for monitoring and treating neurodegenerative diseases.

Looking closer at the Congo

DEFF Research Database (Denmark)

Jansson, Johanna; Jiang, Wenran

2011-01-01

An NGO report on Chinese investment in the Democratic Republic of Congo opens a vital debate, but its methodology leaves the reader wanting a fuller version of the facts, write Johanna Jansson and Jiang Wenran.......An NGO report on Chinese investment in the Democratic Republic of Congo opens a vital debate, but its methodology leaves the reader wanting a fuller version of the facts, write Johanna Jansson and Jiang Wenran....

Diagnosis of Persistent Fever in the Tropics: Set of Standard Operating Procedures Used in the NIDIAG Febrile Syndrome Study.

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Emilie Alirol

2016-11-01

Full Text Available In resource-limited settings, the scarcity of skilled personnel and adequate laboratory facilities makes the differential diagnosis of fevers complex [1-5]. Febrile illnesses are diagnosed clinically in most rural centers, and both Rapid Diagnostic Tests (RDTs and clinical algorithms can be valuable aids to health workers and facilitate therapeutic decisions [6,7]. The persistent fever syndrome targeted by NIDIAG is defined as presence of fever for at least one week. The NIDIAG clinical research consortium focused on potentially severe and treatable infections and therefore targeted the following conditions as differential diagnosis of persistent fever: visceral leishmaniasis (VL, human African trypanosomiasis (HAT, enteric (typhoid and paratyphoid fever, brucellosis, melioidosis, leptospirosis, malaria, tuberculosis, amoebic liver abscess, relapsing fever, HIV/AIDS, rickettsiosis, and other infectious diseases (e.g., pneumonia. From January 2013 to October 2014, a prospective clinical phase III diagnostic accuracy study was conducted in one site in Cambodia, two sites in Nepal, two sites in Democratic Republic of the Congo (DRC, and one site in Sudan (clinicaltrials.gov no. NCT01766830. The study objectives were to (1 determine the prevalence of the target diseases in patients presenting with persistent fever, (2 assess the predictive value of clinical and first-line laboratory features, and (3 assess the diagnostic accuracy of several RDTs for the diagnosis of the different target conditions.

A review of dengue fever incidence in Kota Bharu, Kelantan, Malaysia during the years 1998-2003.

Science.gov (United States)

Hussin, Narwani; Jaafar, Jesni; Naing, Nyi Nyi; Mat, Hamzah Ag; Muhamad, Abd Haris; Mamat, Mohd Noor

2005-09-01

Dengue is the most common and widespread arthropod borne arboviral infection in the world today. It is estimated that there are at least 100 million cases of dengue fever (DF) annually and 500,000 cases of dengue hemorrhagic fever (DHF) which require hospitalization. In Malaysia, it has become a major public health problem. Malaysia recorded 19,544 dengue cases in 1997, the highest recorded since the disease was made notifiable in the country. Of 19,544 cases, 806 were DHF with 50 deaths. The objectives of this analysis were to describe the incidence of dengue fever and dengue hemorrhagic fever in Kota Bharu, Kelantan, Malaysia for the years 1998-2003 and to explore the characteristics of dengue fever and dengue hemorrhagic fever in Kota Bharu, Kelantan, Malaysia for years 1998-2003. A total of 4,716 dengue cases were notified involving 4,476 (94.9%) DF and 240 (5.1%) DHF cases, which increased though the years. The highest incidence was in January (701 or 14.9%), while the lowest was in May (188 or 4.0%). Forty percent of cases (n=1,890) were in the 15-29 year old group. The Majority were Malays (4,062 or 86.1%) and 2,602 or 55.2% were male. A total of 4,477 cases (95%) were local cases and 4,289 or 91% came from the urban area. For priority areas, 3,772 (80%) were from priority 1. More than half the cases had positive serology results. All symptoms occurred in more than 96% of cases and fever was the commonest (99.7%). The mean values for age, temperature, systolic and diastolic blood pressure (BP) were 27.8 +/- 15.4 years, 37.9 +/- 0.90 degrees C, 115 +/- 15.2 mmHg and 73 +/- 11.1 mmHg, respectively. The mean value for the time interval between the onset of symptoms and diagnosis, onset of symptoms and notification and time of diagnosis to notification were 5.1 +/- 2.3, 5.9 +/- 2.5 and 0.8 +/- 1.1 days, respectively. There were associations between the types of dengue and classification, area and priority area. Among the symptoms, the association was only seen

The first documented case of hemorrhagic stroke caused by Group B streptococcal meningitis

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Beenish Siddiqui

2015-01-01

Full Text Available We report the case of a 47 year-old female with Streptococcus agalactiae (Group B beta-hemolytic streptococcus meningitis complicated by hemorrhagic stroke. The patient presented to the emergency department with altered mental status, agitation, confusion, respiratory distress and fever of one-day duration. Labs showed left shift leukocytosis. CSF exhibited a high white blood cell count with a predominant population of polymononuclear cells, high glucose and protein concentration. CSF cultures grew S. agalactiae. Despite appropriate antimicrobial treatment, her mental status did not improve and head CT showed two hemorrhages, diffuse cerebral edema and a right to left midline shift. After completing the course of her therapy, her mental status improved and the patient was discharged.

Serum levels of inflammatory and regulatory cytokines in patients with hemorrhagic fever with renal syndrome

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Avšič-Županc Tatjana

2011-05-01

Full Text Available Abstract Background Hantaviruses are the causative agents of two zoonotic diseases: hemorrhagic fever with renal syndrome (HFRS and hantavirus cardiopulmonary syndrome (HCPS. The pathogenesis of HFRS is poorly understood. However, it has been suggested that immune mechanisms, including cytokines, might have an important role in HFRS pathogenesis. Thus, the aim of our study was to investigate cytokine profiles in serum samples of HFRS patients from Slovenia and explore a possible correlation between cytokine levels and disease severity. Methods Acute-phase serum samples from 52 patients, diagnosed with DOBV infection, and 61 patients, diagnosed with PUUV infection, were included in this study. Patients were divided into two groups - severe or mild - based on disease severity. Levels of IL-10, IL-12, INF-γ and TNF-α were measured in the serum samples with commercial ELISA tests. Results Increased levels of IL-10, INF-γ, and TNF-α were found in almost all the serum samples tested. On average, higher concentrations were detected in patients infected with DOBV than PUUV. Furthermore, significantly higher levels of IL-10 (P = 0.001 and TNF-α (P = 0.003 were found in patients with a more severe clinical course of disease. The same association between IL-10 (P P = 0.021, and the severity of the disease was observed also when only patients infected with DOBV were considered. No differences in cytokine concentrations according to disease severity were observed in patients infected with PUUV. Concentrations of serum IL-12 in HFRS patients were in the normal range, however, higher levels were detected in patients infected with PUUV than in patients infected with DOBV. Conclusions We suggest that imbalance in production of proinflammatory and regulatory cytokines might be in part responsible for a more severe course of HFRS.

Disease: H00385 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available ine hemorrhagic fever; Bolivian haemorrhagic fever; Venezuelan hemorrhagic fever; Brazilian hemorrhagic feve...morrhagic fever) Sabia mammarenavirus [GN:T40008] (Brazilian hemorrhagic fever) Tacaribe mammarenavirus [GN:

First report on the seroprevalence of the Crimean-Congo haemorrhagic fever virus, a tick-borne virus, in Malaysia's Orang Asli population.

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Lani, R; Mohd Rahim, N F; Hassan, H; Yaghoobi, R; Chang, L-Y; AbuBakar, S; Zandi, K

2015-01-01

The Crimean-Congo haemorrhagic fever virus (CCHFV), which is transmitted by the ticks of Hyalomma spp. in general and H. marginatumin particular, can cause severe disease in humans, with mortality rates of 3-30%. Other than from the bites of infected ticks, CCHFV can also be transmitted through contact with patients with the acute phase of infection or contact with blood or tissues from viraemic livestock.  Outbreaks of human cases of haemorrhagic manifestations have been documented since 1945 and described in parts of Africa, Asia, Eastern Europe and the Middle East and most recently India in 2011. In addition, serological evidence of the disease has been reported in some countries where no human cases were reported. As regional neighbours China and India have been affected by this virus, this study was conducted to determine the seroprevalence of CCHFV among Orang Asli population of Malaysia as the most at risk people who residing in the deep forests. A total of 682 serum samples were collected from the Orang Asli population residing in eight states in peninsular Malaysia and analysed for the presence of anti-CCHFV immunoglobulin G (IgG) using a commercial enzyme-linked immunosorbent assay kit. The study subjects comprised 277 (40.6%) men and 405 (59.4%) women. However, anti-CCHFV IgG was detected in only one female serum sample (0.1%). The presence of anti-CCHFV IgG could not be correlated to age or sex from these findings. The results of this screening survey showed that the seroprevalence of the anti-CCHFV IgG among Malaysia's Orang Asli population is too low for detection or totally negative compared with that in neighbouring countries, such as India and China.

Intracranial hemorrhage and other symptoms in infants associated with human parechovirus in Vienna, Austria.

Science.gov (United States)

Kurz, Herbert; Prammer, Ruth; Bock, Wolfgang; Ollerieth, Robert; Bernert, Günther; Zwiauer, Karl; Aberle, Judith H; Aberle, Stephan W; Fazekas, Tamas; Holter, Wolfgang

2015-12-01

The human parechovirus (HPeV), mainly genotype 3, may cause severe illness in young infants and neonates, including sepsis-like illness and central nervous system (CNS) infection. We lack data concerning the impact and symptoms of HPeV infection in infants in Austria. The aim of the study is to evaluate the spectrum of symptoms and findings in infants with the parechovirus in Vienna and its environs. Patients younger than 3 months of age, with clinically suspected sepsis-like illness or CNS infection and a positive polymerase chain reaction (PCR) for HPeV, were included in the study. Medical records were analyzed retrospectively. Twenty patients were included in the study from 2009 to 2013. The most frequent manifestations were fever and neurological symptoms (89 and 80 %, respectively). Fifty percent of the infants had white blood cell counts out of range. The most notable aspect was cerebral hemorrhage in three neonates, which has not been reported earlier in association with HPeV infection. In Austria, HPeV is a relevant pathogen in sepsis-like disease in infants. The clinical presentation is similar to that described in other studies; cerebral hemorrhage is a new aspect. • Parechovirus infection can cause severe illness in infants. • Symptoms have been described to involve all organs; sepsis-like signs, fever, and irritability are most frequent. • Also in Austria, HPeV plays an important role in severe illnesses in infants. • Severe intracranial hemorrhage is described as a new finding.

Defining Key Entry Events for Crimean-Congo Hemorrhagic Fever Virus in Mammalian Cells

Science.gov (United States)

2012-08-10

ADR-RES Pleural Effusion Adherent 48 hr K-526 Pleural Effusion - lymphoblast Suspension 48 hr MCF-7 Pleural Effusion Adherent 48 hr MDA-MB-231... Pleural Effusion Adherent 48 hr T-47D Pleural Effusion Adherent 48 hr DU-145 Prostate Adherent 48 hr PC-3 Prostate Adherent 48 hr HT-29 Recto-Sigmoid...fast protein liquid chromatography (FPLC) with a Protein A column for affinity purification of the Fc-tagged GN expression product. We eluted products

Comparison of Two Hybrid Models for Forecasting the Incidence of Hemorrhagic Fever with Renal Syndrome in Jiangsu Province, China.

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Wei Wu

Full Text Available Cases of hemorrhagic fever with renal syndrome (HFRS are widely distributed in eastern Asia, especially in China, Russia, and Korea. It is proved to be a difficult task to eliminate HFRS completely because of the diverse animal reservoirs and effects of global warming. Reliable forecasting is useful for the prevention and control of HFRS.Two hybrid models, one composed of nonlinear autoregressive neural network (NARNN and autoregressive integrated moving average (ARIMA the other composed of generalized regression neural network (GRNN and ARIMA were constructed to predict the incidence of HFRS in the future one year. Performances of the two hybrid models were compared with ARIMA model.The ARIMA, ARIMA-NARNN ARIMA-GRNN model fitted and predicted the seasonal fluctuation well. Among the three models, the mean square error (MSE, mean absolute error (MAE and mean absolute percentage error (MAPE of ARIMA-NARNN hybrid model was the lowest both in modeling stage and forecasting stage. As for the ARIMA-GRNN hybrid model, the MSE, MAE and MAPE of modeling performance and the MSE and MAE of forecasting performance were less than the ARIMA model, but the MAPE of forecasting performance did not improve.Developing and applying the ARIMA-NARNN hybrid model is an effective method to make us better understand the epidemic characteristics of HFRS and could be helpful to the prevention and control of HFRS.

Evaluation of Intraventricular Hemorrhage in Pediatric Intracerebral hemorrhage

OpenAIRE

Kleinman, Jonathan T; Beslow, Lauren A; Engelmann, Kyle; Smith, Sabrina E; Licht, Daniel J; Ichord, Rebecca N; Jordan, Lori C

2011-01-01

Previous studies of pediatric intracerebral hemorrhage have investigated isolated intraparenchymal hemorrhage. We investigated whether detailed assessment of intraventricular hemorrhage enhanced outcome prediction after intracerebral hemorrhage. We prospectively enrolled 46 children, full-term to 17 years, median age 2.7 years with spontaneous intraparenchymal hemorrhage and/or intraventricular hemorrhage. Outcome was assessed with the King’s Outcome Scale for Childhood Head Injury. Twenty-si...

Single-particle cryo-electron microscopy of Rift Valley fever virus

International Nuclear Information System (INIS)

Sherman, Michael B.; Freiberg, Alexander N.; Holbrook, Michael R.; Watowich, Stanley J.

2009-01-01

Rift Valley fever virus (RVFV; Bunyaviridae; Phlebovirus) is an emerging human and veterinary pathogen causing acute hepatitis in ruminants and has the potential to cause hemorrhagic fever in humans. We report a three-dimensional reconstruction of RVFV vaccine strain MP-12 (RVFV MP-12) by cryo-electron microcopy using icosahedral symmetry of individual virions. Although the genomic core of RVFV MP-12 is apparently poorly ordered, the glycoproteins on the virus surface are highly symmetric and arranged on a T = 12 icosahedral lattice. Our RVFV MP-12 structure allowed clear identification of inter-capsomer contacts and definition of possible glycoprotein arrangements within capsomers. This structure provides a detailed model for phleboviruses, opens new avenues for high-resolution structural studies of the bunyavirus family, and aids the design of antiviral diagnostics and effective subunit vaccines.

