Sample records for scarlet fever

  1. Scarlet fever (United States)

    ... streptococcus . This is the same bacteria that cause strep throat . Causes Scarlet fever was once a very serious ... fever is infection with the bacteria that cause strep throat. An outbreak of strep throat or scarlet fever ...

  2. Scarlet Fever

    Centers for Disease Control (CDC) Podcasts


    Katherine Fleming-Dutra, pediatrician, discusses scarlet fever, its cause, how to treat it, and how to prevent its spread.  Created: 6/9/2011 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 6/9/2011.

  3. Signs of scarlet fever (image) (United States)

    Scarlet fever is a disease caused by an infection with group A beta-hemolytic streptococcal bacteria that occurs in a small percentage of people with strep throat. The illness typically begins with a fever and ...

  4. Acute cholecystitis in a child with scarlet fever: A rare association ...

    African Journals Online (AJOL)

    Group A streptococcal infection is common in children; however, scarlet fever is now considered rare except for isolated outbreaks. One of the rarest complications of scarlet fever is acute cholecystitis – very few cases have been reported in the literature. A 5-year-old boy was admitted with scarlet fever complicated by acute ...

  5. Scarlet Fever: A Group A Streptococcal Infection (United States)

    ... uses them Stay home from work, school, or daycare until you no longer have a fever and ... last updated: January 22, 2018 Content source: National Center for Immunization and Respiratory Diseases , Division of Bacterial ...

  6. Impact of meteorological changes on the incidence of scarlet fever in Hefei City, China (United States)

    Duan, Yu; Huang, Xiao-lei; Wang, Yu-jie; Zhang, Jun-qing; Zhang, Qi; Dang, Yue-wen; Wang, Jing


    Studies on scarlet fever with meteorological factors included were few. We aimed to illustrate meteorological factors' effects on monthly incidence of scarlet fever. Cases of scarlet fever were collected from the report of legal infectious disease in Hefei City from 1985 to 2006; the meteorological data were obtained from the weather bureau of Hefei City. Monthly incidence and corresponding meteorological data in these 22 years were used to develop the model. The model of auto regressive integrated moving average with covariates was used in statistical analyses. There was a highest peak from March to June and a small peak from November to January. The incidence of scarlet fever ranges from 0 to 0.71502 (per 105 population). SARIMAX (1,0,0)(1,0,0)12 model was fitted with monthly incidence and meteorological data optimally. It was shown that relative humidity ( β = -0.002, p = 0.020), mean temperature ( β = 0.006, p = 0.004), and 1 month lag minimum temperature ( β = -0.007, p < 0.001) had effect on the incidence of scarlet fever in Hefei. Besides, the incidence in a previous month (AR( β) = 0.469, p < 0.001) and in 12 months before (SAR( β) = 0.255, p < 0.001) was positively associated with the incidence. This study shows that scarlet fever incidence was negatively associated with monthly minimum temperature and relative humidity while was positively associated with mean temperature in Hefei City, China. Besides, the ARIMA model could be useful not only for prediction but also for the analysis of multiple correlations.

  7. Scarlet Fever Epidemic in China Caused by Streptococcus pyogenes Serotype M12: Epidemiologic and Molecular Analysis

    Directory of Open Access Journals (Sweden)

    Yuanhai You


    Full Text Available From 2011, Hong Kong and mainland China have witnessed a sharp increase in reported cases, with subsequent reports of epidemic scarlet fever in North Asia and the United Kingdom. Here we examine epidemiological data and investigate the genomic context of the predominantly serotype M12 Streptococcus pyogenes scarlet fever isolates from mainland China. Incident case data was obtained from the Chinese Nationwide Notifiable Infectious Diseases Reporting Information System. The relative risk of scarlet fever in recent outbreak years 2011–2016 was calculated using the median age-standardised incidence rate, compared to years 2003–2010 prior this outbreak. Whole genome sequencing was performed on 32 emm12 scarlet fever isolates and 13 emm12 non-scarlet fever isolates collected from different geographic regions of China, and compared with 203 published emm12 S. pyogenes genomes predominantly from scarlet fever outbreaks in Hong Kong (n = 134 and the United Kingdom (n = 63. We found during the outbreak period (2011–2016, the median age-standardised incidence in China was 4.14/100,000 (95% confidence interval (CI 4.11-4.18, 2.62-fold higher (95% CI 2.57-2.66 than that of 1.58/100,000 (95% CI 1.56-1.61 during the baseline period prior to the outbreak (2003−2010. Highest incidence was reported for children 5 years of age (80.5/100,000. Streptococcal toxin encoding prophage φHKU.vir and φHKU.ssa in addition to the macrolide and tetracycline resistant ICE-emm12 and ICE-HKU397 elements were found amongst mainland China multi-clonal emm12 isolates suggesting a role in selection and expansion of scarlet fever lineages in China. Global dissemination of toxin encoded prophage has played a role in the expansion of scarlet fever emm12 clones. These findings emphasize the role of comprehensive surveillance approaches for monitoring of epidemic human disease.

  8. Scarlet Fever Upsurge in England and Molecular-Genetic Analysis in North-West London, 2014

    Centers for Disease Control (CDC) Podcasts


    Sarah Gregory reads an abridged version of the article, Scarlet Fever Upsurge in England and Molecular-Genetic Analysis in North-West London, 2014.  Created: 8/16/2016 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 8/16/2016.

  9. Scarlet fever is caused by a limited number of Streptococcus pyogenes lineages and is associated with the exotoxin genes ssa, speA and speC. (United States)

    Silva-Costa, Catarina; Carriço, Joao A; Ramirez, Mario; Melo-Cristino, Jose


    Several outbreaks of scarlet fever caused by Streptococcus pyogenes were recently reported. Scarlet fever is historically considered a toxin-mediated disease, dependent on the production of the exotoxins SpeA and SpeC, but a strict association between scarlet fever and these exotoxins is not always detected. The aims of this study were to characterize the scarlet fever bacterial isolates recovered from patients in a Lisbon hospital and to identify any distinctive characteristics of such isolates. We characterized a collection of 303 pharyngeal S. pyogenes collected between 2002 and 2008. One-hundred and one were isolated from scarlet fever patients and 202 were associated to a diagnosis of tonsillo-pharyngitis. Isolates were characterized by T and emm typing, pulsed field gel electrophoresis profiling and superantigen gene profiling. The diversity of the scarlet fever isolates was lower than that of the pharyngitis isolates. Specific lineages of emm87, emm4 and emm3 were overrepresented in scarlet fever isolates but only 1 pulsed field gel electrophoresis major lineage was significantly associated with scarlet fever. Multivariate analysis indicated associations of ssa, speA and speC with scarlet fever. In nonoutbreak conditions, scarlet fever is caused by a number of distinct genetic lineages. The lower diversity of these isolates and the association with specific exotoxin genes indicates that some lineages are more prone to cause this presentation than others even in nonoutbreak conditions.

  10. Scarlet fever: A not so typical exanthematous pharyngotonsillitis (based on 171 cases). (United States)

    García-Vera, César; de Dios Javierre, Bárbara; Castán Larraz, Beatriz; Arana Navarro, Teresa; Cenarro Guerrero, Teresa; Ruiz Pastora, Rafael; Sánchez Gimeno, Javier


    To describe the age, signs and clinical symptoms of children with scarlet fever at the present time, and to check whether they are equivalent to those with traditional streptococcal pharyngotonsillitis. An observational, retrospective study was conducted on the clinical records of 5500 children aged from 0 to 15 years attending a primary health care center. A record was made of the percentage of the cases in which signs and symptoms appear and the Centor score was calculated. Microbiological diagnosis of the disease was made using the rapid antigen-detection test or traditional culture. A total of 171 out of 252 scarlet fever diagnoses were microbiologically verified in 158 patients. The median age was 3.8 years (interquartile range: 2.91-4.78), with the majority (57%) under the age of 4 years. There was fever in 89% of the processes (95% CI: 84-94%), with a temperature of >38°C in 73% (95% CI: 65-80%), enlarged lymph nodes in 70% (95% CI: 58-82%), absence of cough in 73% (95% CI: 65-80%), and tonsillar exudate in only 24% (95% CI: 17-31%). The Centor score (n=105) was ≤2 points in 86% (95% CI: 79-92%). The only difference regarding age is that episodes in patients under the age of 4 years old have significantly higher fever (>38°C) than the older ones (80% versus 63%. OR 3.13; 95% CI: 1.46-6.71). Scarlet fever pharyngotonsillitis differs from the traditional streptococcal pharyngotonsillitis, and its evaluation using clinical prediction rules such as Centor or McIsaac is questionable. The main diagnostic key must certainly be rash, regardless of patient age. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  11. Emergence of scarlet fever Streptococcus pyogenes emm12 clones in Hong Kong is associated with toxin acquisition and multidrug resistance. (United States)

    Davies, Mark R; Holden, Matthew T; Coupland, Paul; Chen, Jonathan H K; Venturini, Carola; Barnett, Timothy C; Zakour, Nouri L Ben; Tse, Herman; Dougan, Gordon; Yuen, Kwok-Yung; Walker, Mark J


    A scarlet fever outbreak began in mainland China and Hong Kong in 2011 (refs. 1-6). Macrolide- and tetracycline-resistant Streptococcus pyogenes emm12 isolates represent the majority of clinical cases. Recently, we identified two mobile genetic elements that were closely associated with emm12 outbreak isolates: the integrative and conjugative element ICE-emm12, encoding genes for tetracycline and macrolide resistance, and prophage ΦHKU.vir, encoding the superantigens SSA and SpeC, as well as the DNase Spd1 (ref. 4). Here we sequenced the genomes of 141 emm12 isolates, including 132 isolated in Hong Kong between 2005 and 2011. We found that the introduction of several ICE-emm12 variants, ΦHKU.vir and a new prophage, ΦHKU.ssa, occurred in three distinct emm12 lineages late in the twentieth century. Acquisition of ssa and transposable elements encoding multidrug resistance genes triggered the expansion of scarlet fever-associated emm12 lineages in Hong Kong. The occurrence of multidrug-resistant ssa-harboring scarlet fever strains should prompt heightened surveillance within China and abroad for the dissemination of these mobile genetic elements.