Single-particle cryo-electron microscopy of Rift Valley fever virus.

Science.gov (United States)

Sherman, Michael B; Freiberg, Alexander N; Holbrook, Michael R; Watowich, Stanley J

2009-04-25

Rift Valley fever virus (RVFV; Bunyaviridae; Phlebovirus) is an emerging human and veterinary pathogen causing acute hepatitis in ruminants and has the potential to cause hemorrhagic fever in humans. We report a three-dimensional reconstruction of RVFV vaccine strain MP-12 (RVFV MP-12) by cryo-electron microcopy using icosahedral symmetry of individual virions. Although the genomic core of RVFV MP-12 is apparently poorly ordered, the glycoproteins on the virus surface are highly symmetric and arranged on a T=12 icosahedral lattice. Our RVFV MP-12 structure allowed clear identification of inter-capsomer contacts and definition of possible glycoprotein arrangements within capsomers. This structure provides a detailed model for phleboviruses, opens new avenues for high-resolution structural studies of the bunyavirus family, and aids the design of antiviral diagnostics and effective subunit vaccines.

The spatial analysis on hemorrhagic fever with renal syndrome in Jiangsu province, China based on geographic information system.

Science.gov (United States)

Bao, Changjun; Liu, Wanwan; Zhu, Yefei; Liu, Wendong; Hu, Jianli; Liang, Qi; Cheng, Yuejia; Wu, Ying; Yu, Rongbin; Zhou, Minghao; Shen, Hongbing; Chen, Feng; Tang, Fenyang; Peng, Zhihang

2014-01-01

Hemorrhagic fever with renal syndrome (HFRS) is endemic in mainland China, accounting for 90% of total reported cases worldwide, and Jiangsu is one of the most severely affected provinces. In this study, the authors conducted GIS-based spatial analyses in order to determine the spatial distribution of the HFRS cases, identify key areas and explore risk factors for public health planning and resource allocation. Interpolation maps by inverse distance weighting were produced to detect the spatial distribution of HFRS cases in Jiangsu from 2001 to 2011. Spatio-temporal clustering was applied to identify clusters at the county level. Spatial correlation analysis was conducted to detect influencing factors of HFRS in Jiangsu. HFRS cases in Jiangsu from 2001 to 2011 were mapped and the results suggested that cases in Jiangsu were not distributed randomly. Cases were mainly distributed in northeastern and southwestern Jiangsu, especially in Dafeng and Sihong counties. It was notable that prior to this study, Sihong county had rarely been reported as a high-risk area of HFRS. With the maximum spatial size of 50% of the total population and the maximum temporal size of 50% of the total population, spatio-temporal clustering showed that there was one most likely cluster (LLR = 624.52, Phighways, railways, rivers and lakes. The application of GIS together with spatial interpolation, spatio-temporal clustering and spatial correlation analysis can effectively identify high-risk areas and factors influencing HFRS incidence to lay a foundation for researching its pathogenesis.

High IFN-alpha responses associated with depletion of lymphocytes and natural IFN-producing cells during classical swine fever

NARCIS (Netherlands)

Summerfield, A.; Alves, M.; Ruggli, N.; Bruin, de M.G.M.; McCullough, K.C.

2006-01-01

During the acute phase of the viral hemorrhagic disease, classical swine fever (CSF), a severe hematologic depletion in primary lymphoid organs and depletion of peripheral blood T and B lymphocytes are observed. The onset of these pathologic events is before viremia and independent of leukocyte

[YEL-AND meningoencephalitis in a 4-year-old boy consecutive to a yellow-fever vaccine].

Science.gov (United States)

Gerin, M; Wroblewski, I; Bost-Bru, C; N'guyen, M-A; Debillon, T

2014-04-01

Yellow fever is a vector-borne disease transmitted by an endemic mosquito in sub-Saharan Africa and tropical South America. It causes fever and possibly liver and renal failure with hemorrhagic signs, which may be fatal. The yellow-fever vaccine is an attenuated vaccine that is recommended for all travelers over the age of 9 months in high-risk areas. Adverse effects have been reported: minor symptoms (such as viral syndrome), hypersensitivity reactions, and major symptoms such as viscerotropic disease (YEL-AVD) and neurotropic disease (YEL-AND). The yellow-fever vaccine-associated autoimmune disease with central nervous system involvement (such as acute disseminated encephalomyelitis) associates fever and headaches, neurologic dysfunction, seizures, cerebrospinal fluid (CSF) pleocytosis, and elevated protein, with neuroimaging consistent with multifocal areas of demyelization. The presence of antibodies or virus in CSF, within 1-30 days following vaccination, and the exclusion of other causes is necessary for diagnosis. We describe herein the case of a 4-year-old child who presented with severe encephalitis consecutive to a yellow-fever vaccine, with favorable progression. Diagnosis is based on the chronology of clinical and paraclinical signs and the presence of yellow-fever-specific antibodies in CSF. The treatment consists of symptomatic treatment and immunoglobulin injection. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Dengue e dengue hemorrágico: aspectos do manejo na unidade de terapia intensiva Dengue and dengue hemorrhagic fever: management issues in an intensive care unit

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Sunit Singhi

2007-05-01

this review, a literature search was made on Pubmed and on the World Health Organization (WHO and PAHO websites using the terms dengue and dengue shock syndrome. This information was complemented with personal practice. SUMMARY OF THE FINDINGS: Dengue is the most important arthropod-borne viral disease of humans. Its presentation is protean and varies from an undifferentiated viral syndrome to hemorrhagic fever and severe shock. Dengue fever is a self-limiting, nonspecific illness characterized by fever, headache, myalgia, and constitutional symptoms. Its severe forms (hemorrhagic fever and shock syndrome may lead to multisystem involvement and death. Early diagnosis, close monitoring for deterioration and response to treatment are necessary in all cases. WHO has provided a stepwise approach to management that is useful for milder forms and early shock. In the more severe forms aggressive fluid resuscitation and support for failing organs is necessary for the critically ill patient. Research addressing pathophysiological differences between dengue shock and septic shock, choice of fluids, inotropes and techniques of organ support are likely to yield benefits for the critically ill. CONCLUSIONS: There is no specific therapy for dengue infections. Good supportive care may be lifesaving, but ultimately initiatives aimed at vector control and prevention of mosquito bites may provide the greatest benefits.

Elevated Dengue Virus Nonstructural Protein 1 Serum Levels and Altered Toll-Like Receptor 4 Expression, Nitric Oxide, and Tumor Necrosis Factor Alpha Production in Dengue Hemorrhagic Fever Patients

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Denise Maciel Carvalho

2014-01-01

Full Text Available Background. During dengue virus (DV infection, monocytes produce tumor necrosis factor alpha (TNF-α and nitric oxide (NO which might be critical to immunopathogenesis. Since intensity of DV replication may determine clinical outcomes, it is important to know the effects of viral nonstructural protein 1 (NS1 on innate immune parameters of infected patients. The present study investigates the relationships between dengue virus nonstructural protein 1 (NS1 serum levels and innate immune response (TLR4 expression and TNF-α/NO production of DV infected patients presenting different clinical outcomes. Methodology/Principal Findings. We evaluated NO, NS1 serum levels (ELISA, TNF-α production by peripheral blood mononuclear cells (PBMCs, and TLR4 expression on CD14+ cells from 37 dengue patients and 20 healthy controls. Early in infection, increased expression of TLR4 in monocytes of patients with dengue fever (DF was detected compared to patients with dengue hemorrhagic fever (DHF. Moreover, PBMCs of DHF patients showed higher NS1 and lower NO serum levels during the acute febrile phase and a reduced response to TLR4 stimulation by LPS (with a reduced TNF-α production when compared to DF patients. Conclusions/Significance. During DV infection in humans, some innate immune parameters change, depending on the NS1 serum levels, and phase and severity of the disease which may contribute to development of different clinical outcomes.

Demographic and clinico-epidemiological features of dengue fever in Faisalabad, Pakistan.

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Faiz Ahmed Raza

Full Text Available This cross-sectional study was carried out to explore the epidemiological and clinical features of dengue fever in Faisalabad, Pakistan during 2011 and 2012. During the study period, anti-dengue IgM positive cases were reported in the post-monsoon period during the months of August-December. Certain hotspots for the dengue infection were identified in the city that coincide with the clusters of densely populated urban regions of the city. Out of total 299 IgM positive patients (male 218 and female 81; there were 239 dengue fever (DF and 60 dengue hemorrhagic fever (DHF patients. There was decrease in the median age of dengue patients from 31 years in 2011 to 21.5 years in 2012 (p<0.001. Abdominal pain was seen in 35% DHF patients followed by nausea in 28.3%, epistaxis in 25% and rash in 20% patients (p<0.05. Patients reported to be suffering from high-grade fever for an average of 8.83 days in DHF as compared to 5.82 days in DF before being hospitalized. Co-morbidities were found to be risk factor for the development of DHF in dengue patients. Clinical and laboratory features of dengue cases studied could be used for the early identification of patients at risk of severe dengue fever.

Dengue fever Potential Area at Pademangan Barat Sub District, North Jakarta

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Tri E. B. Soesilo

2011-06-01

Full Text Available Dengue hemorrhagic fever is an infectious disease that contagious by Aedes aegypti mosquito’s bites. Anybody could infectious by this illness, without differentiate their sex, age, social status, and economic status as well. Nevertheless, at slum area, where mosquito’s larva is easy to find, the number of infectious people is presuming high. By using primary data and analyze with geography information system (GIS, the study found that the number of infectious people of dengue fever do not have any positive correlation with larva amount, that was monitored through clean water in the surrounding neighborhood area. The number of infectious people have correlation with the dirty areas that caused by the piling of used articles and inundate area. Gender and age do not have any influence with the number of infectious people.

Mycoremediation of congo red dye by filamentous fungi.

Science.gov (United States)

Bhattacharya, Sourav; Das, Arijit; G, Mangai; K, Vignesh; J, Sangeetha

2011-10-01

Azo, anthroquinone and triphenylmethane dyes are the major classes of synthetic colourants, which are difficult to degrade and have received considerable attention. Congo red, a diazo dye, is considered as a xenobiotic compound, and is recalcitrant to biodegradative processes. Nevertheless, during the last few years it has been demonstrated that several fungi, under certain environmental conditions, are able to transfer azo dyes to non toxic products using laccases. The aim of this work was to study the factors influencing mycoremediation of Congo red. Several basidiomycetes and deuteromycetes species were tested for the decolourisation of Congo red (0.05 g/l) in a semi synthetic broth at static and shaking conditions. Poor decolourisation was observed when the dye acted as the sole source of nitrogen, whereas semi synthetic broth supplemented with fertilizer resulted in better decolourisation. Decolourisation of Congo red was checked in the presence of salts of heavy metals such as mercuric chloride, lead acetate and zinc sulphate. Decolourisation parameters such as temperature, pH, and rpm were optimized and the decolourisation obtained at optimized conditions varied between 29.25- 97.28% at static condition and 82.1- 100% at shaking condition. Sodium dodecyl sulphate polyacrylamide gel electrophoretic analysis revealed bands with molecular weights ranging between 66.5 to 71 kDa, a characteristic of the fungal laccases. High efficiency decolourisation of Congo red makes these fungal forms a promising choice in biological treatment of waste water containing Congo red.

Mycoremediation of Congo red dye by filamentous fungi

Directory of Open Access Journals (Sweden)

Sourav Bhattacharya

2011-12-01

Full Text Available Azo, anthroquinone and triphenylmethane dyes are the major classes of synthetic colourants, which are difficult to degrade and have received considerable attention. Congo red, a diazo dye, is considered as a xenobiotic compound, and is recalcitrant to biodegradative processes. Nevertheless, during the last few years it has been demonstrated that several fungi, under certain environmental conditions, are able to transfer azo dyes to non toxic products using laccases. The aim of this work was to study the factors influencing mycoremediation of Congo red. Several basidiomycetes and deuteromycetes species were tested for the decolourisation of Congo red (0.05 g/l in a semi synthetic broth at static and shaking conditions. Poor decolourisation was observed when the dye acted as the sole source of nitrogen, whereas semi synthetic broth supplemented with fertilizer resulted in better decolourisation. Decolourisation of Congo red was checked in the presence of salts of heavy metals such as mercuric chloride, lead acetate and zinc sulphate. Decolourisation parameters such as temperature, pH, and rpm were optimized and the decolourisation obtained at optimized conditions varied between 29.25- 97.28% at static condition and 82.1- 100% at shaking condition. Sodium dodecyl sulphate polyacrylamide gel electrophoretic analysis revealed bands with molecular weights ranging between 66.5 to 71 kDa, a characteristic of the fungal laccases. High efficiency decolourisation of Congo red makes these fungal forms a promising choice in biological treatment of waste water containing Congo red.

Identification of pathogens for differential diagnosis of fever with jaundice in the Central African Republic: a retrospective assessment, 2008-2010.

Science.gov (United States)

Gadia, Christelle Luce Bobossi; Manirakiza, Alexandre; Tekpa, Gaspard; Konamna, Xavier; Vickos, Ulrich; Nakoune, Emmanuel

2017-11-29

Febrile jaundice results clinically in generalized yellow coloration of the teguments and mucous membranes due to excess plasma bilirubin, accompanied by fever. Two types are found: conjugated and unconjugated bilirubin jaundice. Jaundice is a sign in several diseases due to viruses (viral hepatitis and arbovirus), parasites (malaria) and bacteria (leptospirosis). In the Central African Republic (CAR), only yellow fever is included on the list of diseases for surveillance. The aim of this study was to identify the other pathogens that can cause febrile jaundice, for better management of patients. Between 2008 and 2010, 198 sera negative for yellow fever IgM were randomly selected from 2177 samples collected during yellow fever surveillance. Laboratory analyses targeted four groups of pathogens: hepatitis B, C, delta and E viruses; dengue, chikungunya, Zika, Crimean-Congo haemorrhagic fever, West Nile and Rift Valley arboviruses; malaria parasites; and bacteria (leptospirosis). Overall, 30.9% sera were positive for hepatitis B, 20.2% for hepatitis E, 12.3% for hepatitis C and 8.2% for malaria. The majority of positive sera (40.4%) were from people aged 16-30 years. Co-infection with at least two of these pathogens was also found. These findings suggest that a systematic investigation should be undertaken of infectious agents that cause febrile jaundice in the CAR.

Intracerebral Hemorrhage

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... Home » Patients & Families » About Stroke » Intracerebral Hemorrhage Intracerebral Hemorrhage What is a Stroke? Ischemic Stroke Intracerebral Hemorrhage Subarachnoid Hemorrhage Pediatric Stroke Warning Signs Stroke Statistics ...

[Effects of sodium ethamsylate on anticoagulant and anti-aggregation activity of vascular endothelium in hemorrhagic fever patients with renal syndrome].

Science.gov (United States)

Davidovich, I M; Sirotin, B Z; Parshina, T A

1999-01-01

To elucidate effects of sodium ethamsylate (SE) on anticoagulant and antiaggregation activity of vascular endothelium in patients suffering from hemorrhagic fever with renal syndrome (HFRS). A trial of SE enrolled 70 HFRS patients (58 males, 12 females aged under 30 years) compatible by the disease severity. They were divided into two groups. 42 patients of the control group received standard therapy, 28 patients of the study group received adjuvant 12% solution of SE in daily dose 1500-2000 mg in the course of HFRS oliguria period. Hemostatic parameters were measured before and after the cuff test to investigate the condition of vascular wall with calculation of the athrombogenicity index (the ratio of the relevant indices before and after the cuff test). SE effects on vascular endothelium was assessed by a blind method. In oliguria, both groups had baseline antiaggregation indices significantly higher than in the control. After the cuff test, control patients' indices tended to an increase while in the study group there was a marked decrease. The trend in anticoagulant activity of microvascular endothelium did not differ much with the groups. This picture persisted also in polyuria. In convalescence hemostasis was similar in both groups. SE enhances antiaggregant activity of vascular endothelium in oliguria period of HFRS without affecting its anticoagulant properties. This is explained by a direct effect of SE on vascular endothelium.

Countermeasure development for Rift Valley fever: deletion, modification or targeting of major virulence factor NSs.

Science.gov (United States)

Lihoradova, Olga; Ikegami, Tetsuro

2014-01-01

Rift Valley fever (RVF) is a mosquito-borne zoonotic disease characterized by a high rate of abortion in ruminants, and febrile illness, hemorrhagic fever, retinitis and encephalitis in humans. RVF is caused by the RVF virus (RVFV), belonging to the genus Phlebovirus of the family Bunyaviridae . RVFV encodes a major virulence factor, NSs , which is dispensable for viral replication, yet required for evasion of host innate immune responses. RVFV NSs inhibits host gene upregulation at the transcriptional level, while promoting viral translation in the cytoplasm. In this article, we summarize the virology and pathology of RVF, and countermeasure development for RVF, with emphasis on NSs function and applications.

[The warning model and influence of climatic changes on hemorrhagic fever with renal syndrome in Changsha city].

Science.gov (United States)

Xiao, Hong; Tian, Huai-yu; Zhang, Xi-xing; Zhao, Jian; Zhu, Pei-juan; Liu, Ru-chun; Chen, Tian-mu; Dai, Xiang-yu; Lin, Xiao-ling

2011-10-01

To realize the influence of climatic changes on the transmission of hemorrhagic fever with renal syndrome (HFRS), and to explore the adoption of climatic factors in warning HFRS. A total of 2171 cases of HFRS and the synchronous climatic data in Changsha from 2000 to 2009 were collected to a climate-based forecasting model for HFRS transmission. The Cochran-Armitage trend test was employed to explore the variation trend of the annual incidence of HFRS. Cross-correlations analysis was then adopted to assess the time-lag period between the climatic factors, including monthly average temperature, relative humidity, rainfall and Multivariate Elño-Southern Oscillation Index (MEI) and the monthly HFRS cases. Finally the time-series Poisson regression model was constructed to analyze the influence of different climatic factors on the HFRS transmission. The annual incidence of HFRS in Changsha between 2000 - 2009 was 13.09/100 000 (755 cases), 9.92/100 000 (578 cases), 5.02/100 000 (294 cases), 2.55/100 000 (150 cases), 1.13/100 000 (67 cases), 1.16/100 000 (70 cases), 0.95/100 000 (58 cases), 1.40/100 000 (87 cases), 0.75/100 000 (47 cases) and 1.02/100 000 (65 cases), respectively. The incidence showed a decline during these years (Z = -5.78, P Climate factors significantly influence the incidence of HFRS. If the influence of variable-autocorrelation, seasonality, and long-term trend were controlled, the accuracy of forecasting by the time-series Poisson regression model in Changsha would be comparatively high, and we could forecast the incidence of HFRS in advance.

Yellow fever virus: genetic and phenotypic diversity and implications for detection, prevention and therapy.

Science.gov (United States)

Beasley, David W C; McAuley, Alexander J; Bente, Dennis A

2015-03-01

Yellow fever virus (YFV) is the prototypical hemorrhagic fever virus, yet our understanding of its phenotypic diversity and any molecular basis for observed differences in disease severity and epidemiology is lacking, when compared to other arthropod-borne and haemorrhagic fever viruses. This is, in part, due to the availability of safe and effective vaccines resulting in basic YFV research taking a back seat to those viruses for which no effective vaccine occurs. However, regular outbreaks occur in endemic areas, and the spread of the virus to new, previously unaffected, areas is possible. Analysis of isolates from endemic areas reveals a strong geographic association for major genotypes, and recent epidemics have demonstrated the emergence of novel sequence variants. This review aims to outline the current understanding of YFV genetic and phenotypic diversity and its sources, as well as the available animal models for characterizing these differences in vivo. The consequences of genetic diversity for detection and diagnosis of yellow fever and development of new vaccines and therapeutics are discussed. Copyright © 2015 Elsevier B.V. All rights reserved.

Yellow fever vaccine-associated neurotropic disease (YEL-AND) - A case report.

Science.gov (United States)

Florczak-Wyspiańska, Jolanta; Nawotczyńska, Ewa; Kozubski, Wojciech

Yellow fever (YF) is a mosquito-borne viral hemorrhagic fever, which is a serious and potentially fatal disease with no specific antiviral treatment that can be effectively prevented by an attenuated vaccine (YEL). Despite the long history of safe and efficacious YF vaccination, sporadic case reports of serious adverse events (SAEs) have been reported, including yellow fever vaccine-associated neurotropic disease (YEL-AND). YEL-AND usually appears within one month of YF vaccination, manifesting as meningoencephalitis, Guillain-Barré syndrome (GBS) or acute disseminated encephalomyelitis (ADEM). We report a case of YEL-AND with meningitis presentation in a 39-year-old Caucasian man without evidence of significant risk factors, which was confirmed by the presence of the YF virus and specific immunoglobulin G (IgG) antibodies in the cerebrospinal fluid (CSF). In conclusion, we should stress the importance of balancing the risk of SAEs associated with the vaccine and the benefits of YF vaccination for each patient individually. Copyright © 2016 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Frequency, pattern and management of acute abdomen in dengue fever in Karachi, Pakistan.

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Shamim, Muhammad

2010-07-01

This study aimed to determine the frequency, pattern and management of acute abdomen in patients with dengue fever. This descriptive case series is a prospective analysis of acute abdomen in dengue fever that was performed at three secondary care hospitals in Karachi, Pakistan from June 1, 2005 to December 31, 2008. The inclusion criterion was all patients with confirmed diagnosis of dengue fever. Patients with incomplete laboratory, ultrasound or histopathology data were excluded. Among 357 patients with dengue fever, 43 (12.04%) had acute abdomen. There were 15 men and 28 women, with a median age of 29 years. These included 26 cases of acute cholecystitis, 7 cases of acute appendicitis, 7 cases of nonspecific peritonitis, and 3 cases of acute pancreatitis. Dengue hemorrhagic fever/shock syndrome was found in acute pancreatitis, and two of these patients died. Emergency surgery was required in eight patients (5 appendectomy and 3 open cholecystectomy). Substantial transfusion of blood and its components was required in eight patients who underwent emergency surgery. Early diagnosis and prompt conservative management of dengue acute abdomen is necessary to avoid mortality and emergency surgery-related morbidity. However, if needed, surgery can be performed with acceptable morbidity. Copyright © 2010 Asian Surgical Association. Published by Elsevier B.V. All rights reserved.

Exosomes Enter Vaccine Development: Strategies Meeting Global Challenges of Emerging Infections.

Science.gov (United States)

Jungbauer, Alois

2018-04-01

New approaches for vaccination must be developed in order to meet the grand challenges for emerging infectious diseases. Exosomes now enter vaccine development and these are strategies are meeting these global challenges, as demonstrated by Anticoli et al., in this issue of Biotechnology Journal. Using exosome vaccines has been now been demonstrated in vivo for several viruses such as Ebola Virus VP24, VP40, and NP, Influenza Virus NP, Crimean-Congo Hemorrhagic Fever NP, West Nile Virus NS3, and Hepatitis C Virus NS3. Now this technology must be tested in clinics. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Metabolomics analyses identify platelet activating factors and heme breakdown products as Lassa fever biomarkers.

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Trevor V Gale

2017-09-01

Full Text Available Lassa fever afflicts tens of thousands of people in West Africa annually. The rapid progression of patients from febrile illness to fulminant syndrome and death provides incentive for development of clinical prognostic markers that can guide case management. The small molecule profile of serum from febrile patients triaged to the Viral Hemorrhagic Fever Ward at Kenema Government Hospital in Sierra Leone was assessed using untargeted Ultra High Performance Liquid Chromatography Mass Spectrometry. Physiological dysregulation resulting from Lassa virus (LASV infection occurs at the small molecule level. Effects of LASV infection on pathways mediating blood coagulation, and lipid, amino acid, nucleic acid metabolism are manifest in changes in the levels of numerous metabolites in the circulation. Several compounds, including platelet activating factor (PAF, PAF-like molecules and products of heme breakdown emerged as candidates that may prove useful in diagnostic assays to inform better care of Lassa fever patients.

Radiation degradation of Congo Red in aqueous solution

International Nuclear Information System (INIS)

Ma Hongjuan; Wang Min; Yang Ruiyuan; Wang Wenfeng; Shen Zhongqun; Yao Side

2006-01-01

About one-half of the dyes used in textile industry are azo dyes, and as a consequence a lot of azo dyes are released into the environment with industrial wastewater. Because of complex structures of the dyes, biological, physical and chemical treatments of dye effluents are inefficient. In this study, radiation degradation of Congo Red in aqueous solutions was investigated in different reaction systems. Both pulsed radiolysis and laser flash photolysis experiments were carried out for better understandings of degradation mechanisms involved in the treatments. Congo Red solutions saturated by air, N 2 O, O 2 , N 2 O or N 2 and added with tert-butanol were irradiated to 0-14.8 kGy. The absorption spectra, degradation efficiency, TOC (total organic carbon) removal and pH changes of the solutions were investigated. The main radiolytic products from Congo Red samples irradiated in steady-state were determined by HPLC-MS. And probable reaction mechanisms were proposed. Effects of primary species from water radiolysis, such as e aq - , . OH and . O 2 . /HO 2 . on the degradation behavior of the dye were discussed. Below 5 kGy in γ-rays irradiation, the bleaching efficiency of Congo Red was (N 2 +tert-butanol) >O 2 >air>N 2 O>N 2 . Complete degradation of Congo Red was observed at 4.0, 5.5 and 10.2 kGy irradiation of the aqueous solutions saturated by N 2 with tert-butanol added, O 2 and N 2 O, respectively. With just oxidative or reductive species, highly conjugated part of Congo Red molecules could be destroyed. While oxidative species produced from water radiolysis could oxidize the Congo Red more effectively, making the dye to break into fatty acids and CO 2 finally. In the solution saturated with N 2 and air, the primary active species were both of oxidative and reductive and the highly conjugated part of Congo Red molecules could not be destroyed completely up to 14.8 kGy of γ-ray irradiation. It was more difficult to achieve high TOC removal in comparison with �

Tri-phasic fever in dengue fever.

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D, Pradeepa H; Rao, Sathish B; B, Ganaraj; Bhat, Gopalakrishna; M, Chakrapani

2018-04-01

Dengue fever is an acute febrile illness with a duration of 2-12 days. Our observational study observed the 24-h continuous tympanic temperature pattern of 15 patients with dengue fever and compared this with 26 others with fever due to a non-dengue aetiology. A tri-phasic fever pattern was seen among two-thirds of dengue fever patients, but in only one with an inflammatory disease. One-third of dengue fever patients exhibited a single peak temperature. Continuous temperature monitoring and temperature pattern analysis in clinical settings can aid in the early differentiation of dengue fever from non-dengue aetiology.

Congo Basin precipitation: Assessing seasonality, regional interactions, and sources of moisture

Science.gov (United States)

Dyer, Ellen L. E.; Jones, Dylan B. A.; Nusbaumer, Jesse; Li, Harry; Collins, Owen; Vettoretti, Guido; Noone, David

2017-07-01

Precipitation in the Congo Basin was examined using a version of the National Center for Atmospheric Research Community Earth System Model (CESM) with water tagging capability. Using regionally defined water tracers, or tags, the moisture contribution from different source regions to Congo Basin precipitation was investigated. We found that the Indian Ocean and evaporation from the Congo Basin were the dominant moisture sources and that the Atlantic Ocean was a comparatively small source of moisture. In both rainy seasons the southwestern Indian Ocean contributed about 21% of the moisture, while the recycling ratio for moisture from the Congo Basin was about 25%. Near the surface, a great deal of moisture is transported from the Atlantic into the Congo Basin, but much of this moisture is recirculated back over the Atlantic in the lower troposphere. Although the southwestern Indian Ocean is a major source of Indian Ocean moisture, it is not associated with the bulk of the variability in precipitation over the Congo Basin. In wet years, more of the precipitation in the Congo Basin is derived from Indian Ocean moisture, but the spatial distribution of the dominant sources is shifted, reflecting changes in the midtropospheric circulation over the Indian Ocean. During wet years there is increased transport of moisture from the equatorial and eastern Indian Ocean. Our results suggest that reliably capturing the linkages between the large-scale circulation patterns over the Indian Ocean and the local circulation over the Congo Basin is critical for future projections of Congo Basin precipitation.