  12. Molecular epidemiological characteristics of Streptococcus pyogenes strains involved in an outbreak of scarlet fever in China, 2011. (United States)

    You, Yuan Hai; Song, Yan Yan; Yan, Xiao Mei; Wang, Hai Bin; Zhang, Meng Han; Tao, Xiao Xia; Li, Lei Lei; Zhang, Yu Xin; Jiang, Xi Hong; Zhang, Bing Hua; Zhou, Hao; Xiao, Di; Jin, Lian Mei; Feng, Zi Jian; Luo, Feng Ji; Zhang, Jian Zhong


    To investigate molecular characterization of streptococcus pyogenes isolates involved in an outbreak of scarlet fever in China in 2011. Seventy-four Streptococcal pyogenes involved in an outbreak of scarlet fever were isolated from pediatric patients in the areas with high incidence in China from May to August of 2011. Emm genotyping, pulsed-field gel electrophoresis (PFGE), superantigen (SAg) genes and antimicrobial susceptibility profiling were analyzed for these isolates. A total of 4 different emm types were identified. Emm12 was the most prevalent type which contained four predominating PFGE patterns corresponding to four different virulence and superantigen profiles. Emm12 (79.7%) and emm1 (14.9%) accounted for approximately 94% of all the isolates. The speA gene was all negative in emm12 isolates and positive in emm1 isolates. All strains were resistant to erythromycin, and 89.4% of them were resistant to erythromycin, tracycline, and clindamycin simultaneously. Several highly diversified clones with a high macrolide resistance rate comprise a predominant proportion of circulating strains, though no new emm type was found in this outbreak. The data provide a baseline for further surveillance of scarlet fever, which may contribute to the explanation of the outbreak and development of a GAS vaccine in China. Copyright © 2013 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  13. Syndromic surveillance models using Web data: the case of scarlet fever in the UK. (United States)

    Samaras, Loukas; García-Barriocanal, Elena; Sicilia, Miguel-Angel


    Recent research has shown the potential of Web queries as a source for syndromic surveillance, and existing studies show that these queries can be used as a basis for estimation and prediction of the development of a syndromic disease, such as influenza, using log linear (logit) statistical models. Two alternative models are applied to the relationship between cases and Web queries in this paper. We examine the applicability of using statistical methods to relate search engine queries with scarlet fever cases in the UK, taking advantage of tools to acquire the appropriate data from Google, and using an alternative statistical method based on gamma distributions. The results show that using logit models, the Pearson correlation factor between Web queries and the data obtained from the official agencies must be over 0.90, otherwise the prediction of the peak and the spread of the distributions gives significant deviations. In this paper, we describe the gamma distribution model and show that we can obtain better results in all cases using gamma transformations, and especially in those with a smaller correlation factor.

  14. Streptococcus pyogenes and re-emergence of scarlet fever as a public health problem (United States)

    Wong, Samson SY; Yuen, Kwok-Yung


    Explosive outbreaks of infectious diseases occasionally occur without immediately obvious epidemiological or microbiological explanations. Plague, cholera and Streptococcus pyogenes infection are some of the epidemic-prone bacterial infections. Besides epidemiological and conventional microbiological methods, the next-generation gene sequencing technology permits prompt detection of genomic and transcriptomic profiles associated with invasive phenotypes. Horizontal gene transfer due to mobile genetic elements carrying virulence factors and antimicrobial resistance, or mutations associated with the two component CovRS operon are important bacterial factors conferring survival advantage or invasiveness. The high incidence of scarlet fever in children less than 10 years old suggests that the lack of protective immunity is an important host factor. A high population density, overcrowded living environment and a low yearly rainfall are environmental factors contributing to outbreak development. Inappropriate antibiotic use is not only ineffective for treatment, but may actually drive an epidemic caused by drug-resistant strains and worsen patient outcomes by increasing the bacterial density at the site of infection and inducing toxin production. Surveillance of severe S. pyogenes infection is important because it can complicate concurrent chickenpox and influenza. Concomitant outbreaks of these two latter infections with a highly virulent and drug-resistant S. pyogenes strain can be disastrous. PMID:26038416

  15. Association of the shuffling of Streptococcus pyogenes clones and the fluctuation of scarlet fever cases between 2000 and 2006 in central Taiwan

    Directory of Open Access Journals (Sweden)

    Wang Wan-Ling


    Full Text Available Abstract Background The number of scarlet fever occurrences reported between 2000 and 2006 fluctuated considerably in central Taiwan and throughout the nation. Isolates of Streptococcus pyogenes were collected from scarlet fever patients in central Taiwan and were characterized by emm sequencing and a standardized pulsed-field gel electrophoresis (PFGE method. National weekly report data were collected for investigating epidemiological trends. Results A total of 23 emm types were identified in 1,218 S. pyogenes isolates. The five most prevalent emm types were emm12 (50.4%, emm4 (23.2%, emm1 (16.4%, emm6 (3.8% and emm22 (3.0%. PFGE analysis with SmaI suggested that, with a few exceptions, strains with a common emm type belonged to the same clone. There were two large emm12 clones, one with DNA resistant to cleavage by SmaI. Each prevalent emm clone had major PFGE strain(s and many minor strains. Most of the minor strains emerged in the population and disappeared soon after. Even some major strains remained prevalent for only 2–3 years before declining. The large fluctuation of scarlet fever cases between 2000 and 2006 was associated with the shuffling of six prevalent emm clones. In 2003, the dramatic drop in scarlet fever cases in central Taiwan and throughout the whole country was associated with the occurrence of a severe acute respiratory syndrome (SARS outbreak that occurred between late-February and mid-June in Taiwan. Conclusion The occurrences of scarlet fever in central Taiwan in 2000–2006 were primarily caused by five emm types, which accounted for 96.8% of the isolates collected. Most of the S. pyogenes strains (as defined by PFGE genotypes emerged and lasted for only a few years. The fluctuation in the number of scarlet fever cases during the seven years can be primarily attributed to the shuffling of six prevalent emm clones and to the SARS outbreak in 2003.

  16. The complete genome sequence of Yersinia pseudotuberculosis IP31758, the causative agent of Far East scarlet-like fever.

    Directory of Open Access Journals (Sweden)

    Mark Eppinger


    Full Text Available The first reported Far East scarlet-like fever (FESLF epidemic swept the Pacific coastal region of Russia in the late 1950s. Symptoms of the severe infection included erythematous skin rash and desquamation, exanthema, hyperhemic tongue, and a toxic shock syndrome. The term FESLF was coined for the infection because it shares clinical presentations with scarlet fever caused by group A streptococci. The causative agent was later identified as Yersinia pseudotuberculosis, although the range of morbidities was vastly different from classical pseudotuberculosis symptoms. To understand the origin and emergence of the peculiar clinical features of FESLF, we have sequenced the genome of the FESLF-causing strain Y. pseudotuberculosis IP31758 and compared it with that of another Y. pseudotuberculosis strain, IP32953, which causes classical gastrointestinal symptoms. The unique gene pool of Y pseudotuberculosis IP31758 accounts for more than 260 strain-specific genes and introduces individual physiological capabilities and virulence determinants, with a significant proportion horizontally acquired that likely originated from Enterobacteriaceae and other soil-dwelling bacteria that persist in the same ecological niche. The mobile genome pool includes two novel plasmids phylogenetically unrelated to all currently reported Yersinia plasmids. An icm/dot type IVB secretion system, shared only with the intracellular persisting pathogens of the order Legionellales, was found on the larger plasmid and could contribute to scarlatinoid fever symptoms in patients due to the introduction of immunomodulatory and immunosuppressive capabilities. We determined the common and unique traits resulting from genome evolution and speciation within the genus Yersinia and drew a more accurate species border between Y. pseudotuberculosis and Y. pestis. In contrast to the lack of genetic diversity observed in the evolutionary young descending Y. pestis lineage, the population

  17. Acute cholecystitis in a child with scarlet fever: A rare association

    African Journals Online (AJOL)

    upper quadrant, associated with mild fever. On examination there was tenderness in the right upper quadrant of his abdomen. His amylase was 35 IU/L, lipase 22.6 IU/L, full blood count 16 800/µL. (neutrophils 65%) and CRP 74 mg/L. Virology studies including. Epstein-Barr virus (EBV, hepatitis A, B and C, cytomegalovirus.