FEVER AS INDICATOR TO SECONDARY INFECTION IN DENGUE VIRAL INFECTION

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Soegeng Soegijanto

2018-04-01

Full Text Available Dengue Virus Infections are distributed in tropical and sub-tropical regions and transmitted by the mosquitoes such as Aedes aegypti and Aedes albopictus. Dengue virus can cause dengue fever, dengue hemorrhagic fever and dengue shock syndrome or dengue and severe dengue classified by World Health Organization. Beside it concurrent infection virus salmonella had been found some cases who showed fever more than 7 days. Concurrent infection with two agents can result in an illness having overlapping symptoms creating a diagnostic dilemma for treating physician, such as dengue fever with typhoid fever. The aim of this research is detection of dengue virus and secondary infection with Salmonella typhi in patients suspected dengue virus infection. Detection of dengue virus and Salmonella typhi using immunochromatography test such as NS1, IgG/IgM for dengue virus infection, and IgM/IgG Salmonella and blood culture. The fifty children with dengue virus infection came to Soerya hospital and 17 cases suspected dengue virus infection, five cases showed a positive NS1 on the second day of fever and one case concurrent with clinical manifestation of convulsi on the third days of fever there were five cases only showed positive. It was showed in this study that on the fourth to six day of fever in dengue virus infection accompanied by antibody IgM & IgG dengue. There were 12 cases showed the clinical manifestation of concurrent dengue viral infection and Salmonella, all of them showed a mild clinical manifestation and did not show plasma leakage and shock. In this study we found the length of stay of concurrent Dengue Virus Infection and Salmonella infection is more than 10 days. These patients were also more likely to have co-existing haemodynamic disturbances and bacterial septicaemia which would have required treatment with inotropes and antibiotics. This idea is very important to make update dengue viral management to decrease mortality in outbreak try to

Surveillance for yellow Fever virus in non-human primates in southern Brazil, 2001-2011: a tool for prioritizing human populations for vaccination.

OpenAIRE

Marco A B Almeida; Jader da C Cardoso; Edmilson Dos Santos; Daltro F da Fonseca; Laura L Cruz; Fernando J C Faraco; Marilina A Bercini; Kátia C Vettorello; Mariana A Porto; Renate Mohrdieck; Tani M S Ranieri; Maria T Schermann; Alethéa F Sperb; Francisco Z Paz; Zenaida M A Nunes

2014-01-01

Author Summary Yellow fever (YF) is a viral hemorrhagic disease that affects humans as well as several species of non-human primates, especially New World monkeys found in South America. Yellow fever virus (YFV) is maintained in a natural cycle involving tree-hole breeding mosquitoes and non-human primates hosts. Because YF is often fatal in susceptible New World monkey populations, sudden die-offs of New World monkeys or epizootics can signal YFV circulation in an environment where humans ma...

Yellow fever vaccine: an effective vaccine for travelers.

Science.gov (United States)

Verma, Ramesh; Khanna, Pardeep; Chawla, Suraj

2014-01-01

Yellow fever (YF) is an acute viral communicable disease transmitted by an arbovirus of the Flavivirus genus. It is primarily a zoonotic disease, especially the monkeys. Worldwide, an estimated 200,000 cases of yellow fever occurred each year, and the case-fatality rate is ~15%. Forty-five endemic countries in Africa and Latin America, with a population of close to 1 billion, are at risk. Up to 50% of severely affected persons from YF die without treatment. During 2009, 55 cases and 18 deaths were reported from Brazil, Colombia, and Peru. Brazil reported the maximum number of cases and death, i.e., 42 cases with 11 deaths. From January 2010 to March 2011, outbreaks of YF were reported to the WHO by Cameroon, Democratic Republic of Congo, Cote d'Ivoire, Guinea, Sierra Leone, Senegal, and Uganda. Cases were also reported in three northern districts of Abim, Agago, and Kitugun near the border with South Sudan. YF usually causes fever, muscle pain with prominent backache, headache, shivers, loss of appetite, and nausea or vomiting. Most patients improve, and their symptoms disappear after 3 to 4 d. Half of the patients who enter the toxic phase die within 10-14 d, while the rest recover without significant organ damage. Vaccination has been the single most important measure for preventing YF. The 17D-204 YF vaccine is a freeze-dried, live attenuated, highly effective vaccine. It is available in single-dose or multi-dose vials and should be stored at 2-8 °C. It is reconstituted with normal saline and should be used within 1 h of reconstitution. The 0.5 mL dose is delivered subcutaneously. Revaccination is recommended every 10 y for people at continued risk of exposure to yellow fever virus (YFV). This vaccine is available worldwide. Travelers, especially to Africa or Latin America from Asia, must have a certificate documenting YF vaccination, which is required by certain countries for entry under the International Health Regulations (IHR) of the WHO.

Bilateral adrenal hemorrhage in polycythemia vera

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Shruti Bhandari

2016-09-01

Full Text Available Bilateral adrenal hemorrhage (BAH is a rare complication typically seen in critically ill patients, which can lead to acute adrenal insufficiency and death unless it is recognized promptly and treated appropriately. We describe the case of a 64-year-old man with polycythemia vera found to be unresponsive with fever, hypotension, tachycardia, and hypoglycemia. Electrocardiogram showed ST-elevation with elevated troponin, hemoglobin, prothrombin time, and partial thromboplastin time. He required aggressive ventilator and vasopressor support. Despite primary coronary intervention, he remained hypotensive. Random cortisol level was low. He received stress dose hydrocortisone with immediate hemodynamic stability. BAH was highly suspected and was confirmed by non-contrast abdominal computed tomography. Prompt recognition and timely initiated treatment remain crucial to impact the mortality associated with acute adrenal insufficiency.

Yellow Fever outbreak in Darfur, Sudan in October 2012; the initial outbreak investigation report

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Mohammed A. Soghaier

2013-10-01

Full Text Available Summary: Introduction: Sudan is subject to repeated outbreaks, including Viral Hemorrhagic Fever (VHF, which is considered to be a very serious illness. Yellow Fever (YF outbreaks in Sudan have been reported from the 1940s through 2005. In 2012, a new outbreak of YF occurred in the Darfur region. Objective: To identify the potential for an outbreak, to diagnose the disease and to be able to recognize its cause among the initial reported cases. Methodology: >This is a descriptive and investigative field study that applies standard communicable disease outbreak investigation steps. The study involved clinical, serological, entomological and environmental surveys. Results: The field investigation confirmed the outbreak and identified its cause to be YF. Conclusion: National surveillance systems should be strong enough to detect VHFs in a timely manner. Local health facilities should be prepared to promptly treat the initial cases because the case fatality ratios (CFRs are usually very high among the index cases. Keywords: Yellow Fever, Sudan, Darfur, VHFs, Soghaier

An experience in the clinical use of specific immunoglobulin from horse blood serum for prophylaxis of Ebola haemorrhagic fever.

Science.gov (United States)

Borisevich, I V; Chemikova, Natalya K; Markov, V I; Krasnianskiy, V P; Borisevich, S V; Rozhdestvenskiy, E V

The aim of this work was to estimate the efficacy and safety of single intramuscular introduction of specific heterologous immunoglobulin as prophylactic drug against Ebola hemorrhagic fever. Materials and methods. The specific heterologous immunoglobulin was introduced as a special prophylactic drug to 28 patients in epidemic situations, after skin hurt with infectious materials or contact with infectious blood. Clinico-laboratory observation was performed in 24 subjects after single intramuscular introduction of heterologous immunoglobulin Ebola. The samples of blood serum were investigated for immunoglobulin Ebola and antibodies to horse gamma-globulin on the 30th and 60th days after prophylaxis. Results. None of the subjects of the study contracted Ebola fever. There were no anaphylactic reactions after special prophylaxis with specific heterologous immunoglobulin. Among the subjects with normal allergic state 31% responded with local reactions; 13%, with a general reaction (mild case of the serum disease). Almost no reaction was observed in patients with unfavorable allergic state subjected to desensitizing therapy; in the absence of desensitizing therapy, 50% of patients with unfavorable allergic state exhibited local reactions; 17%, mild cases of the serum disease; 33%, moderate cases of the serum disease. In summary, if the tactics of immunoglobulin application was right, the quantity of local allergic reactions was 28%; of wide spread reactions, 6%. Weak serum disease was observed in 11% of the subjects. The prognostic period of resistance to Ebola fever was less than 30 days. Conclusion. The prophylactic use of specific immunoglobulin from horse blood serum against hemorrhagic Ebola fever is effective and relatively safe in patients subjected to desensitizing therapy.

Monitoring Forest Carbon Stocks and Fluxes in the Congo Basin

OpenAIRE

2010-01-01

The Central African Forests Commission (COMIFAC) and its partners (OFAC, USAID, EC-JRC, OSFAC, WWF, WRI, WCS, GOFC-GOLD, START, UN-FAO) organized an international conference on "Monitoring of Carbon stocks and fluxes in the Congo Basin" in Brazzaville, Republic of Congo, 2-4 February 2010. The conference brought together leading international specialists to discuss approaches for quantifying stocks and flows of carbon in tropical forests of the Congo Basin. The conference provided a unique op...

An inactivated yellow fever 17DD vaccine cultivated in Vero cell cultures.

Science.gov (United States)

Pereira, Renata C; Silva, Andrea N M R; Souza, Marta Cristina O; Silva, Marlon V; Neves, Patrícia P C C; Silva, Andrea A M V; Matos, Denise D C S; Herrera, Miguel A O; Yamamura, Anna M Y; Freire, Marcos S; Gaspar, Luciane P; Caride, Elena

2015-08-20

Yellow fever is an acute infectious disease caused by prototype virus of the genus Flavivirus. It is endemic in Africa and South America where it represents a serious public health problem causing epidemics of hemorrhagic fever with mortality rates ranging from 20% to 50%. There is no available antiviral therapy and vaccination is the primary method of disease control. Although the attenuated vaccines for yellow fever show safety and efficacy it became necessary to develop a new yellow fever vaccine due to the occurrence of rare serious adverse events, which include visceral and neurotropic diseases. The new inactivated vaccine should be safer and effective as the existing attenuated one. In the present study, the immunogenicity of an inactivated 17DD vaccine in C57BL/6 mice was evaluated. The yellow fever virus was produced by cultivation of Vero cells in bioreactors, inactivated with β-propiolactone, and adsorbed to aluminum hydroxide (alum). Mice were inoculated with inactivated 17DD vaccine containing alum adjuvant and followed by intracerebral challenge with 17DD virus. The results showed that animals receiving 3 doses of the inactivated vaccine (2 μg/dose) with alum adjuvant had neutralizing antibody titers above the cut-off of PRNT50 (Plaque Reduction Neutralization Test). In addition, animals immunized with inactivated vaccine showed survival rate of 100% after the challenge as well as animals immunized with commercial attenuated 17DD vaccine. Copyright © 2015 Elsevier Ltd. All rights reserved.

Findings at brain MRI in children with dengue fever and neurological symptoms

International Nuclear Information System (INIS)

Rastogi, Ruchi; Garg, Bhavya

2016-01-01

Dengue is a flavivirus of the genus arbovirus with four serotypes, from DEN 1 to DEN 4. There has been an increase in incidence of dengue infection in children in the tropics and subtropics. Dengue has a variable clinical presentation, with many patients being asymptomatic. Its clinical manifestations in children vary from fever and arthralgia to life-threatening dengue hemorrhagic fever and dengue shock syndrome. We describe MRI findings in children with neurological involvement including dengue encephalopathy, acute hypoxic injury and dengue encephalitis. Dengue encephalopathy is usually secondary to multisystem derangement such as shock, hepatitis, coagulopathy and concurrent bacterial infection and is relatively common. Dengue encephalitis from direct neuronal invasion is rare. Nonspecific changes are seen on brain MRI in dengue infection. Clinical and laboratory findings as well as outcome do not necessarily correspond with brain MRI findings. (orig.)

Findings at brain MRI in children with dengue fever and neurological symptoms

Energy Technology Data Exchange (ETDEWEB)

Rastogi, Ruchi; Garg, Bhavya [Indraprastha Apollo Hospitals, Department of Radiodiagnosis, New Delhi (India)

2016-01-15

Dengue is a flavivirus of the genus arbovirus with four serotypes, from DEN 1 to DEN 4. There has been an increase in incidence of dengue infection in children in the tropics and subtropics. Dengue has a variable clinical presentation, with many patients being asymptomatic. Its clinical manifestations in children vary from fever and arthralgia to life-threatening dengue hemorrhagic fever and dengue shock syndrome. We describe MRI findings in children with neurological involvement including dengue encephalopathy, acute hypoxic injury and dengue encephalitis. Dengue encephalopathy is usually secondary to multisystem derangement such as shock, hepatitis, coagulopathy and concurrent bacterial infection and is relatively common. Dengue encephalitis from direct neuronal invasion is rare. Nonspecific changes are seen on brain MRI in dengue infection. Clinical and laboratory findings as well as outcome do not necessarily correspond with brain MRI findings. (orig.)

Impact of climate trends on tick-borne pathogen transmission

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Agustin eEstrada-Pena

2012-03-01

Full Text Available Recent advances in climate research together with a better understanding of tick-pathogen interactions, the distribution of ticks and the diagnosis of tick-borne pathogens raise questions about the impact of environmental factors on tick abundance and spread and the prevalence and transmission of tick-borne pathogens. While undoubtedly climate plays a role in the changes in distribution and seasonal abundance of ticks, it is always difficult to disentangle factors impacting on the abundance of tick hosts from those exerted by human habits. All together, climate, host abundance and social factors may explain the upsurge of epidemics transmitted by ticks to humans. Herein we focused on tick-borne pathogens that affect humans with pandemic potential. Borrelia burgdorferi s.l. (Lyme disease, Anaplasma phagocytophilum (human granulocytic anaplasmosis and tick-borne encephalitis virus (tick-borne encephalitis are transmitted by Ixodes spp. Crimean-Congo hemorrhagic fever virus (Crimean-Congo hemorrhagic fever is transmitted by Hyalomma spp. In this review, we discussed how vector tick species occupy the habitat as a function of different climatic factors, and how these factors impact on tick survival and seasonality. How molecular events at the tick-pathogen interface impact on pathogen transmission is also discussed. Results from statistically and biologically derived models are compared to show that while statistical models are able to outline basic information about tick distributions, biologically derived models are necessary to evaluate pathogen transmission rates and understand the effect of climatic variables and host abundance patterns on pathogen transmission. The results of these studies could be used to build early alert systems able to identify the main factors driving the subtle changes in tick distribution and seasonality and the prevalence of tick-borne pathogens.