  18. Effect of administration of Streptococcus salivarius K12 on the occurrence of streptococcal pharyngo-tonsillitis, scarlet fever and acute otitis media in 3 years old children. (United States)

    Di Pierro, F; Colombo, M; Giuliani, M G; Danza, M L; Basile, I; Bollani, T; Conti, A M; Zanvit, A; Rottoli, A S


    Streptococcus salivarius K12 (BLIS K12) is a probiotic strain strongly antagonistic to the growth of Streptococcus pyogenes, the most important bacterial cause of pharyngeal infections in humans. Shown to colonize the oral cavity and to be safe for human use, BLIS K12 has previously been reported to reduce pharyngo-tonsillitis episodes in children or adults known to have experienced recurrent streptococcal infection. The present study was focussed upon evaluating the role of BLIS K12 in the control of streptococcal disease and acute otitis media in children attending the first year of kindergarten. By randomization, 222 enrolled children attending the first year of kindergarten were divided into a treated group (N = 111) receiving for 6 months a daily treatment with BLIS K12 (Bactoblis®) and a control group (N = 111) who were monitored as untreated controls. During the 6 months of treatment and 3 months of follow-up, the children were evaluated for treatment tolerance, and for episodes of streptococcal pharyngo-tonsillitis, scarlet fever and acute otitis media. During the 6-month trial (N = 111 per group) the incidence of streptococcal pharyngo-tonsillitis, scarlet fever and acute otitis media was approximately 16%, 9% and 44% respectively in the treated group and 48%, 4% and 80% in the control group. During the 3-months follow-up (N = 29 per group) the corresponding rates of infection were 15%, 0% and 12% in the treated group and 26%, 6% and 36% in the controls. No apparent side effects were detected in the treated group either during treatment or follow-up. All of the enrolled children completed the study. The daily administration of BLIS K12 to children attending their first year of kindergarten was associated with a significant reduction in episodes of streptococcal pharyngitis and acute otitis media. No protection against scarlet fever was detected.

  19. Scarlet Fever (For Parents) (United States)

    ... that can happen in kids who also have strep throat or strep skin infections. The strep bacteria make ... Eating can be painful for kids with severe strep throat, so serving soft foods or a liquid diet ...

  20. Operation Pied Piper: a geographical reappraisal of the impact of wartime evacuation on scarlet fever and diphtheria rates in England and Wales, 1939-1945. (United States)

    Smallman-Raynor, M R; Cliff, A D


    This paper examines the geographical impact of the British Government's wartime evacuation scheme on notified rates of two common acute childhood diseases (scarlet fever and diphtheria) in the 1470 local government districts of England and Wales, 1939-1945. Drawing on the notifications of communicable diseases collated by the General Register Office (GRO), we establish pre-war (baseline) disease rates for the 1470 districts. For the war years, techniques of binary logistic regression analysis are used to assess the associations between (a) above-baseline ('raised') disease rates in evacuation, neutral and reception districts and (b) the major phases of the evacuation scheme. The analysis demonstrates that the evacuation was temporally associated with distinct national and regional effects on notified levels of disease activity. These effects were most pronounced in the early years of the dispersal (1939-1941) and corresponded with initial levels of evacuation-related population change at the regional and district scales.

  1. The Fuzzy Scarlet Letter (United States)

    Pallas, Aaron M.


    Critics of the public release of teacher evaluation scores sometimes liken these ratings to the scarlet letter worn by Hester Prynne in Nathaniel Hawthorne's classic novel. The comparison is apt. But public school teachers who are subjected to public shaming because of their students' test scores can rarely expect the opportunities for redemption…

  2. Sensibilidad antimicrobiana y caracterización de cepas de Streptococcus pyogenes aisladas de un brote de escarlatina Antimicrobial sensitivity and typing of Streptococcus pyogenes strains isolated during a scarlet fever outbreak

    Directory of Open Access Journals (Sweden)

    Alberto González Pedraza-Avilés


    Full Text Available Objetivo. Evaluar la actividad in vitro de 13 antibióticos contra 47 Streptococcus pyogenes grupo A (SGA. Determinar la presencia de genes que codifican para exotoxina pirogénica estreptocóccica A (SpeA y serotipos con base en proteína M. Material y métodos. Estudio transversal hecho en el Centro de Salud Dr. José Castro Villagrana sobre un brote de escarlatina en el Colegio Espíritu de América, entre diciembre de 1999 y enero de 2000. El número de niños estudiados fue 137. Se extrajeron porcentajes de sensibilidad. La concentración inhibitoria mínima (CIM se obtuvo por microdilución semiautomatizada. Se utilizó un secuenciador automatizado de DNA para el análisis de variación de secuencias en los genes que codifican para proteína M y SpeA. Resultados. Todas las cepas fueron sensibles a beta-lactámicos y clindamicina; 12.7% fueron resistentes a eritromicina. El serotipo M2 fue el más frecuente, 27 del total. Prácticamente todas las bacterias (96% con el gen SpeA tienen el gen que codifica para el serotipo M2. Conclusiones. Debido a la reciente reaparición de infecciones por SGA se sugiere realizar estudios tanto de sensibilidad a macrólidos y beta-lactámicos, como de epidemiología molecular.Objective. To evaluate the in vitro activities of 13 antimicrobial agents against 47 group A Streptococcus pyogenes (GAS strains, and to determine the presence of genes encoding streptococcal pyrogenic exotoxin A (SpeA and the M--protein serotypes. Materials and Methods. A cross-sectional study was conducted at Centro de Salud Dr. José Castro Villagrana, during a scarlet fever outbreak occurring between December 1999 and January 2000, among 137 children at Colegio Espíritu de América. Minimum Inhibitory Concentrations (MICs were obtained by the semiautomated microdilution method. Automated DNA sequencing was used for analysis of sequence variation in genes encoding the M protein, and SpeA. Results. All strains were sensitive to

  3. Source / component separation with NMF and scarlet (United States)

    Melchior, Peter; Moolekamp, Fred; LSST Data Management, WFIRST Preparatory Science


    Astronomical data are often superpositions of multiple source signals. I will introduce the open-source analysis framework scarlet, based on the Non-negative Matrix Factorization (NMF), that achieves efficient source separation and enables flexible constraints or priors on the shape of the signals and/or the signal amplitude across multiple observations.I will demonstrate scarlet's capabilities of separating multi-component photo-z distributions, AGN jets from host galaxies, and more generally: crowded extragalactic fields in the HSC survey. I will also discuss extensions for joint pixel-level deblending with images from LSST and WFIRST, and for hyperspectral or grism data.

  4. Oscar Wilde and the scarlet woman. (United States)

    Hanson, E


    In the late nineteenth century, England was embroiled in a political debate over the importation of Roman Catholic rituals into the Anglican Church, not to mention the re-establishment of the Roman Church itself in Great Britain. Victorian anti-Catholic rhetoric draws upon the figure of the Whore of Babylon to depict the Roman Catholic Church as the Scarlet Woman, a femme fatale who perverts Christianity and seduces Englishmen with elaborate rituals and lascivious whisperings in the confessional. In writing Salomé, Oscar Wilde played ironically on the hysterical eroticism of the No Popery movement by mining the paradox of biblical sensuality. He invested his play with a biblical wealth of archaic metaphors and gestures that took their cues from The Song of Songs and The Book of Revelation. He became the ecclesiastical dandy that evangelicals feared most, a poet enamored of the Scarlet Woman, a would-be convert who exposed the scandal of Christianity as art.

  5. morphological descriptors and micro satellite diversity among scarlet ...

    African Journals Online (AJOL)

    Prof. Adipala Ekwamu

    section Oliganthes, Dunal Bitter. The scarlet eggplant (S. aethiopicum L) comprises of four groups (Gilo, Shum, Aculeatum and ..... 3= Yellow orange, 4= Deep orange, 5= Fired red, 6= Poppy red, 7= Scarlet red, 8= Brown, 9= Black. 9. Fruit cross section. 1= Circular (no grooves), 3= Elliptic, no grooves, 5= Few grooves, ...

  6. mScarlet : a bright monomeric red fluorescent protein for cellular imaging

    NARCIS (Netherlands)

    Bindels, D.S.; Haarbosch, L.; van Weeren, L.; Postma, M.; Wiese, K.E.; Mastop, M.; Aumonier, S.; Gotthard, G.; Royant, A.; Hink, M.A.; Gadella Jr, T.W.J.