A review on the Ebola virus, outbreak history and the current research tools to control the disease

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Cesar Marcial Escobedo-Bonilla

2015-01-01

Full Text Available The Ebola virus is a zoonotic pathogen causing hemorrhagic fever disease with a high mortality rate. The distribution of this pathogen has been limited to woodlands from Central and West Africa and the forest-savannah ecotone in East Africa. The likely reservoir species are frugivorous bats living in these areas. This pathogen is becoming an increasing threat to human populations since its distribution range is expanding faster than expected. The current Ebola outbreaks in Western Africa and in the Democratic Republic of Congo have rapidly spread infecting high numbers of individuals in five African countries. The disease has reached the United States and Spain. This expansion is due partly to increasing global connectivity. This situation represents a new challenge to control the spread of the disease. Experimental drugs have been used to treat a few infected people with promising results. This gives hope for an effective treatment against Ebola hemorrhagic fever in the near future, though thousands of people remain at risk of infection. The present review aims to give an update of the knowledge on the disease, including features of the Ebola virus, the history of disease outbreaks in Africa and the tools that are being developed in order to control this re-emergent disease.

Temperature-sensitive mutations for live-attenuated Rift Valley fever vaccines: Implications from other RNA viruses

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Shoko eNishiyama

2015-08-01

Full Text Available Rift Valley fever (RVF is a mosquito-borne zoonotic disease endemic to the African continent. RVF is characterized by high rate of abortions in ruminants and hemorrhagic fever, encephalitis or blindness in humans. RVF is caused by the Rift Valley fever virus (RVFV: genus Phlebovirus, family Bunyaviridae. Vaccination is the only known effective strategy to prevent the disease, but there are no licensed RVF vaccines available for humans. A live-attenuated vaccine candidate derived from the wild-type pathogenic Egyptian ZH548 strain, MP-12, has been conditionally licensed for veterinary use in the United States. MP-12 displays a temperature-sensitive (ts phenotype and does not replicate at 41oC. The ts mutation limits viral replication at a specific body temperature and may lead to an attenuation of the virus. Here we will review well-characterized ts mutations for RNA viruses, and further discuss the potential in designing novel live-attenuated vaccines for RVF.

The AFHSC-Division of GEIS Operations Predictive Surveillance Program: a multidisciplinary approach for the early detection and response to disease outbreaks.

Science.gov (United States)

Witt, Clara J; Richards, Allen L; Masuoka, Penny M; Foley, Desmond H; Buczak, Anna L; Musila, Lillian A; Richardson, Jason H; Colacicco-Mayhugh, Michelle G; Rueda, Leopoldo M; Klein, Terry A; Anyamba, Assaf; Small, Jennifer; Pavlin, Julie A; Fukuda, Mark M; Gaydos, Joel; Russell, Kevin L; Wilkerson, Richard C; Gibbons, Robert V; Jarman, Richard G; Myint, Khin S; Pendergast, Brian; Lewis, Sheri; Pinzon, Jorge E; Collins, Kathrine; Smith, Matthew; Pak, Edwin; Tucker, Compton; Linthicum, Kenneth; Myers, Todd; Mansour, Moustafa; Earhart, Ken; Kim, Heung Chul; Jiang, Ju; Schnabel, Dave; Clark, Jeffrey W; Sang, Rosemary C; Kioko, Elizabeth; Abuom, David C; Grieco, John P; Richards, Erin E; Tobias, Steven; Kasper, Matthew R; Montgomery, Joel M; Florin, Dave; Chretien, Jean-Paul; Philip, Trudy L

2011-03-04

The Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System Operations (AFHSC-GEIS) initiated a coordinated, multidisciplinary program to link data sets and information derived from eco-climatic remote sensing activities, ecologic niche modeling, arthropod vector, animal disease-host/reservoir, and human disease surveillance for febrile illnesses, into a predictive surveillance program that generates advisories and alerts on emerging infectious disease outbreaks. The program's ultimate goal is pro-active public health practice through pre-event preparedness, prevention and control, and response decision-making and prioritization. This multidisciplinary program is rooted in over 10 years experience in predictive surveillance for Rift Valley fever outbreaks in Eastern Africa. The AFHSC-GEIS Rift Valley fever project is based on the identification and use of disease-emergence critical detection points as reliable signals for increased outbreak risk. The AFHSC-GEIS predictive surveillance program has formalized the Rift Valley fever project into a structured template for extending predictive surveillance capability to other Department of Defense (DoD)-priority vector- and water-borne, and zoonotic diseases and geographic areas. These include leishmaniasis, malaria, and Crimea-Congo and other viral hemorrhagic fevers in Central Asia and Africa, dengue fever in Asia and the Americas, Japanese encephalitis (JE) and chikungunya fever in Asia, and rickettsial and other tick-borne infections in the U.S., Africa and Asia.

The AFHSC-Division of GEIS Operations Predictive Surveillance Program: a multidisciplinary approach for the early detection and response to disease outbreaks

Science.gov (United States)

2011-01-01

The Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System Operations (AFHSC-GEIS) initiated a coordinated, multidisciplinary program to link data sets and information derived from eco-climatic remote sensing activities, ecologic niche modeling, arthropod vector, animal disease-host/reservoir, and human disease surveillance for febrile illnesses, into a predictive surveillance program that generates advisories and alerts on emerging infectious disease outbreaks. The program’s ultimate goal is pro-active public health practice through pre-event preparedness, prevention and control, and response decision-making and prioritization. This multidisciplinary program is rooted in over 10 years experience in predictive surveillance for Rift Valley fever outbreaks in Eastern Africa. The AFHSC-GEIS Rift Valley fever project is based on the identification and use of disease-emergence critical detection points as reliable signals for increased outbreak risk. The AFHSC-GEIS predictive surveillance program has formalized the Rift Valley fever project into a structured template for extending predictive surveillance capability to other Department of Defense (DoD)-priority vector- and water-borne, and zoonotic diseases and geographic areas. These include leishmaniasis, malaria, and Crimea-Congo and other viral hemorrhagic fevers in Central Asia and Africa, dengue fever in Asia and the Americas, Japanese encephalitis (JE) and chikungunya fever in Asia, and rickettsial and other tick-borne infections in the U.S., Africa and Asia. PMID:21388561

Splinter hemorrhages

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Fingernail hemorrhage ... Splinter hemorrhages look like thin, red to reddish-brown lines of blood under the nails. They run in the direction of nail growth. They are named splinter hemorrhages because they look like a splinter under the ...

Decolorisation of Congo Red by Aeromonas hydrophila Under Microaerophilic Conditions

International Nuclear Information System (INIS)

El Gizawy, S.; Refae, R.A.; Abd El Kareem, H.; Gomaa, O.M.; Hamed, H.

2009-01-01

Among 22 local bacterial isolates, Aeromonas hydrophila isolated from Bolti fish showed a remarkable ability to decolorize congo red under microaerophilic conditions (98.8% in 48 hrs) without prior adaptation. The bacterium had the ability to grow and decolorized high concentrations of congo red which varied from 50 to 1000 mg/l , the decolorisation was irrelevant to bacterial growth. The strain was capable of decolorizing congo red under a wide range of temperatures (20-40 degree C), ph (3-8), NaCl (0-200 mg/l) and also had the ability to decolorized mono, di and poly azo dyes. This bacterium is notable in its ability to decolorized the diazo congo red under extreme conditions of temperature, ph, salinity and high dye concentrations which makes it suitable for decolorisation under extreme industrial conditions

Clinical Outcome Prediction in Aneurysmal Subarachnoid Hemorrhage Using Bayesian Neural Networks with Fuzzy Logic Inferences

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Benjamin W. Y. Lo

2013-01-01

Full Text Available Objective. The novel clinical prediction approach of Bayesian neural networks with fuzzy logic inferences is created and applied to derive prognostic decision rules in cerebral aneurysmal subarachnoid hemorrhage (aSAH. Methods. The approach of Bayesian neural networks with fuzzy logic inferences was applied to data from five trials of Tirilazad for aneurysmal subarachnoid hemorrhage (3551 patients. Results. Bayesian meta-analyses of observational studies on aSAH prognostic factors gave generalizable posterior distributions of population mean log odd ratios (ORs. Similar trends were noted in Bayesian and linear regression ORs. Significant outcome predictors include normal motor response, cerebral infarction, history of myocardial infarction, cerebral edema, history of diabetes mellitus, fever on day 8, prior subarachnoid hemorrhage, admission angiographic vasospasm, neurological grade, intraventricular hemorrhage, ruptured aneurysm size, history of hypertension, vasospasm day, age and mean arterial pressure. Heteroscedasticity was present in the nontransformed dataset. Artificial neural networks found nonlinear relationships with 11 hidden variables in 1 layer, using the multilayer perceptron model. Fuzzy logic decision rules (centroid defuzzification technique denoted cut-off points for poor prognosis at greater than 2.5 clusters. Discussion. This aSAH prognostic system makes use of existing knowledge, recognizes unknown areas, incorporates one's clinical reasoning, and compensates for uncertainty in prognostication.

Internet Backbone in the Democratic Republic of Congo : Feasibility ...

International Development Research Centre (IDRC) Digital Library (Canada)

Internet Backbone in the Democratic Republic of Congo : Feasibility Study and Advocacy. During 7-10 February 2005, representatives of five francophone African countries (Cameroon, Morocco, Niger, Sénégal, and the Democratic Republic of Congo - DRC) met to consider ways and means of galvanizing the appropriation ...

Time-Specific Ecologic Niche Models Forecast the Risk of Hemorrhagic Fever with Renal Syndrome in Dongting Lake District, China, 2005–2010

Science.gov (United States)

Lin, Xiao-Ling; Li, Xiu-Jun; Ma, Gui-Hua; Huang, Ru; Yang, Hui-Suo; Tian, Huaiyu; Xiao, Hong

2014-01-01

Background Hemorrhagic fever with renal syndrome (HFRS), a rodent-borne infectious disease, is one of the most serious public health threats in China. Increasing our understanding of the spatial and temporal patterns of HFRS infections could guide local prevention and control strategies. Methodology/Principal Findings We employed statistical models to analyze HFRS case data together with environmental data from the Dongting Lake district during 2005–2010. Specifically, time-specific ecologic niche models (ENMs) were used to quantify and identify risk factors associated with HFRS transmission as well as forecast seasonal variation in risk across geographic areas. Results showed that the Maximum Entropy model provided the best predictive ability (AUC = 0.755). Time-specific Maximum Entropy models showed that the potential risk areas of HFRS significantly varied across seasons. High-risk areas were mainly found in the southeastern and southwestern areas of the Dongting Lake district. Our findings based on models focused on the spring and winter seasons showed particularly good performance. The potential risk areas were smaller in March, May and August compared with those identified for June, July and October to December. Both normalized difference vegetation index (NDVI) and land use types were found to be the dominant risk factors. Conclusions/Significance Our findings indicate that time-specific ENMs provide a useful tool to forecast the spatial and temporal risk of HFRS. PMID:25184252

Identification of Dobrava, Hantaan, Seoul, and Puumala viruses by one-step real-time RT-PCR.

Science.gov (United States)

Aitichou, Mohamed; Saleh, Sharron S; McElroy, Anita K; Schmaljohn, C; Ibrahim, M Sofi

2005-03-01

We developed four assays for specifically identifying Dobrava (DOB), Hantaan (HTN), Puumala (PUU), and Seoul (SEO) viruses. The assays are based on the real-time one-step reverse transcriptase polymerase chain reaction (RT-PCR) with the small segment used as the target sequence. The detection limits of DOB, HTN, PUU, and SEO assays were 25, 25, 25, and 12.5 plaque-forming units, respectively. The assays were evaluated in blinded experiments, each with 100 samples that contained Andes, Black Creek Canal, Crimean-Congo hemorrhagic fever, Rift Valley fever and Sin Nombre viruses in addition to DOB, HTN, PUU and SEO viruses. The sensitivity levels of the DOB, HTN, PUU, and SEO assays were 98%, 96%, 92% and 94%, respectively. The specificity of DOB, HTN and SEO assays was 100% and the specificity of the PUU assay was 98%. Because of the high levels of sensitivity, specificity, and reproducibility, we believe that these assays can be useful for diagnosing and differentiating these four Old-World hantaviruses.

The spatial analysis on hemorrhagic fever with renal syndrome in Jiangsu province, China based on geographic information system.

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Changjun Bao

Full Text Available Hemorrhagic fever with renal syndrome (HFRS is endemic in mainland China, accounting for 90% of total reported cases worldwide, and Jiangsu is one of the most severely affected provinces. In this study, the authors conducted GIS-based spatial analyses in order to determine the spatial distribution of the HFRS cases, identify key areas and explore risk factors for public health planning and resource allocation.Interpolation maps by inverse distance weighting were produced to detect the spatial distribution of HFRS cases in Jiangsu from 2001 to 2011. Spatio-temporal clustering was applied to identify clusters at the county level. Spatial correlation analysis was conducted to detect influencing factors of HFRS in Jiangsu.HFRS cases in Jiangsu from 2001 to 2011 were mapped and the results suggested that cases in Jiangsu were not distributed randomly. Cases were mainly distributed in northeastern and southwestern Jiangsu, especially in Dafeng and Sihong counties. It was notable that prior to this study, Sihong county had rarely been reported as a high-risk area of HFRS. With the maximum spatial size of 50% of the total population and the maximum temporal size of 50% of the total population, spatio-temporal clustering showed that there was one most likely cluster (LLR = 624.52, P<0.0001, RR = 8.19 and one second-most likely cluster (LLR = 553.97, P<0.0001, RR = 8.25, and both of these clusters appeared from 2001 to 2004. Spatial correlation analysis showed that the incidence of HFRS in Jiangsu was influenced by distances to highways, railways, rivers and lakes.The application of GIS together with spatial interpolation, spatio-temporal clustering and spatial correlation analysis can effectively identify high-risk areas and factors influencing HFRS incidence to lay a foundation for researching its pathogenesis.

An inactivated cell-culture vaccine against yellow fever.

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Monath, Thomas P; Fowler, Elizabeth; Johnson, Casey T; Balser, John; Morin, Merribeth J; Sisti, Maggie; Trent, Dennis W

2011-04-07

Yellow fever is a lethal viral hemorrhagic fever occurring in Africa and South America. A highly effective live vaccine (17D) is widely used for travelers to and residents of areas in which yellow fever is endemic, but the vaccine can cause serious adverse events, including viscerotropic disease, which is associated with a high rate of death. A safer, nonreplicating vaccine is needed. In a double-blind, placebo-controlled, dose-escalation, phase 1 study of 60 healthy subjects between 18 and 49 years of age, we investigated the safety and immunogenicity of XRX-001 purified whole-virus, β-propiolactone-inactivated yellow fever vaccine produced in Vero cell cultures and adsorbed to aluminum hydroxide (alum) adjuvant. On two visits 21 days apart, subjects received intramuscular injections of vaccine that contained 0.48 μg or 4.8 μg of antigen. Levels of neutralizing antibodies were measured at baseline and on days 21, 31, and 42. The vaccine induced the development of neutralizing antibodies in 100% of subjects receiving 4.8 μg of antigen in each injection and in 88% of subjects receiving 0.48 μg of antigen in each injection. Antibody levels increased by day 10 after the second injection, at which time levels were significantly higher with the 4.8-μg formulation than with the 0.48-μg formulation (geometric mean titer, 146 vs. 39; Pvaccine groups than in the placebo group: mild pain, tenderness, and (much less frequently) itching at the injection site. One case of urticaria was observed on day 3 after the second dose of 4.8 μg of vaccine. A two-dose regimen of the XRX-001 vaccine, containing inactivated yellow fever antigen with an alum adjuvant, induced neutralizing antibodies in a high percentage of subjects. XRX-001 has the potential to be a safer alternative to live attenuated 17D vaccine. (Funded by Xcellerex; ClinicalTrials.gov number, NCT00995865.).

Differences in Mortality and Clinical Manifestations of Dengue Hemorrhagic Fever in Taiwan in Different Years: A Comparison for Cases in 2014 and 2015 Epidemics.

Science.gov (United States)

Chang, Ko; Huang, Chung-Hao; Lee, Ing-Kit; Lu, Po-Liang; Lin, Chun-Yu; Chen, Tun-Chieh; Lai, Ping-Chang; Hsieh, Hsiao-Cheng; Yu, Hsin-Liang; Hung, Chih-Hsing; Wu, Meng-Chieh; Chin, Yi-Ying; Huang, Chun-Chi; Wu, Deng-Chyang; Chen, Yen-Hsu

2017-08-01

People in southern Taiwan experienced two major dengue outbreaks in 2014 and 2015. The mortality and clinical features were very different between these 2 years. Dengue virus serotype 1 (DENV-1) caused epidemic outbreak in 2014 and DENV-2 was predominant in 2015. The characteristics of dengue hemorrhagic fever (DHF) cases in the 2 years was analyzed. We conducted a retrospective chart review to analyze the clinical and laboratory features of 206 adult patients with DHF in southern Taiwan in 2014 and 2015. The mortality rate of DHF cases in 2015 was higher than that of cases in 2014 (38.7% versus 12.4%, P mortality cases, diabetes, chronic renal failure, proton-pump inhibitors using, platelet transfusion, and Charlson comorbidity index score (Charlson score) were also higher in 2015. Multivariate analysis for the mortality cases revealed that the risk factors were Charlson score ≥ 5 ( P = 0.02, odds ratio [OR] = 4.07, 95% confidence interval [CI] = 1.244-13.307), severe hepatitis ( P mortality and more complications, such as gastrointestinal bleeding, severe hepatitis, and myocarditis, than in 2014 in southern Taiwan. In the 2-year DHF case series, Charlson score ≥ 5, severe hepatitis, and acute renal failure were independent significant variables for mortality.

Trends of major disease outbreaks in the African region, 2003–2007 ...

African Journals Online (AJOL)

... the Integrated Disease Surveillance and Response (IDSR) strategy aimed at ... fevers (e.g. Ebola, Rift Valley fever, Crimean-Congo fever and yellow fever). ... Conclusions: To successfully reduce the levels of morbidity and mortality resulting ...

Diabetes with hypertension as risk factors for adult dengue hemorrhagic fever in a predominantly dengue serotype 2 epidemic: a case control study.

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Junxiong Pang

Full Text Available BACKGROUND: Dengue hemorrhagic fever (DHF is a severe form of dengue, characterized by bleeding and plasma leakage. A number of DHF risk factors had been suggested. However, these risk factors may not be generalized to all populations and epidemics for screening and clinical management of patients at risk of developing DHF. This study explored demographic and comorbidity risk factors for DHF in adult dengue epidemics in Singapore in year 2006 (predominantly serotype 1 and in year 2007-2008 (predominantly serotype 2. METHODS: A retrospective case-control study was conducted with 149 DHF and 326 dengue fever (DF patients from year 2006, and 669 DHF and 1,141 DF patients from year 2007-2008. Demographic and reported comorbidity data were collected from patients previously. We performed multivariate logistic regression to assess the association between DHF and demographic and co-morbidities for year 2006 and year 2007-2008, respectively. RESULTS: Only Chinese (adjusted odds ratio [AOR] = 1.90; 95% confidence interval [CI]: 1.01-3.56 was independently associated with DHF in year 2006. In contrast, age groups of 30-39 years (AOR = 1.41; 95% CI:1.09-1.81, 40-49 years (AOR = 1.34; 95% CI:1.09-1.81, female (AOR = 1.57; 95% CI:1.28-1.94, Chinese (AOR = 1.67; 95% CI:1.24-2.24, diabetes (AOR = 1.78; 95% CI:1.06-2.97, and diabetes with hypertension (AOR = 2.16; 95%CI:1.18-3.96 were independently associated with DHF in year 2007-2008. Hypertension was proposed to have effect modification on the risk of DHF outcome in dengue patients with diabetes. Chinese who had diabetes with hypertension had 2.1 (95% CI:1.07-4.12 times higher risk of DHF compared with Chinese who had no diabetes and no hypertension. CONCLUSIONS: Adult dengue patients in Singapore who were 30-49 years, Chinese, female, had diabetes or diabetes with hypertension were at greater risk of developing DHF during epidemic of predominantly serotype 2. These risk factors

Shared IgG Infection Signatures vs. Hemorrhage-Restricted IgA Clusters in Human Dengue: A Phenotype of Differential Class-Switch via TGFβ1

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Chung-Hao Huang

2017-12-01

Full Text Available Phenotypic manifestations of infectious diseases are closely related to individual immune responses. Methods to extract information from patients’ own immune reactions would be of great use for both diagnosis and treatment. Dengue fever is one of the diseases that clinical aggravations could occur paradoxically after humoral immunity appears. This property makes dengue fever an excellent disease model to explore. A principal component analyses (PCAs-based framework derived from a prior vaccination study was developed. The framework was verified by successful demonstrations of known IgG signatures from a Mexico Dengue data set. Afterward the pipeline was tested upon de novo IgG and IgA libraries of Dengue patients from southern Taiwan. We discovered four infection signatures within IgG repertoires, two of which were identical to previous reports. However, it was IgA but not IgG that could differentiate hemorrhagic from non-hemorrhagic patients. IgA repertoires were found more diversified among bleeders, from whom seven signature clusters were characterized. The expressions of transforming growth factor beta 1 (TGFβ1 and accordingly mediated class-switch activity of IgA were distinct only among the PCA-segregated bleeding group. In sum, intercontinental sharing of IgG signatures in dengue fever was demonstrated via a unified working flow. Differential regulation of IgA class-switch with associated diversity expansion plus existences of hemorrhage-restricted clusters were shown. The ability of the framework to find common IgG signatures would implicate applications to infections even from unknown pathogens. The clusters within IgA repertoires could offer perspectives to other IgA-related bleeding disorders such as Henoch-Schönlein purpura or IgA nephropathy. Substantiated grounds for IgA-specific effector function via TGFβ1-mediated class-switch would be a new factor to consider for infectious diseases.

Opportunities for Hydrologic Research in the Congo Basin

Science.gov (United States)

Alsdorf, D. E.; Beighley, E., II; Lee, H.; Tshimanga, R.; Spencer, R. G.; O'Loughlin, F.

2014-12-01

We review the published results on the Congo Basin hydrology and find that there are historic data, ongoing measurement recording efforts, and important model results. Annual rainfall is ~2000 mm/yr along an east-west trend, decreasing northward and southward to ~1100 mm/yr. While some studies show rain gauges at specific locations with declines in P greater than 10% from 1960 to 1990, other studies suggest that basin wide decreases from 1951 to 1993 are modest at 4.5% or that the trend is minimal. Studies during the 1950s using lysimeters, pans, and models suggest that the annual potential ET varies little across the basin at a 1100 mm/yr to 1200 mm/yr. Over the past century, river discharge data has been collected at 100s of stream gauges with historic and recent data at 96 locations now publicly available. Discharge of the Congo River at Kinshasa-Brazzaville experienced an increase of 21% during 1960-1970 in comparison to background values of the previous decades and of today. There does not appear to be a long-term discharge trend over the century of record. Satellite altimetry measurements collected during high and low flows show that the Cuvette Centrale wetland water levels are consistently 0.5m to 3m higher in elevation than the immediately adjacent Congo River levels. Wetland water depths are shallow at about 1m whereas the Congo is typically less than 15m deep everywhere upstream of Kinshasa. The wetlands do not appear to be marked by sizable channels such that the flows are diffusive. CO2 and CH4 evasion from the Congo waters directly to the atmosphere are estimated at 1.6 to 3.2 Tg/yr for CH4 from the Cuvette wetland waters and 105 to 204 g C/m2/yr for CO2 from waters of the Oubangui River. Using these published results, we suggest seven hypotheses that may lead to important water and carbon cycle discoveries. These hypotheses focus on the source of the Cuvette waters and how those waters leave the wetland; on river discharge generated by historic

Yellow Fever

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... Testing Vaccine Information Testing for Vaccine Adverse Events Yellow fever Vaccine Continuing Education Course Yellow Fever Home Prevention Vaccine Vaccine Recommendations Reactions to Yellow Fever Vacine Yellow Fever Vaccine, Pregnancy, & ... Transmission Symptoms, Diagnosis, & Treatment Maps Africa ...

Case definition for Ebola and Marburg haemorrhagic fevers: a complex challenge for epidemiologists and clinicians.

Science.gov (United States)

Pittalis, Silvia; Fusco, Francesco Maria; Lanini, Simone; Nisii, Carla; Puro, Vincenzo; Lauria, Francesco Nicola; Ippolito, Giuseppe

2009-10-01

Viral haemorrhagic fevers (VHFs) represent a challenge for public health because of their epidemic potential, and their possible use as bioterrorism agents poses particular concern. In 1999 the World Health Organization (WHO) proposed a case definition for VHFs, subsequently adopted by other international institutions with the aim of early detection of initial cases/outbreaks in western countries. We applied this case definition to reports of Ebola and Marburg virus infections to estimate its sensitivity to detect cases of the disease. We analyzed clinical descriptions of 795 reported cases of Ebola haemorrhagic fever: only 58.5% of patients met the proposed case definition. A similar figure was obtained reviewing 169 cases of Marburg diseases, of which only 64.5% were in accordance with the case definition. In conclusion, the WHO case definition for hemorrhagic fevers is too specific and has poor sensitivity both for case finding during Ebola or Marburg outbreaks, and for early detection of suspected cases in western countries. It can lead to a hazardous number of false negatives and its use should be discouraged for early detection of cases.

Cerebral vasculitis and lateral rectus palsy - two rare central nervous system complications of dengue fever: two case reports and review of the literature.

Science.gov (United States)

Herath, H M M; Hewavithana, J S; De Silva, C M; Kularathna, O A R; Weerasinghe, N P

2018-04-19

Dengue fever is a common mosquito-borne viral illness with a clinical spectrum ranging from a simple febrile illness to potentially life-threatening complications such as dengue hemorrhagic fever and dengue shock syndrome. Dengue infection can affect many organs, including the central nervous system. The neurological manifestations reported in dengue infections are meningitis, encephalitis, stroke, acute disseminated encephalomyelitis, and Guillain-Barré syndrome. We report the cases of two interesting patients with confirmed dengue infection who presented with complications of possible central nervous system vasculitis and cranial nerve palsy. The first patient was a 53-year-old previously healthy Singhalese woman who developed acute-onset slurring of speech and ataxia with altered sensorium 1 day after recovery from a critical period of dengue hemorrhagic fever. Subsequent investigations revealed evidence of encephalopathy with brainstem ischemic infarctions. Her clinical picture was compatible with central nervous system vasculitis. She was treated successfully with intravenous steroids and had a full functional recovery. The second patient was a middle-aged Singhalese woman who had otherwise uncomplicated dengue infection. She developed binocular diplopia on day 4 of fever. An ocular examination revealed a convergent squint in the left eye with lateral rectus palsy but no other neurological manifestation. Central nervous system vasculitis due to dengue infection is a very rare phenomenon, and to the best of our knowledge, only one case of central nervous system vasculitis has been reported to date, in a patient of pediatric age. Cranial nerve palsy related to dengue infection is also rare, and only a few cases of isolated abducens nerve palsy have been reported to date. The two cases described in this report illustrate the rare but important central nervous system manifestations of dengue fever and support the fact that the central nervous system is one of the

Acute Hemorrhagic Leukoencephalitis in Children: A Case Report

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Gholam Reza Khademi

2016-05-01

Full Text Available Acute hemorrhagic leukoencephalitis (AHLE is a rare demyelinating disease characterized by an acute rapidly progressive fulminant inflammation of the white matter. In this case report, we introduce a case of AHLE in children with an interesting and lengthy process and successful treatment. A previously healthy 13-year-old girl was admitted to the hospital because of fever and loss of consciousness. After 4 days, she was referred to our pediatric intensive care unit in Mashhad, Iran. On admission, she had right-sided parotiditis. With a diagnosis of AHLE, our patient was treated with methylprednisolone, intravenous immunoglobulin, acyclovir, and plasmapheresis. AHLE is a rare and severe demyelinating disease, the mortality and morbidity of which can be decreased by early detection and treatment with steroid therapy, intravenous immunoglobulin, acyclovir, and plasmapheresis.

Preretinal hemorrhage

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Eduardo Felippe

2004-12-01

Full Text Available A case of Valsalva hemorrhagic retinopathy treated with Nd:YAGlaser indescribed. The patient presented decreased visual acuityafter coughing, and a preretinal hemorrhage was diagnosed in theposterior pole; puncturing the posterior hyaloid face was performedwith Nd:Yag laser. Rapid hemorrhage absorption was observedafter the therapy proposed and visual acuity was recovered. Nd:Yaglaser proved to be safe and efficient in the management of preretinalhemorrhage.

Water level fluctuations in the Congo basin derived from ENVISAT satellite altimetry

OpenAIRE

Becker, M.; da Silva, J. S.; Calmant, Stéphane; Robinet, V.; Linguet, L.; Seyler, Frédérique

2014-01-01

In the Congo Basin, the elevated vulnerability of food security and the water supply implies that sustainable development strategies must incorporate the effects of climate change on hydrological regimes. However, the lack of observational hydro-climatic data over the past decades strongly limits the number of studies investigating the effects of climate change in the Congo Basin. We present the largest altimetry-based dataset of water levels ever constituted over the entire Congo Basin. This...