    We report the engineering of mScarlet, a truly monomeric red fluorescent protein with record brightness, quantum yield (70%) and fluorescence lifetime (3.9 ns). We developed mScarlet starting with a consensus synthetic template and using improved spectroscopic screening techniques; mScarlet's

  7. mScarlet: a bright monomeric red fluorescent protein for cellular imaging. (United States)

    Bindels, Daphne S; Haarbosch, Lindsay; van Weeren, Laura; Postma, Marten; Wiese, Katrin E; Mastop, Marieke; Aumonier, Sylvain; Gotthard, Guillaume; Royant, Antoine; Hink, Mark A; Gadella, Theodorus W J


    We report the engineering of mScarlet, a truly monomeric red fluorescent protein with record brightness, quantum yield (70%) and fluorescence lifetime (3.9 ns). We developed mScarlet starting with a consensus synthetic template and using improved spectroscopic screening techniques; mScarlet's crystal structure reveals a planar and rigidified chromophore. mScarlet outperforms existing red fluorescent proteins as a fusion tag, and it is especially useful as a Förster resonance energy transfer (FRET) acceptor in ratiometric imaging.

  8. Observations on the behaviour of the Scarlet Ibis, Eudocimus ruber, in Artis Zoo, Amsterdam

    NARCIS (Netherlands)

    Spil, R.E.; Walstijn, van M.W.; Albrecht, H.


    The Scarlet Ibis, Eudocimus ruber (Linnaeus), fam. Threskiornithidae, is the closest relative of the White Ibis, Eudocimus albus (Linnaeus). The two species live in adjoining geographical areas. Nothing is known about the Scarlet Ibis’s breeding biology in the wild and only little about its breeding

  9. Hemorrhagic Fevers (United States)

    ... of viruses. These include the Ebola and Marburg, Lassa fever, and yellow fever viruses. VHFs have common ... the animals that carry them live. For example, Lassa fever is limited to rural areas of West ...

  10. Dengue fever (United States)

    ... Endy TP, Rothman AL, Barrett AD. Flaviviruses (dengue, yellow fever, Japanese encephalitis, West Nile encephalitis, St. Louis encephalitis, tick-borne encephalitis, Kyasanur forest disease, Alkhurma hemorrhagic fever, Zika). In: Bennett JE, Dolin ...

  11. Lassa Fever (United States)

    ... Search Form Controls Cancel Submit Search the CDC Lassa Fever Note: Javascript is disabled or is not ... US) French Recommend on Facebook Tweet Share Compartir Lassa fever is an acute viral illness that occurs ...

  12. Dengue fever

    African Journals Online (AJOL)

    Introduction. Dengue fever is caused by dengue viruses. (DENV). Transmission of DENV has increased dramatically in the past two decades making DENV the most important human pathogens among arthropod-borne viruses (1). About 50-. 100 million dengue fever infections occur every year in tropical and subtropical.

  13. Yellow Fever (United States)

    ... febrile illness to severe liver disease with bleeding. Yellow fever disease is diagnosed based on symptoms, physical findings, laboratory testing, and travel history, including the possibility of exposure to ... specific treatment for yellow fever; care is based on symptoms. Steps to ...

  14. The Continuity of American Letters in "The Scarlet Letter" and "The Beast in the Jungle." (United States)

    Gottschalk, Jane


    Fictional works, of different literary periods, which share a common perception of man can be explicated and compared with each other to illustrate a continuing tradition in American literature. Such a basis for comparison exists between Hawthorne's romance, "The Scarlet Letter," which appeared in 1850, and Henry James' fantasy,…

  15. Early procurement of scarlet macaws and the emergence of social complexity in Chaco Canyon, NM. (United States)

    Watson, Adam S; Plog, Stephen; Culleton, Brendan J; Gilman, Patricia A; LeBlanc, Steven A; Whiteley, Peter M; Claramunt, Santiago; Kennett, Douglas J


    High-precision accelerator mass spectrometer (AMS) (14)C dates of scarlet macaw (Ara macao) skeletal remains provide the first direct evidence from Chaco Canyon in northwestern New Mexico that these Neotropical birds were procured from Mesoamerica by Pueblo people as early as ∼ A.D. 900-975. Chaco was a prominent prehistoric Pueblo center with a dense concentration of multistoried great houses constructed from the 9th through early 12th centuries. At the best known great house of Pueblo Bonito, unusual burial crypts and significant quantities of exotic and symbolically important materials, including scarlet macaws, turquoise, marine shell, and cacao, suggest societal complexity unprecedented elsewhere in the Puebloan world. Scarlet macaws are known markers of social and political status among the Pueblos. New AMS (14)C-dated scarlet macaw remains from Pueblo Bonito demonstrate that these birds were acquired persistently from Mesoamerica between A.D. 900 and 1150. Most of the macaws date before the hypothesized apogeal Chacoan period (A.D. 1040-1110) to which they are commonly attributed. The 10th century acquisition of these birds is consistent with the hypothesis that more formalized status hierarchies developed with significant connections to Mesoamerica before the post-A.D. 1040 architectural florescence in Chaco Canyon.

  16. Pandemic Fear and Literature: Observations from Jack London’s The Scarlet Plague

    Centers for Disease Control (CDC) Podcasts


    Sarah Gregory reads an abridged version of the essay, Pandemic Fear and Literature: Observations from Jack London’s The Scarlet Plague.  Created: 11/18/2014 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 11/20/2014.

  17. Mixed marriages in Ba's so long a letter and scarlet song | Simon ...

    African Journals Online (AJOL)

    Love is the prerequisite for marriage in all cultures. This fact is negated in the marriage relationships described in Ba's two works. This paper examines mixed marriages in Mariama Ba's So Long a Letter and Scarlet Song and its impact on women. It also highlights the woman's predicament in general and the way forward ...

  18. Studies on population dynamics of the scarlet mite, Brevipalpus phoenicis, a pest of tea in Indonesia

    NARCIS (Netherlands)

    Oomen, P.A.


    Tea is the national drink of Indonesia. The habitual consumption prevents intestinal infections; the production provides many Indonesians with a living. The production is affected by scarlet mites (Brevipalpus phoenicis GEIJSKES), an important pest of tropical and

  19. Dengue hemorrhagic fever (United States)

    Hemorrhagic dengue; Dengue shock syndrome; Philippine hemorrhagic fever; Thai hemorrhagic fever; Singapore hemorrhagic fever ... Four different dengue viruses are known to cause dengue hemorrhagic fever. Dengue hemorrhagic fever occurs when a person is bitten by ...

  20. Haemorrhagic Fevers, Viral (United States)

    ... is usually applied to disease caused by Arenaviridae (Lassa fever, Junin and Machupo), Bunyaviridae (Crimean-Congo haemorrhagic ... fever Dengue and severe dengue Ebola virus disease Lassa fever Marburg haemorrhagic fever Rift Valley fever Multimedia, ...

  1. Rheumatic fever (United States)

    ... condition are: Loss of control of emotions, with bouts of unusual crying or laughing Quick, jerky movements ... minor criteria include: Fever High ESR Joint pain Abnormal EKG You'll likely be diagnosed with rheumatic ...

  2. Valley fever (United States)

    ... especially the first trimester) People of Native American, African, or Philippine descent may also get more severe ... that causes Valley fever) Chest x-ray Sputum culture Sputum smear (KOH test) Tests done for more ...

  3. Typhoid fever (United States)

    ... It is most commonly caused due to a bacteria called Salmonella typhi ( S typhi ). ... Enteric fever ... electrolyte packets. Antibiotics are given to kill the bacteria. ... check current recommendations before choosing an antibiotic.

  4. Yellow fever (United States)

    ... SJ, Endy TP, Rothman AL, Barrett AD. Flaviviruses (dengue, yellow fever, Japanese encephalitis, West Nile encephalitis, St. ... any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should ...

  5. Valley Fever (United States)

    ... loss Headache Valley fever Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  6. Q fever (United States)

    ... bacteria can infect: Sheep Goats Cattle Dogs Cats Birds Rodents Ticks Infected animals shed these bacteria in: Birth products Feces Milk Urine Humans usually get Q fever by breathing in contaminated droplets released into the air by ...

  7. Dengue Fever (United States)

    ... change the water in birdbaths, dog bowls, and flower vases at least once a week. By taking ... Cholera West Nile Virus First Aid: Vomiting Are Insect Repellents With DEET Safe for Kids? Dengue Fever ...

  8. Influence of biostimulant and substrate volume on root growth and development of scarlet sage (Salvia splendens L.) transplants


    Zeljković Svjetlana B.; Parađiković Nada A.; Babić Tamara S.; Đurić Gordana D.; Oljača Rodoljub M.; Vinković Tomislav M.; Tkalec Monika B.


    The influence of biostimulant and substrate volume on scarlet sage transplants growth and development was examined in this investigation. There was one cultivar of scarlet sage used in trial which was transplanted in pots of two different volumes. Plants were treated with biostimulant (Radifarm) in concentration of 0.25% or left untreated (control). During the trial, root and aboveground fresh and dry mass were recorded. Treatment with biostimulant and bigg...

  9. Scarlet Macaw (Ara macao, Psittaciformes: Psittacidae Nest Characteristics in the Osa Peninsula Conservation Area (ACOSA, Costa Rica

    Directory of Open Access Journals (Sweden)

    John L Guittar


    Full Text Available The Scarlet Macaw (Ara macao is an endangered species. In Costa Rica, the Scarlet Macaw population of the Central Pacific Conservation Area (ACOPAC, n =432 individuals has undergone considerable study and has been used effectively as a flagship species for regional conservation. Costa Rica’s only other viable Scarlet Macaw population, located in the Osa Peninsula Conservation Area (ACOSA, n=800-1200 individuals, remains virtually unstudied. We studied ACOSA Scarlet Macaw nest cavities from February 19th to March 22nd 2006. Through informal interviews with park guards and residents, we found a total of 57 potential nests in 52 trees. Eleven nests were reported as frequently poached. Scarlet Macaws used 14 identified tree species, ten of which are unrecorded in Costa Rica. The most common nesting trees were Caryocar costaricense (n=12, 24%, Schizolobium parahyba (n=9, 18.0%, Ceiba pentandra (n=7, 14.0% and Ficus sp. (n=5, 10.0%. We compare nesting characteristics to those recorded in ACOPAC. A combination of bottom-up and top-down strategies are necessary to ensure the Scarlet Macaw’s long-term success, including environmental education in local schools, community stewardship of active nests, and the advertisement of stricter penalties for poaching. Rev. Biol. Trop. 57 (1-2: 387-393. Epub 2009 June 30.

  10. Dengue fever (image) (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.

  11. Yellow Fever Vaccine (United States)

    What is yellow fever?Yellow fever is a serious disease caused by the yellow fever virus. It is found in certain parts of Africa and South America. Yellow fever is spread through the bite of an infected ...

  12. Rheumatic Fever (United States)

    ... without the antibiotics in your bloodstream, the streptococcal bacteria can still multiply and affect your heart and other organs. If your strep infection leads to rheumatic fever, your doctor may prescribe anti-inflammatory medicines or aspirin to reduce the swelling ...

  13. Dengue fever

    African Journals Online (AJOL)

    degreasing metabolic acidosis (15). Give paracetamol for fever and analgesia. Avoid aspirin, ibuprofen and other non-steroidal anti-inflammatory agents as they may aggravate gastritis or bleeding (15). Acetylsalicylic acid (aspirin) may be associated with Reye's syndrome. Monitor patients at least 6 hourly in 24 hours.

  14. Orchid Fever (United States)

    Oliver, Phillip


    Exotic, captivating, and seductive, orchids have long fascinated plant lovers. They first attracted the attention of Westerners in the 17th century, when explorers brought back samples from South America and Asia. By the mid-1800s, orchid collecting had reached a fever pitch, not unlike that of the Dutch tulip craze of the 1630s, with rich (and…

  15. Lassa fever

    African Journals Online (AJOL)


    The illness usually begins insidiously with fever, weakness, malaise joint pain or lumber pain cough and severe headache. Pharyngitis often exudative and conjunctivitis may occur early. In severe cases prostration dehydration and facial or neck oedema can occur (3). Laboratory findings include Serum aminotransferases.

  16. Beach almond (Terminalia catappa, Combretaceae) seed production and predation by scarlet macaws (Ara macao) and variegated squirrels (Sciurus variegatoides). (United States)

    Henn, Jonathan J; McCoy, Michael B; Vaughan, Christopher S


    Knowledge of ecological impacts of exotic beach almond (Terminalia catappa) in the central Pacific of Costa Rica are little known, but studies have found this species to be a potentially important food source for endangered scarlet macaws (Ara macao). In this study, reproductive phenology and seed predation by variegated squirrels (Sciurus variegatoides) and scarlet macaws were measured during March and April 2011 on beaches of central Pacific coastal Costa Rica. Seed productivity and predation levels were quantified on a weekly basis for 111 beach almond trees to assess the importance of beach almond as a food source for scarlet macaws and the extent of resource partitioning between seed predators. Seed production of the trees was great (about 194 272 seeds) and approximately 67% of seeds were predated by seed predators. Macaws consumed an estimated 49% of seeds while squirrels consumed 18%. Additionally, evidence of resource partitioning between squirrels and macaws was found. Scarlet macaws preferred to feed on the northern side and edge of the canopy while squirrels preferred to feed on the southern and inside parts of the canopy. Both species ate most seeds on the ocean side of the tree. Despite the status of this tree as an exotic species, the beach almond appears to be an important resource for scarlet macaw population recovery. The resource produced by this tree should be taken into account as reforestation efforts continue in Costa Rica.

  17. Typhoid fever

    DEFF Research Database (Denmark)

    Wain, John; Hendriksen, Rene S.; Mikoleit, Matthew L.


    cause of enteric fever, but now S Typhi is being displaced by infections with drug-resistant S enterica serovar Paratyphi A. New conjugate vaccines are imminent and new treatments have been promised, but the engagement of local medical and public health institutions in endemic areas is needed to allow......, especially those in Africa. The main barriers to control are vaccines that are not immunogenic in very young children and the development of multidrug resistance, which threatens efficacy of antimicrobial chemotherapy. Clinicians, microbiologists, and epidemiologists worldwide need to be familiar...... with shifting trends in enteric fever. This knowledge is crucial, both to control the disease and to manage cases. Additionally, salmonella serovars that cause human infection can change over time and location. In areas of Asia, multidrug-resistant Salmonella enterica serovar Typhi (S Typhi) has been the main...

  18. [Milk fever]. (United States)

    Dumont, M


    Infectious complications following delivery were, in the past, attributed to "milk fever": these were milk congestion, milk deposits, rancid milk, etc., that were held responsible. The milk was reabsorbed into the blood of the patient and settled in the peritoneum ("milk peritonitis"), in the broad ligaments (pelvic abscess), in the thighs (phlebitis) and also in the breasts (breast abscess). This belief, originated by Aristotle, was accepted by excellent authors like Andre Levret (1703-1780), one of the most famous French obstetricians and Nicolas Puzos, at the same time. More recently, authors alluded to it and blamed "milk fever" for being at the origin of dramatic pictures which they described in their novels, like Victor Hugo and Guy de Maupassant, for instance.

  19. Dengue fever


    Badreddine, Samar; Al-Dhaheri, Fahmi; Al-Dabbagh, Ammar; Al-Amoudi, Abdulrahman; Al-Ammari, Maged; Elatassi, Nader; Abbas, Haytham; Magliah,Rami; Malibari, Abdulbasit; Almoallim, Hani


    Objectives: To delineate the clinical features and outcomes of dengue infection and to guide clinician of early diagnosis and identification of risks factors for dengue hemorrhagic fever. Methods: This study is a retrospective cross-sectional. Clinical records of 567 patients with a confirmed diagnosis of dengue infection, admitted to a single hospital in Jeddah, Saudi Arabia, between January 2010 and June 2014 were reviewed. Results: Dengue infection was most common in adult males. Sixty-eig...

  20. Scarlet Macaw, Ara macao, (Psittaciformes: Psittacidae diet in Central Pacific Costa Rica

    Directory of Open Access Journals (Sweden)

    Christopher Vaughan


    Full Text Available From 1993 to 1997, we observed Scarlet Macaw (Ara macao feeding behavior in Central Pacific Costa Rica. Feeding data acquired in this study were not collected systematically, but opportunistically whenever macaws were observed feeding. To supplement feeding observations, we conducted interviews with local residents. Scarlet Macaws fed on seeds, fruits, leaves, flowers and/or bark of 43 plant species. Various plant parts eaten by macaws from several tree species contain secondary compounds toxic to humans, and additional species included in their diet are nonnative, introduced for agricultural purposes. Important macaw feeding tree species are Ceiba pentandra, Schizolobium parahybum, and Hura crepitans; these species are also crucial to this macaw population because of nest cavities they provide. The results of this study contribute to the conservation of Scarlet Macaws in Central Pacific Costa Rica through promoting protection of individual trees, and through local elementary school reforestation programs focusing on tree species that macaws use for feeding and/or nesting. Scarlet Macaw conservation is extremely important, as numerous population pressures have caused significant declines in macaw numbers in Costa Rica. Rev. Biol. Trop. 54 (3: 919-926. Epub 2006 Sept. 29.Entre 1993-97, observamos el comportamiento de alimentación de la lapa roja (Ara macao en el Pacifico Central de Costa Rica. La lapa roja se alimentó de semillas, frutas, hojas, flores y corteza de 43 especies de plantas. Varias partes de las plantas comidas por las lapas contienen compuestos secundarios tóxicos al ser humano, y especies adicionales incluidas en la dieta son exóticas; introducidas por razones agrícolas, forestales o estéticas. Especies de árboles importantes como alimento de la lapa roja incluyen: Ceiba pentandra, Schizolobium parahybum, y Hura crepitans; también son criticas para la población de la lapa roja debido a proveen cavidades para anidaci

  1. The scarlet eye colour gene of the tephritid fruit fly: Bactrocera tryoni and the nature of two eye colour mutations. (United States)

    Zhao, J T; Bennett, C L; Stewart, G J; Frommer, M; Raphael, K A


    A homologue of the Drosophila melanogaster eye-colour gene, scarlet (st), has been isolated from the genome of the tephritid fruit fly, Bactrocera tryoni. The comparison of the B. tryoni and D. melanogaster scarlet gene shows 71.2% and 79.3% sequence identity at the DNA and the derived amino acid level, respectively. Two allelic eye-colour mutations of B. tryoni, orange-eyes and lemon-eyes, have been recovered and found to be colocalized with the st gene. The st gene sequence in the two mutant strains has been examined for DNA sequence changes and expression levels.