Knowledge, attitude and practice of healthcare workers concerning Crimean-Congo hemorrhagic fever in Western Iran

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Mojtaba Salimi

2016-06-01

Conclusions: Knowledge of Kermanshah healthcare staff about CCHF was poor, especially nurses in a high risk job category. Therefore, it is necessary to conduct specific training programs for the disease identification, transmission, prevention, and treatment as well as the use of personal protection and safety devices.

Sequence Optimized Real-Time RT-PCR Assay for Detection of Crimean-Congo Hemorrhagic Fever Virus

Science.gov (United States)

2017-03-21

on the linear range of the curve 129 using a nonlinear regression analysis. A two-way ANOVA with Sidak’s multiple comparisons test was 130 done to...currently fielded CCHFV assay. 31 TR-17-094 DISTRIBUTION STATEMENT A: Approved for public release; distribution is unlimited. 2 Introduction 32...analyses were performed using GraphPrism 6 (GraphPad Software, San Diego, CA). 128 Assay linearity based on the preliminary LOD was determined based

Fever

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Tamas Bartfai

2010-01-01

Full Text Available Measurement of body temperature remains one of the most common ways to assess health. An increase in temperature above what is considered to be a normal value is inevitably regarded as a sure sign of disease and referred to with one simple word: fever. In this review, we summarize how research on fever allowed the identification of the exogenous and endogenous molecules and pathways mediating the fever response. We also show how temperature elevation is common to different pathologies and how the molecular components of the fever-generation pathway represent drug targets for antipyretics, such as acetylsalicylic acid, the first “blockbuster drug”. We also show how fever research provided new insights into temperature and energy homeostasis, and into treatment of infection and inflammation.

Lesula: a new species of Cercopithecus monkey endemic to the Democratic Republic of Congo and implications for conservation of Congo's central basin.

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John A Hart

Full Text Available In June 2007, a previously undescribed monkey known locally as "lesula" was found in the forests of the middle Lomami Basin in central Democratic Republic of Congo (DRC. We describe this new species as Cercopithecus lomamiensis sp. nov., and provide data on its distribution, morphology, genetics, ecology and behavior. C. lomamiensis is restricted to the lowland rain forests of central DRC between the middle Lomami and the upper Tshuapa Rivers. Morphological and molecular data confirm that C. lomamiensis is distinct from its nearest congener, C. hamlyni, from which it is separated geographically by both the Congo (Lualaba and the Lomami Rivers. C. lomamiensis, like C. hamlyni, is semi-terrestrial with a diet containing terrestrial herbaceous vegetation. The discovery of C. lomamiensis highlights the biogeographic significance and importance for conservation of central Congo's interfluvial TL2 region, defined from the upper Tshuapa River through the Lomami Basin to the Congo (Lualaba River. The TL2 region has been found to contain a high diversity of anthropoid primates including three forms, in addition to C. lomamiensis, that are endemic to the area. We recommend the common name, lesula, for this new species, as it is the vernacular name used over most of its known range.

Ongoing spillover of Hantaan and Gou hantaviruses from rodents is associated with hemorrhagic fever with renal syndrome (HFRS in China.

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Wen Wang

Full Text Available BACKGROUND: Longquan City, Zhejiang province, China, has been seriously affected by hemorrhagic fever with renal syndrome (HFRS since the first cases were registered in 1974. To understand the epidemiology and emergence of HFRS in Longquan, which may be indicative of large parts of rural China, we studied long-term incidence patterns and performed a molecular epidemiological investigation of the causative hantaviruses in human and rodent populations. METHOD/PRINCIPAL FINDINGS: During 1974-2011, 1866 cases of HFRS were recorded in Longquan, including 20 deaths. In 2011, the incidence of HFRS remained high, with 19.61 cases/100,000 population, despite the onset of vaccination in 1997. During 1974-1998, HFRS cases in Longquan occurred mainly in winter, while in the past decade the peak of HFRS has shifted to the spring. Notably, the concurrent prevalence of rodent-borne hantaviruses in the region was also high. Phylogenetic analyses of viral sequences recovered from rodents in Longquan revealed the presence of novel genetic variants of Gou virus (GOUV in Rattus sp. rats and Hantaan virus (HTNV in the stripe field mice, respectively. Strikingly, viral sequences sampled from infected humans were very closely related to those from rodents. CONCLUSIONS/SIGNIFICANCE: HFRS represents an important public health problem in Longquan even after years of preventive measures. Our data suggest that continual spillover of the novel genetic variant of GOUV and the new genetic lineage of HTNV are responsible for the high prevalence of HFRS in humans. In addition, this is the first report of GOUV associated with human HFRS cases, and our data suggest that GOUV is now the major cause of HFRS in this region.

Acute hemorrhagic edema of infancy: a troubling cutaneous presentation with a self-limiting course.

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Savino, Francesco; Lupica, Maria M; Tarasco, Valentina; Locatelli, Emanuela; Viola, Serena; di Montezemolo, Luca C; Coppo, Paola

2013-01-01

Acute hemorrhagic edema of infancy (AHEI) is an unusual form of leukocytoclastic vasculitis with dramatic distinguishing skin lesions that occurs in infants ages 4 to 24 months old. The disease presents with skin eruptions that usually start with large (1-5 cm), symmetrically distributed, hemorrhagic lesions in a characteristic cockade pattern. The lesions are typically located on the lower extremities, face (in particular the ears, cheeks, and eyelids), and gluteal area. Fever may accompany skin eruptions. Clinical presentation at onset requires clinical and laboratory examination to distinguish it from more serious diseases and other vasculitis. The main differential diagnosis of AHEI is Henoch-Schönlein purpura. AHEI is generally a self-limiting disease, so a conservative approach should be considered. Topical or systemic corticosteroid therapy has been reported to be beneficial, as well as antihistamines and dapsone, although AHEI usually resolves completely with or without treatment. We report two cases of AHEI and an update of the literature. © 2012 Wiley Periodicals, Inc.

Physiological and biochemical responses of Chlorella vulgaris to Congo red.

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Hernández-Zamora, Miriam; Perales-Vela, Hugo Virgilio; Flores-Ortíz, César Mateo; Cañizares-Villanueva, Rosa Olivia

2014-10-01

Extensive use of synthetic dyes in many industrial applications releases large volumes of wastewater. Wastewaters from dying industries are considered hazardous and require careful treatment prior to discharge into receiving water bodies. Dyes can affect photosynthetic activities of aquatic flora and decrease dissolved oxygen in water. The aim of this study was to evaluate the effect of Congo red on growth and metabolic activity of Chlorella vulgaris after 96h exposure. Exposure of the microalga to Congo red reduced growth rate, photosynthesis and respiration. Analysis of chlorophyll a fluorescence emission showed that the donor side of photosystem II was affected at high concentrations of Congo red. The quantum yield for electron transport (φEo), the electron transport rate (ETR) and the performance index (PI) also decreased. The reduction in the ability to absorb and use the quantum energy increased non-photochemical (NPQ) mechanisms for thermal dissipation. Overall, Congo red affects growth and metabolic activity in photosynthetic organisms in aquatic environments. Copyright © 2014 Elsevier Inc. All rights reserved.

Chemical composition of the mineral waters of the Congo River

International Nuclear Information System (INIS)

Tshiashala, M.D.; Lumu, B.M.; Lobo, K.K.; Tshisumpa, M.; Wembo, L.S.

2003-01-01

Atomic absorption spectrophotometry has been applied to river Congo waters for a global monitoring of trace element contents. 15 elements Ag, Au, Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, Na, Ni, Pb and Zn have been determined in samples collected at 2 sites along the river Congo. Results are compared with those observed in other river waters collected in Kinshasa and elsewhere and for compliance with the international quality standards elaborated by the Who, USA and SSRU. The waters of river Congo have been found less mineralized than those of river Niger. They are of the same order of magnitude than those observed in some local rivers such as Ndjili, Lubudi, Funa, Tshangu and Tshenke.

Incidence of Intraventricular Hemorrhage and Post Hemorrhagic Hydrocephalus in Preterm Infants

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Negar Sajjadian

2010-07-01

Full Text Available "nGerminal matrix-intraventricular hemorrhage (IVH is the most common variety of neonatal intracranial hemorrhage and is characteristics of the premature infant. The importance of the lesion relates not only to its high incidence but to their attendant complications (IC: hydrocephalus. Brain sonography is the procedure of choice in diagnosis of germinal matrix- intraventricular hemorrhage and hydrocephalus. In this study we have used brain sonography for detection of intraventricular hemorrhage and post hemorrhagic hydrocephalus and their incidences. The studied population was consisted of premature neonate (birth weight equal or less than 1500g and gestational age equal or less than 37 weeks who admitted in Mofid Hospital NICU (Tehran, Iran during a one year period. For all neonate (including criteria brain sonography in first week of life was done and in presence of IVH, serial Brain sonography was done weekly for detection of hydrocephalus. A total of 57 neonate entered the study. Intraventicular-germinal matrix hemorrhage was seen in 64.4% (35 patients. Forty percent of patients with intraventricular-germinal matrix hemorrhage had grade I, 11% grade II, 25.7% grade III, 2.8% grade VI. Hydrocephalus was detected in 20 percent of patients who had intraventricular-germinal matrix hemorrhage. That incidence of IVH in our study in comparison with other area and situation is higher. Hydrocephaly had direct relation with severity of IVH. This shows that with control of risk factor of IVH, we can control Post hemorrhagic hydrocephalus.

CT differential diagnosis between hypertensive putaminal hemorrhage and hemorrhagic infarction localized in basal ganglia

International Nuclear Information System (INIS)

Tazawa, Toshiaki; Mizukami, Masahiro; Kawase, Takeshi.

1984-01-01

The symptoms of hypertensive putaminal hemorrhage and of middle cerebral artery occlusion are sometimes similar to each other. Hemorrhage sometimes occurs following cerebral infarction. We experienced 7 patients with hemorrhages localized in the basal ganglia following cerebral infarction. The CT findings of 55 patients with putaminal hemorrhage and 7 patients with hemorrhagic infarction localized at the basal ganglia were investigated retrospectively in order to discuss their characteristics. The high-density area (HD) of a putaminal hemorrhage was homogeneous on a plain CT within a week of the onset. There was a close correlation between the size of the HD and the timing of its disappearance. The HD with a maximum diameter of A cm generally disappeared A weeks after. On the other hand, the HD of a hemorrhagic infarction was lower in density than that of the putaminal hemorrhage. The HD of a hemorrhagic infarction generally disappeared earlier than that of a putaminal hemorrhage. Ring enhancement was visualized on contrast-enhanced CT (CECT) from 2 or 3 weeks after the onset in patients with putaminal hemorrhages except in the case of small hemorrhages (less than 1 cm diameter). Ring enhancement was also visualized in 6 out of 7 patients with hemorrhagic infarction; one of them was recognized within a week of the onset. Contrast enhancement of the cortex in the territory of the middle cerebral artery was visualized in 4 out of 7 patients with hemorrhagic infarction. This finding seems to indicate one characteristic of hemorrhagic infarction. (author)

Attenuation of pathogenic Rift Valley fever virus strain through the chimeric S-segment encoding sandfly fever phlebovirus NSs or a dominant-negative PKR.

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Nishiyama, Shoko; Slack, Olga A L; Lokugamage, Nandadeva; Hill, Terence E; Juelich, Terry L; Zhang, Lihong; Smith, Jennifer K; Perez, David; Gong, Bin; Freiberg, Alexander N; Ikegami, Tetsuro

2016-11-16

Rift Valley fever is a mosquito-borne zoonotic disease affecting ruminants and humans. Rift Valley fever virus (RVFV: family Bunyaviridae, genus Phlebovirus) causes abortions and fetal malformations in ruminants, and hemorrhagic fever, encephalitis, or retinitis in humans. The live-attenuated MP-12 vaccine is conditionally licensed for veterinary use in the US. However, this vaccine lacks a marker for the differentiation of vaccinated from infected animals (DIVA). NSs gene is dispensable for RVFV replication, and thus, rMP-12 strains lacking NSs gene is applicable to monitor vaccinated animals. However, the immunogenicity of MP-12 lacking NSs was not as high as parental MP-12. Thus, chimeric MP-12 strains encoding NSs from either Toscana virus (TOSV), sandfly fever Sicilian virus (SFSV) or Punta Toro virus Adames strain (PTA) were characterized previously. Although chimeric MP-12 strains are highly immunogenic, the attenuation through the S-segment remains unknown. Using pathogenic ZH501 strain, we aimed to demonstrate the attenuation of ZH501 strain through chimeric S-segment encoding either the NSs of TOSV, SFSV, PTA, or Punta Toro virus Balliet strain (PTB). In addition, we characterized rZH501 encoding a human dominant-negative PKR (PKRΔE7), which also enhances the immunogenicity of MP-12. Study done on mice revealed that attenuation of rZH501 occurred through the S-segment encoding either PKRΔE7 or SFSV NSs. However, rZH501 encoding either TOSV, PTA, or PTB NSs in the S-segment uniformly caused lethal encephalitis. Our results indicated that the S-segments encoding PKRΔE7 or SFSV NSs are attenuated and thus applicable toward next generation MP-12 vaccine candidates that encode a DIVA marker.

[Clinical and epidemiologic characteristics of hemorrhagic fever with renal syndrome in patients treated at the Dr. Fran Mihaljević Clinic for Infectious Diseases in Zagreb].