  2. [Lassa fever]. (United States)

    Fleischer, K; Köhler, B; Kirchner, A; Schmid, J


    A 22-year-old female German student was admitted with fever of unknown origin for 5 days to the hospital of her hometown immediately after returning from a 7-week journey under simple conditions through 4 West African countries. After exclusion of malaria and typhoid and nonrespondence to antibiosis, she was transferred on the 4th day to the Department of Tropical Medicine in Würzburg. After the clinical assumption of Lassa fever, the virus was confirmed by PCR within 3 hours (Bernhard Nocht Institute, Hamburg) on the 10th day of her illness. The assumption was based on travel history, continuous fever, cough, pharyngitis, thoracic pain, and exclusion of other acute infections. From the beginning, the patient was cared for with barrier nursing and after diagnosis under strict isolation in an intensive care unit reserved for her alone by a team of doctors and nurses specialized in tropical medicine and intensive care. The staff was protected through isolation suits with filters. Monitoring and therapy entailed all methods of intensive care and intravenous administration of ribavirin 16 mg/kg body weight = 900 mg every 6 hours. The patient died on the 14th day of her illness in a volume deficiency shock due to uncontrollable heavy hemorrhage from all organs including the skin, a so-called "leakage syndrome". Conclusions are drawn regarding training in tropical medicine, diagnostics of highly contagious infections, intensive care of patients affected with them under isolation, contact tracing, psychological crisis intervention for personnel, media information, care of the infectious corpse and disposal of infectious waste.

  3. Rat-bite fever (United States)

    ... dwellings may help prevent rat-bite fever. Taking antibiotics by mouth after a rat bite may also help prevent this illness. Alternative Names Streptobacillary fever; Streptobacillosis; Haverhill fever; Epidemic arthritic ...

  4. Dengue Fever Testing (United States)

    ... Links Patient Resources For Health Professionals Subscribe Search Dengue Fever Testing Send Us Your Feedback Choose Topic ... Images View Sources Ask Us Also Known As Dengue Fever Antibodies Dengue Fever Virus Formal Name Dengue ...

  5. Dengue Fever Treatment (United States)

    ... with facebook share with twitter share with linkedin Dengue Fever Treatment Dengue Fever Dengue Fever Biology and Transmission Prevention Diagnosis ... of genomic data, and advances the understanding and treatment of dengue disease. Content last reviewed on February 7, 2011 ...

  6. Viral Hemorrhagic Fevers (United States)

    ... 4 viruses that cause two other hemorrhagic fevers, dengue hemorrhagic fever and yellow fever. Virus Families Information ... 2014 Content source: Centers for Disease Control and Prevention National Center for Emerging and Zoonotic Infectious Diseases ( ...

  7. [BPNN simulation of photocatalytic degradation of reactive scarlet BES by UV-Vis spectrophotometer]. (United States)

    Zhang, Yun-Tao; He, Guo-Li; Xiang, Ming-Li


    The use of chemometric techniques and multivariate experimental designs for the photocatalytic reaction of reactive scarlet BES in aqueous solution under ultraviolet light irradiation is described. The efficiency of photocatalytic degradation was evaluated by the analysis of the parameter of decoloration efficiency determined by UV absorption at 540 nm using a UV-Vis spectrophotometer in different conditions. Five factors, such as the amount of titanium oxide ([TiO2]), the concentrations of reactive scarlet BES (c(0)), irradiation time (t), the pH value (pH) and temperature (T), were studied. [TiO2]. c(0), t and pH selected on the basis of the results of variance analysis by Plackett-Burman design were used as independent variables. Training sets and test sets of back propagation neural network (BPNN) were formed by Box-Behnken design and uniform design U10 (10 x 5(2) x 2) respectively. The process of photocatalytic degradation of the target object was simulated by the BPNN model. The correlation coefficient (r) of the calculation results for training set and test set by BPNN is 0.996 4 and 0.963 6 respectively, and the mean relative errors between the predictive value and experimental value of decoloration efficiency are 6.14 and 7.76, respectively. The modeled BPNN was applied to analyze the influence of four factors on decoloration efficiency. The results showed that the initial conditions of c(0) being lower, pH 5.0 and appropriate amount of [TiO2] contribute to improving the decoloration efficiency of reactive scarlet BES. Under the condition of c(0) = 40 mg x L(-1), the optimized experimental condition of the system was obtained: [TiO2] = 1.20 g x L(-1) and pH 5.0. Under the optimized experimental condition, the experimental value of decoloration efficiency is 98.20% when irradiation time is 35 minutes and the predictive value of decoloration efficiency is 99.16% under the same condition. The relative error of decoloration efficiency between the predictive

  8. The man in the scarlet cloak. The mysterious death of Peter Anthony Motteux. (United States)

    Ober, W B


    Peter Anthony Motteux (1663-1718), a Huguenot refugee in London, established a literary reputation by completing Sir Thomas Urquhart's translation of Rabelais' Gargantua and Pantagruel, then Cervantes' Don Quixote. He later became an import-export merchant. On his 55th birthday he donned his scarlet cloak and went out on the town. He picked up a prostitute and after some dalliance returned to her bordello. Shortly thereafter he was found dead, although the evidence is that he was in good health when he arrived. Literary evidence is that he died from assisted erotic asphyxia, a variant of autoerotic asphyxia, cf. the case of Frantisek Koczwara (Am J Forensic Med Pathol 5:145-149, 1984.)

  9. Amorphous diamond-structured photonic crystal in the feather barbs of the scarlet macaw. (United States)

    Yin, Haiwei; Dong, Biqin; Liu, Xiaohan; Zhan, Tianrong; Shi, Lei; Zi, Jian; Yablonovitch, Eli


    Noniridescent coloration by the spongy keratin in parrot feather barbs has fascinated scientists. Nonetheless, its ultimate origin remains as yet unanswered, and a quantitative structural and optical description is still lacking. Here we report on structural and optical characterizations and numerical simulations of the blue feather barbs of the scarlet macaw. We found that the sponge in the feather barbs is an amorphous diamond-structured photonic crystal with only short-range order. It possesses an isotropic photonic pseudogap that is ultimately responsible for the brilliant noniridescent coloration. We further unravel an ingenious structural optimization for attaining maximum coloration apparently resulting from natural evolution. Upon increasing the material refractive index above the level provided by nature, there is an interesting transition from a photonic pseudogap to a complete bandgap.

  10. Experimental capabilities of 0.4 PW, 1 shot/min Scarlet laser facility for high energy density science. (United States)

    Poole, P L; Willis, C; Daskalova, R L; George, K M; Feister, S; Jiang, S; Snyder, J; Marketon, J; Schumacher, D W; Akli, K U; Van Woerkom, L; Freeman, R R; Chowdhury, E A


    We report on the recently completed 400 TW upgrade to the Scarlet laser at The Ohio State University. Scarlet is a Ti:sapphire-based ultrashort pulse system that delivers >10  J in 30 fs pulses to a 2 μm full width at half-maximum focal spot, resulting in intensities exceeding 5×1021  W/cm2. The laser fires at a repetition rate of once per minute and is equipped with a suite of on-demand and on-shot diagnostics detailed here, allowing for rapid collection of experimental statistics. As part of the upgrade, the entire laser system has been redesigned to facilitate consistent, characterized high intensity data collection at high repetition rates. The design and functionality of the laser and target chambers are described along with initial data from commissioning experimental shots.

  11. Familial Mediterranean Fever (United States)

    ... fever usually begin during childhood. They occur in bouts called attacks that last one to three days. ... Mediterranean fever isn't treated. Complications can include: Abnormal protein in the blood. During attacks of familial ...

  12. Q fever - early (United States)

    ... fever is usually noticed while looking for the cause of pneumonia . ... In rare cases, Q fever causes a heart infection that can lead to ... ) Liver infection (chronic hepatitis) Lung infection ( pneumonia )

  13. Q fever in Greenland

    DEFF Research Database (Denmark)

    Koch, Anders; Svendsen, Claus Bo; Christensen, Jens Jorgen


    We report a patient with Q fever endocarditis in a settlement in eastern Greenland (Isortoq, Ammassalik area). Likely animal sources include sled dogs and seals. Q fever may be underdiagnosed in Arctic areas but may also represent an emerging infection.......We report a patient with Q fever endocarditis in a settlement in eastern Greenland (Isortoq, Ammassalik area). Likely animal sources include sled dogs and seals. Q fever may be underdiagnosed in Arctic areas but may also represent an emerging infection....

  14. Degradation and detoxification of disperse dye Scarlet RR by Galactomyces geotrichum MTCC 1360. (United States)

    Jadhav, S U; Ghodake, G S; Telke, A A; Tamboli, D P; Govindwar, S P


    Galactomyces geotrichum MTCC 1360 degraded the Scarlet RR (100 mg/l) dye within 18 h, under shaking conditions (150 rpm) in malt yeast medium. The optimum pH and the temperature for decolorization were pH 12 and 50 degrees , respectively. Enzymatic studies revealed an induction of the enzymes, including flavin reductase during the initial stage and lignin peroxidase after complete decolorization of the dye. Decolorization of the dye was induced by the addition of CaCO3 to the medium. EDTA had an inhibitory effect on the dye decolorization along with the laccase activity. The metabolites formed after complete decolorization were analyzed by UV-VIS, HPLC, and FTIR. The GC/MS identification of 3 H quinazolin-4- one, 2-ethylamino-acetamide, 1-chloro-4-nitro-benzene, N- (4-chloro-phenyl)-hydroxylamine, and 4-chloro-pheny-lamine as the final metabolites corroborated with the degradation pathway is suggested to understand the mechanism used by G.geotrichum and thereby aiding development of technologies for the application of this organism to the cleaning-up of aquatic and terrestrial environments.

  15. High phenolics Rutgers Scarlet Lettuce improves glucose metabolism in high fat diet-induced obese mice. (United States)

    Cheng, Diana M; Roopchand, Diana E; Poulev, Alexander; Kuhn, Peter; Armas, Isabel; Johnson, William D; Oren, Andrew; Ribnicky, David; Zelzion, Ehud; Bhattacharya, Debashish; Raskin, Ilya


    The ability of high phenolic Rutgers Scarlet Lettuce (RSL) to attenuate metabolic syndrome and gut dysbiosis was studied in very high fat diet (VHFD)-fed mice. Phenolic absorption was assessed in vivo and in a gastrointestinal tract model. Mice were fed VHFD, VHFD supplemented with RSL (RSL-VHFD) or store-purchased green lettuce (GL-VHFD), or low-fat diet (LFD) for 13 weeks. Compared to VHFD or GL-VHFD-fed groups, RSL-VHFD group showed significantly improved oral glucose tolerance (pphenolics chlorogenic acid, quercetin-3-glucoside, and quercetin-malonyl-glucoside were bioaccessible in the TIM-1 digestion model, but had relatively low recovery. RSL phenolics contributed to attenuation of post-prandial hyperglycemia. Changes in gut microbiota were likely due to microbiota accessible carbohydrates in RSL and GL rather than RSL phenolics, which may be metabolized, absorbed, or degraded before reaching the colon. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  16. Recurrent fever in children


    Sofia Torreggiani; Giovanni Filocamo; Susanna Esposito


    Children presenting with recurrent fever may represent a diagnostic challenge. After excluding the most common etiologies, which include the consecutive occurrence of independent uncomplicated infections, a wide range of possible causes are considered. This article summarizes infectious and noninfectious causes of recurrent fever in pediatric patients. We highlight that, when investigating recurrent fever, it is important to consider age at onset, family history, duration of febrile episodes,...

  17. Reducing Capacity, Chlorogenic Acid Content and Biological Activity in a Collection of Scarlet (Solanum aethiopicum and Gboma (S. macrocarpon Eggplants

    Directory of Open Access Journals (Sweden)

    Mariola Plazas


    Full Text Available Scarlet (Solanum aethiopicum and gboma (S. macrocarpon eggplants are important vegetables in Sub-Saharan Africa. Few studies have been made on these crops regarding the diversity of phenolic content and their biological activity. We have studied the reducing activity, the chlorogenic acid and other phenolic acid contents in a collection of 56 accessions of scarlet eggplant, including the four cultivated groups (Aculeatum, Gilo, Kumba, Shum and the weedy intermediate S. aethiopicum-S. anguivi types, as well as in eight accessions of gboma eggplant, including the cultivated S. macrocarpon and its wild ancestor, S. dasyphyllum. A sample of the accessions evaluated in this collection has been tested for inhibition of nitric oxide (NO using macrophage cell cultures. The results show that there is a great diversity in both crops for reducing activity, chlorogenic acid content and chlorogenic acid peak area (% of total phenolic acids. Heritability (H2 for these traits was intermediate to high in both crops. In all samples, chlorogenic acid was the major phenolic acid and accounted for more than 50% of the chromatogram peak area. Considerable differences were found among and within groups for these traits, but the greatest values for total phenolics and chlorogenic acid content were found in S. dasyphyllum. In most groups, reducing activity was positively correlated (with values of up to 0.904 in the Aculeatum group with chlorogenic acid content. Inhibition of NO was greatest in samples having a high chlorogenic acid content. The results show that both crops are a relevant source of chlorogenic acid and other phenolic acids. The high diversity found also indicates that there are good prospects for breeding new scarlet and gboma eggplant cultivars with improved content in phenolics and bioactive properties.

  18. A multi-platform draft de novo genome assembly and comparative analysis for the Scarlet Macaw (Ara macao.

    Directory of Open Access Journals (Sweden)

    Christopher M Seabury

    Full Text Available Data deposition to NCBI Genomes: This Whole Genome Shotgun project has been deposited at DDBJ/EMBL/GenBank under the accession AMXX00000000 (SMACv1.0, unscaffolded genome assembly. The version described in this paper is the first version (AMXX01000000. The scaffolded assembly (SMACv1.1 has been deposited at DDBJ/EMBL/GenBank under the accession AOUJ00000000, and is also the first version (AOUJ01000000. Strong biological interest in traits such as the acquisition and utilization of speech, cognitive abilities, and longevity catalyzed the utilization of two next-generation sequencing platforms to provide the first-draft de novo genome assembly for the large, new world parrot Ara macao (Scarlet Macaw. Despite the challenges associated with genome assembly for an outbred avian species, including 951,507 high-quality putative single nucleotide polymorphisms, the final genome assembly (>1.035 Gb includes more than 997 Mb of unambiguous sequence data (excluding N's. Cytogenetic analyses including ZooFISH revealed complex rearrangements associated with two scarlet macaw macrochromosomes (AMA6, AMA7, which supports the hypothesis that translocations, fusions, and intragenomic rearrangements are key factors associated with karyotype evolution among parrots. In silico annotation of the scarlet macaw genome provided robust evidence for 14,405 nuclear gene annotation models, their predicted transcripts and proteins, and a complete mitochondrial genome. Comparative analyses involving the scarlet macaw, chicken, and zebra finch genomes revealed high levels of nucleotide-based conservation as well as evidence for overall genome stability among the three highly divergent species. Application of a new whole-genome analysis of divergence involving all three species yielded prioritized candidate genes and noncoding regions for parrot traits of interest (i.e., speech, intelligence, longevity which were independently supported by the results of previous human GWAS

  19. Marburg Hemorrhagic Fever (Marburg HF) (United States)

    ... Submit Search the CDC Marburg hemorrhagic fever (Marburg HF) Note: Javascript is disabled or is not supported ... Fever (VHF) Information for Specific Groups, References... Marburg HF Outbreak Distribution Map Factsheet: Marburg Hemorrhagic Fever [PDF – ...

  20. Q Fever: Statistics and Epidemiology (United States)

    ... Other Spotted Fever Rocky Mountain Spotted Fever More Epidemiology and Statistics Recommend on Facebook Tweet Share Compartir ... in 2007. In 2008, the Q fever case definition was changed to allow for the reporting of ...

  1. Rat Bite Fever (United States)

    ... Issues Listen Español Text Size Email Print Share Rat Bite Fever Page Content Article Body Rat-bite fever is a disease that occurs in humans who have been bitten by an infected rat or, in some cases, squirrels, mice, cats, and ...

  2. African tick bite fever

    DEFF Research Database (Denmark)

    Johansen, Jakob Aaquist; Thybo, Søren


    The incident of spotted fever imported to Denmark is unknown. We present a classic case of African Tick Bite Fever (ATBF) to highlight a disease, which frequently infects wildlife enthusiasts and hunters on vacation in South Africa. ATBF has a good prognosis and is easily treated with doxycyclin...

  3. Haemoragisk Rift Valley Fever

    DEFF Research Database (Denmark)

    Fabiansen, Christian; Thybo, Søren


    A case of fatal hemorrhagic Rift Valley fever during an epidemic in Kenya's North Eastern Province in January 2007 is described.......A case of fatal hemorrhagic Rift Valley fever during an epidemic in Kenya's North Eastern Province in January 2007 is described....



    Shilpa Anand Hakki


    BACKGROUND There is an alarming increase in the incidence of fever with thrombocytopenia especially during monsoon and peri-monsoon period. Infections with protozoa, bacteria and viruses can cause thrombocytopenia with or without disseminated intravascular coagulation. Commonly, dengue, malaria, scrub typhus and other rickettsial infections, meningococci, Leptospira and certain viral infections present as fever with thrombocytopenia. Occasionally, these patients can go on to devel...

  5. Lithotrites and postoperative fever

    DEFF Research Database (Denmark)

    Chu, David I; Lipkin, Michael E; Wang, Agnes J


    OBJECTIVE: To compare the risks of fever from different lithotrites after percutaneous nephrolithotomy (PNL). MATERIALS AND METHODS: The Clinical Research Office of the Endourological Society (CROES) PNL database is a prospective, multi-institutional, international PNL registry. Of 5,803 total...... with fever [Odds Ratio (OR) 1.17, p = 0.413], while diabetes (OR 1.32, p = 0.048), positive urine culture (OR 2.08, p PNL...... fever was not significantly different among the various lithotrites used in the CROES PNL study....