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Puljiz, Ivan; Kuzman, Ilija; Turcinov, Drago; Markotić, Alemka; Celjuska, Elvira

2003-01-01

The aim of the study was to examine and analyze the main epidemiologic and clinical data of 94 patients with hemorrhagic fever with renal syndrome (HFRS) hospitalized at the University Hospital for Infectious Diseases in Zagreb during the HFRS outbreak in Croatia in 2002. A total of 110 patients with clinical diagnosis HFRS were treated at the University Hospital for Infectious Diseases in Zagreb. In 110 of HFRS suspected patients, the clinical diagnosis was verified serologically in 94 patients and they were included in the retrospective study. In 93 patients the diagnosis was confirmed by enzyme-linked immunosorbent assay (ELISA), and in one patient by indirect immunofluorescence assay (IFA). Results were analyzed by the use of descriptive statistics. Puumala (PUU) virus infection was verified in 80 (85.1%), Dobrava (DOB) infection in 8 (8.5%) and cross-reactive antibodies to both PUU and DOB viruses in 5 (5.3%) HFRS patients. In one patient who was confirmed by IFA the hantavirus serotype causing HFRS could not be determined. The localities of the presumed HFRS patient exposure to hantaviruses were mostly in the Zagreb area. Most patients were aged 21-50 (83.0%) and male (76.6%). The majority of HFRS cases occurred between May and August (75.5%). A high proportion of HFRS cases were found in the general population from Zagreb and its surroundings (78.7%). The majority of patients were hospitalized in the febrile stage of the disease (70.2%). The main symptoms were: fever (100%), headache (88.3%) and backache (87.2%). Oliguria was recorded in 56.4% and, anuria in 7.5% of patients, however, only three (3.2%) patients required hemodialysis. Six patients developed hemorrhagic manifestations, especially petechiae on the skin and mucosa. One patient in the convalescent stage had subarachnoidal bleeding. Six patients had pathologic electroencephalogram (EEG) findings and two developed epileptic seizures. Lumbar puncture was performed in 12 patients without inflammatory

Manifestaciones clínicas del dengue hemorrágico en Puerto Rico, 1990-1991 Clinical manifestations of dengue hemorrhagic fever in Puerto Rico, 1990-1991

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José G. Rigau-Pérez

1997-06-01

notificar los casos de DH.The aim of the study reported here was to demonstrate that dengue hemorrhagic fever (DHF occurs in Puerto Rico, that it is underreported, and that this underreporting is due partly to underdiagnosis in hospitals. Surveillance for severe dengue identified 986 hospitalizations for suspected dengue in 1990-1991. At the time, the surveillance system routinely identified 20 DHF cases, including three with dengue shock syndrome (DSS. Our subsequent review of these 986 patients' hospital records identified 102 whose records supported a clinical diagnosis of DHF (88 or DSS (14. Of these 102, 57 had positive virologic or serologic results for dengue and met the World Health Organization criteria for DHF (fever, hemorrhagic manifestations, thrombocytopenia, and excessive capillary permeability. This group of 57 patients had a mean age of 38 years, contained a preponderance of males (34, 59.3%, included eight cases of DSS, and involved two (3.5% fatalities (in females 16 and 55 years old. Hemorrhagic manifestations were mild; hemoconcentration, hypoalbuminemia, and elevated aspartate and alanine aminotransferase levels were frequently encountered. The median duration of hospitalization was five days. The clinical description of these laboratory-positive DHF cases in Puerto Rico is consistent with previous descriptions of DHF in the medical literature; but the patients' age distribution is similar to the pattern typically found in the Americas (where all age groups tend to be affected, as opposed to Southeast Asia (where mostly small children are affected. The number of DHF cases identified by our study was nearly three times that reported through the established surveillance system. Our findings indicate that recognition and reporting of DHF by local clinicians needs to be improved.

CLINICAL AND HEMATOLOGICAL PROFILE OF PATIENTS WITH DENGUE FEVER AT A TERTIARY CARE HOSPITAL – AN OBSERVATIONAL STUDY

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Vishal Vishnu Tewari

2018-03-01

Full Text Available Abstract Background: Dengue is a major health issue with seasonal rise in dengue fever cases imposing an additional burden on hospitals, necessitating bolstering of services in the emergency department, laboratory with creation of additional dengue fever wards. Objectives: To study the clinical and hematological profile of dengue fever cases presenting to a hospital. Methods: Patients with fever and other signs of dengue with either positive NS1 antigen test or IgM or IgG antibody were included. Age, gender, clinical presentation, platelet count and hematocrit were noted and patients classified as dengue fever (DF, dengue hemorrhagic fever (DHF or dengue shock syndrome (DSS. Duration of hospitalization, bleeding manifestations, requirement for platelet component support and mortality were recorded. Results: There were 443 adults and 57 children between 6 months to 77 year age. NS1 was positive in 115 patients (23%. Fever (99.8% and severe bodyache (97.4% were the commonest presentation. DF was seen in 484 (96.8 %, DHF in 10 (2% and DSS in 6 cases (1.2%. OPD treatment was needed in 412 (82% and hospitalization in 88 (18%. Intravenous fluid resuscitation was needed in 16 (3.2% patients. Thrombocytopenia was seen in 335 (67% patients at presentation. Platelet transfusion was needed in 46 (9.2%. PRC transfusion was given in 3 patients with DF and 10 of DHF. Death occurred in 03 DSS and 2 DHF patients. Conclusions: Majority of DF cases can be managed on OPD basis. DHF and DSS carry high mortality. Hospitals can analyze annual data for resource allocation for capacity expansion.

Dengue Fever: Causes, Complications, and Vaccine Strategies

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Niyati Khetarpal

2016-01-01

Full Text Available Dengue is a highly endemic infectious disease of the tropical countries and is rapidly becoming a global burden. It is caused by any of the 4 serotypes of dengue virus and is transmitted within humans through female Aedes mosquitoes. Dengue disease varies from mild fever to severe conditions of dengue hemorrhagic fever and shock syndrome. Globalization, increased air travel, and unplanned urbanization have led to increase in the rate of infection and helped dengue to expand its geographic and demographic distribution. Dengue vaccine development has been a challenging task due to the existence of four antigenically distinct dengue virus serotypes, each capable of eliciting cross-reactive and disease-enhancing antibody response against the remaining three serotypes. Recently, Sanofi Pasteur’s chimeric live-attenuated dengue vaccine candidate has been approved in Mexico, Brazil, and Philippines for usage in adults between 9 and 45 years of age. The impact of its limited application to the public health system needs to be evaluated. Simultaneously, the restricted application of this vaccine candidate warrants continued efforts in developing a dengue vaccine candidate which is additionally efficacious for infants and naïve individuals. In this context, alternative strategies of developing a designed vaccine candidate which does not allow production of enhancing antibodies should be explored, as it may expand the umbrella of efficacy to include infants and naïve individuals.

Adsorption of procion red and congo red dyes using microalgae Spirulina sp

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Risfidian Mohadi

2017-10-01

Full Text Available Adsorption of procion red and congo red dyes using microalgae Spirulina sp was conducted. Spirulina sp was obtained by cultivation and production in laboratory scale. Spirulina sp was used as adsorbent for adsorption of dyes. Adsorption process was studied by kinetic and thermodynamic in order to know the adsorption phenomena. The results showed that kinetically congo red is reactive than procion red on Spirulina sp. On the other hand, thermodynamically procion red was stable than congo red on Spirulina sp which was indicated by adsorption capacity, enthalpy, and entropy.

Sorption behavior of congo red on different plant leaves (abstract)

International Nuclear Information System (INIS)

Khan, M.I.; Mirza, M.L.; Zafar, S.; Khalid, N.

2011-01-01

Batch adsorption studies were carried out to evaluate the potential of different plant leaves (Bougainvillaea Glabra and Citrus Sinensis) for the removal of Congo red dye from aqueous solution by optimizing different parameters such as effect of shaking time, adsorbent dose, initial adsorbate concentration, temperature etc. The experimental data was subjected to different types of isotherm models such as Freundlich, Langmuir and Dubinin-Radushkevich. The maximum adsorption capacity was calculated and was comparable for both the leaves through Freundlich isotherm by using the optimized parameters of weight and time at room temperature. The sorption mean free energy from Dubinin-Radushkevich isotherm was also determined and compared. Pseudo-first and Pseudo-second order kinetics models were tested for the adsorption of Congo red on plant leaves powder. The experimental data fitted well for Pseudo-second order model. The uptake of Congo red was also studied with the variation of temperature. Thermodynamic parameters have been calculated. The results indicate that the plant leaves of Bougainvilia Glabra and Citrus Sinensis are efficient adsorbents for Congo red dye from aqueous solutions and can be used for wastewater management. (author)

Hemorrhagic brain metastases

International Nuclear Information System (INIS)

Takahashi, Motoichiro; Takekawa, S.D.; Suzuki, Kenzo

1986-01-01

Tumor hemorrhage on computed tomography (CT) was found in 14 patients with brain metastases (7 % of two hundred patients with brain metastases), from April 1979 to July 1983. Primary foci of these lesions were the lung (6 patients), breast (2), kidney (2), uterus (2), colon (1) and adrenal gland (1). ''Stroke'' syndrome was the initial presenting symptom in 3 patients; neurological focal sign or symptoms of increased intracranial pressure in the remaining patients. CT demonstrated peritumoral hemorrhage in all patients with solid mass, intratumoral hemorrhage in a few patients and also cerebral or ventricular hemorrhage, which was fatal complication, in 2 patients (colon and breast cancers). A cystic mass with fluid-blood level was noted in a patient with breast cancer. Several predisposing factors including chemotherapy, thrombocytopenia, radiotherapy or combination of these were recognized in 8 patients. Of these, chemotherapy was the most causative factor of tumor hemorrhage. Brain irradiation for hemorrhagic brain metastases was effective for prolongation of mean survival time of these patients as follows; 10 months in irradiated group, whereas 1.5 months in non-irradiated group. (author)

Rat bite fever without fever.

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Stehle, P; Dubuis, O; So, A; Dudler, J

2003-09-01

Rat bite fever is a rarely reported acute febrile bacterial illness caused by Streptobacillus moniliformis or Spirillum minus following a rat bite. It is classically characterised by abrupt onset of fever with rigors, myalgias, headache, and the appearance of a generalised maculopapular petechial skin rash. Polyarthritis complicates the course of the disease in up to 50% of infected patients, and numerous hurdles can make the diagnosis particularly difficult in the absence of fever or rash, as in the present case. A high degree of awareness is necessary to make the correct diagnosis in such cases. Diagnosis has important prognostic implications as the disease is potentially lethal, but easily treatable.

The Rift Valley fever: could re-emerge in Egypt again?

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El-Bahnasawy, Mamdouh; Megahed, Laila Abdel-Mawla; Abdalla Saleh, Hala Ahmed; Morsy, Tosson A

2013-04-01

The Rift Valley fever (RVF) is a neglected, emerging, mosquito-borne disease with severe negative impact on human and animal health and economy. RVF is caused by RVF virus of the family of Bunyaviridae, genus Phlebovirus. RVF is an acute, febrile disease affecting humans and a wide range of animals. The virus is trans-mitted through the bites from mosquitoes and exposure to viremic blood, body fluids, or contact with tissues of infected animals or by inhaling natural virus aerosols, also possibly by consumption of infected unpasteurized milk. The RVF-virus replicate at the site introduction and in local lymphatic followed by viremia and spread to other organs as the liver and central nervous system, causing the hepatic necrosis and eosinophilia cytoplasmic degeneration. The main signs and symptoms are fever, headache, myalgia, arthralgia, photophobia, bradycardia, conjunctivitis and flushing face. Main complications include jaundice, hemorrhagic, meningoencephalitis and retinal lesions. Generally speaking, in the 21st Century, the vector-borne infectious diseases, was accepted as the disaster issues with the considerable significant morbidity and mortality. These facts should be considered by the public health, veterinary and agricultural authorities

[Western area surge for controlling Ebola hemorrhagic fever outbreak in Sierra Leone and evaluation of its effect].

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Chen, Yong; Wu, Dan; Zhang, Wenyi; Chen, Zeliang; Chang, Guohui; Tian, Shuguang; Yang, Ruifu; Liu, Chao

2015-10-01

To investigate the Western Area Surge (WAS) program in the Ebola outbreak of Sierra Leone, and to analyze its implementing effect. The subject of this study was 3,813 laboratory confirmed Ebola hemorrhagic fever (EHF) cases reported in Sierra Leone from November 19, 2014 through January 27, 2015, a period before and after the implementation of the WAS program. To analyze and make conclusions according to the working experience of China Mobile Laboratory Reponses Team in the fight of Ebola outbreak, using WHO published EHF case definition to make diagnosis and compare the number of bed numbers, confirmed EHF cases, samples tested, and positive rates before and after implementation of WAS program. From the implementation of WAS program on 17th December 2014 to half a month later, the total numbers of Ebola holding and treatment centers increased from 640 to 960, six additional laboratories were established. On January, 2015, another two laboratories from America and The Netherlands were established. The numbers of samples tested one month before and after WAS program were 7,891 and 9,783, respectively, with an increase of 24.0 percent, while the positive rate of Ebola virus decreased from 22.2% (1,752/7,891) to 11.0% (1,077/9,783). The positive rate of blood samples decreased from 39.6% (248/626) in the month before WAS program to 27.4% (131/478) (χ2=17.93, P<0.001) in the mother after WAS program, the positive rate of blood samples 22.7% (103/454) to 10% (62/609) (χ2=31.03, P<0.001), accordingly. After 3 weeks of WAS program, in addition to Western Area, another four hotspots in Sierra Leone had also reported a significant decrease of the numbers of confirmed EVD cases. Forty-two days after implementation of WAS program, the daily number of laboratory confirmed EHF cases decreased from 63 to 10. WAS program played a vital role in controlling the EHF outbreak rapidly in Sierra Leone. It could also provide guidance for the control similar large infectious diseases

ADSORPSI CONGO RED PADA HUMIN HASIL ISOLASI DARI TANAH HUTAN DAMAR BATURRADEN PURWOKERTO

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Roy Andreas

2008-05-01

Full Text Available Congo red is one of dyes-stuff in textile industry wastwater. If it is thrown directly without waste management process, the dyes could pollute environtment, especially soil. Humin has OH phenolic and carboxylic functional group which can interacted with congo red. The aim of this study is recognize humin characteristic from the soil of Baturraden resin forest, determine the adsorption capacity and isotherm adsorption pattern of congo red by humin from the soil of Baturraden resin forest. Humin in this study is isolated from the soil of Baturraden resin forest. soil cleared of gravel and dirt, then it extracted by using NaOH of nitrogen atmosphere and purified to applies mixture HCl:HF. Humin that is obtained is used to be interacted with dyes with various contact time, various of pH and concentration of congo red so that the adsorption capacities and isotherm adsorption pattern can be obtained. Result of the study showed that the humin has water content 34.92 %, dust content 8.64 %, total acidity 475 cmol/Kg, carboxylic rate 272.5 cmol/Kg, and OH Phenolic rate 202.5 cmol/Kg. The optimum contact time of congo red adsorption by humin is 40 minutes, with optimum pH is 7, adsorption capacities 57.14 mg/g and isotherm adsorption pattern of congo red by humin is follow the pattern of Langmuir isotherm adsorption.

A fatal case of Brazilian spotted fever in a non-endemic area in Brazil: the importance of having health professionals who understand the disease and its areas of transmission

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