  6. Travelers' Health: Yellow Fever (United States)

    ... Books, Journals, Articles & Websites Resources for the Travel Industry Yellow Book Contents Chapter 3 (83) Yellow Fever ... should be taken to avoid medications, such as aspirin or nonsteroidal anti-inflammatory drugs, which may increase ...

  7. Conventional and phenomics characterization provides insight into the diversity and relationships of hypervariable scarlet (Solanum aethiopicum L. and gboma (S. macrocarpon L. eggplant complexes

    Directory of Open Access Journals (Sweden)

    Mariola ePlazas


    Full Text Available Scarlet (Solanum aethiopicum and gboma (S. macrocarpon eggplants are major vegetable crops in sub-Saharan Africa. Together with their respective wild ancestors (S. anguivi and S. dasyphyllum and intermediate cultivated-wild forms they constitute the so-called scarlet and gboma eggplant complexes. We used conventional descriptors and the high-throughput phenomics tool Tomato Analyzer for characterizing 63 accessions of the scarlet eggplant complex, including the four S. aethiopicum cultivar groups (Aculeatum, Gilo, Kumba, and Shum, Intermediate S. aethiopicum-S. anguivi forms, and S. anguivi, and 12 cultivated and wild accessions of the gboma eggplant complex. A large diversity was found between both complexes, showing that they are very well differentiated from each other. Within the scarlet eggplant complex, many significant differences were also found among cultivar groups, but more differences were found for fruit traits evaluated with Tomato Analyzer than with conventional descriptors. In particular, Tomato Analyzer phenomics characterization was useful for distinguishing small fruited groups (Shum, Intermediate, and S. anguivi, as well as groups for which few or no significant differences were observed for plant traits. Multivariate principal components analysis (PCA separated well all groups, except the Intermediate group which plotted between S. anguivi and small fruited S. aethiopicum accessions. For the gboma eggplant complex, S. dasyphyllum was clearly distinguished from S. macrocarpon and an important diversity was found in the latter. The results have shown that both complexes are hypervariable and have provided insight into their diversity and relationships. The information obtained has important implications for the conservation and management of genetic resources as well as for the selection and breeding of both scarlet and gboma eggplants.

  8. The Fever Effect


    Milton, Damian


    In episode 4 of ‘The A word’, Jo, the young Autistic child depicted in the series has a fever, during which he shows more signs or reciprocal communication and empathy. Whilst it is mentioned in this program that there have been studies in to the ‘fever effect’, in fact there have not been in-depth scientific studies carried out on this phenomenon.

  9. [Dengue fever: clinical features]. (United States)

    Dellamonica, P


    The vector for dengue fever and chikungunya, Aedes albopictus, was recently identified in Southeastern France, although the usual vector for dengue fever is Aedes aegypti, raising the possibility of cases occurring among the local population via viraemic individuals returning from endemic areas. Dengue fever is usually transmitted by Aedes aegypti. It is due to an arbovirus-flavivirus of which four different serotypes are known: Den 1 to 4. Each serotype is responsible for specific prolonged immunity but no cross-reactivity exists between serotypes. Clinically, the onset is abrupt with frontal headache, retro-orbital pain, myalgia, joint pain, prostration and, in many cases, a macular rash usually sparing the face and extremities. Haemorrhagic signs may occur, such as petechiae, purpura, epistaxis or bleeding gingivae. Two severe forms of dengue fever, particularly among children below 3 years of age, include dengue haemorrhagic fever (DHF) and DHF with shock (dengue shock syndrome). If a case is suspected in metropolitan France, the diagnosis should be systematically confirmed by positive specific IgM, RT-PCR or viral isolation. Treatment of dengue fever, whether in its uncomplicated form or with hemorrhagic manifestations or shock, remains symptomatic. There is no specific anti-viral treatment. A case should be notified to allow French health authorities to take the appropriate measures for vector control.

  10. Philornis sp. bot fly larvae in free living scarlet macaw nestlings and a new technique for their extraction. (United States)

    Olah, George; Vigo, Gabriela; Ortiz, Lizzie; Rozsa, Lajos; Brightsmith, Donald J


    Bot fly larvae (Philornis genus) are obligate subcutaneous blood-feeding parasites of Neotropical birds including psittacines. We analyze twelve years of data on scarlet macaw (Ara macao) nestlings in natural and artificial nests in the lowland forests of southeastern Peru and report prevalence and intensity of Philornis parasitism. Bot fly prevalence was 28.9% while mean intensity was 5.0 larvae per infected chick. Prevalence in natural nests (11%, N=90 nestlings) was lower than in wooden nest-boxes (39%, N=57) and PVC boxes (39%, N=109). We describe a new technique of removing Philornis larvae using a reverse syringe design snake bite extractor. We compare this new technique to two other methods for removing bots from macaw chicks and find the new method the most suitable. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Coccinin, an antifungal peptide with antiproliferative and HIV-1 reverse transcriptase inhibitory activities from large scarlet runner beans. (United States)

    Ngai, Patrick H K; Ng, T B


    An antifungal peptide, designated coccinin, with a molecular mass of 7kDa and an N-terminal sequence resembling those of defensins, was purified from the seeds of large scarlet runner beans (Phaseolus coccineus cv. 'Major'). The peptide isolated was unadsorbed on DEAE-cellulose, and adsorbed on Affi-gel blue gel and Mono S. The peptide excerted antifungal activity on a number of fungal species including Botrytis cinerea, Coprinus comatus, Fusarium oxysporum, Mycosphaerella arachidicola, Physalospora piricola, and Rhizoctonia solani. It also inhibited proliferation in the leukemia cell lines HL60 and L1210, and reduced the activity of HIV-1 reverse transcriptase. However, it did not affect proliferation of mouse splenocytes.

  12. Phaseococcin, an antifungal protein with antiproliferative and anti-HIV-1 reverse transcriptase activities from small scarlet runner beans. (United States)

    Ngai, Patrick H K; Ng, T B


    From the seeds of small scarlet runner beans (Phaseolus coccineus 'Minor'), an antifungal protein with an N-terminal sequence homologous to those of defensins was isolated. The antifungal protein bound to Affi-gel blue gel and Mono S but it did not bind to DEAE-cellulose. It was further purified by gel filtration on a Superdex peptide column. It exhibited a molecular mass of 5422 Da as determined by mass spectrometry. The protein, designated as phaseococcin, suppressed mycelial growth in a number of fungi including Botrytis cinerea, Coprinus comatus, Fusarium oxysporum, Mycosphaerella arachidicola, Physalospora piricola, and Rhizoctonia solani. It also inhibited proliferation in several Bacillus species and the leukemia cell lines HL60 and L1210 and curtailed the activity of HIV-1 reverse transcriptase. It did not affect proliferation of mouse splenocytes and neither did it inhibit protein synthesis in a cell-free rabbit reticulocyte lysate system.

  13. A Lacanian Reading of the Two Novels The Scarlet Letter And Private Memoirs And Confessions of A Justified Sinner

    Directory of Open Access Journals (Sweden)

    Marjan Yazdanpanahi


    Full Text Available This paper discusses two novels The Private Memoirs and Confessions of a Justified Sinner and The Scarlet Letter written by James Hogg and Nathaniel Hawthorn from the perspective of Jacques Lacan theories: the mirror stage, the-name-of-the-father and desire. The mirror stage refers to historical value and an essential libidinal relationship with the body-image. The-name-of-the-father is defined as the prohibitive role of the father as the one who lays down the incest taboo in the Oedipus complex. Meanwhile, desire is neither the appetite for satisfaction, nor the demand for love, but the difference that results from the subtraction of the first from the second.

  14. Recurrent Fever in Children

    Directory of Open Access Journals (Sweden)

    Sofia Torreggiani


    Full Text Available Children presenting with recurrent fever may represent a diagnostic challenge. After excluding the most common etiologies, which include the consecutive occurrence of independent uncomplicated infections, a wide range of possible causes are considered. This article summarizes infectious and noninfectious causes of recurrent fever in pediatric patients. We highlight that, when investigating recurrent fever, it is important to consider age at onset, family history, duration of febrile episodes, length of interval between episodes, associated symptoms and response to treatment. Additionally, information regarding travel history and exposure to animals is helpful, especially with regard to infections. With the exclusion of repeated independent uncomplicated infections, many infective causes of recurrent fever are relatively rare in Western countries; therefore, clinicians should be attuned to suggestive case history data. It is important to rule out the possibility of an infectious process or a malignancy, in particular, if steroid therapy is being considered. After excluding an infectious or neoplastic etiology, immune-mediated and autoinflammatory diseases should be taken into consideration. Together with case history data, a careful physical exam during and between febrile episodes may give useful clues and guide laboratory investigations. However, despite a thorough evaluation, a recurrent fever may remain unexplained. A watchful follow-up is thus mandatory because new signs and symptoms may appear over time.

  15. Pathogenesis of Lassa Fever

    Directory of Open Access Journals (Sweden)

    David H. Walker


    Full Text Available Lassa virus, an Old World arenavirus (family Arenaviridae, is the etiological agent of Lassa fever, a severe human disease that is reported in more than 100,000 patients annually in the endemic regions of West Africa with mortality rates for hospitalized patients varying between 5-10%. Currently, there are no approved vaccines against Lassa fever for use in humans. Here, we review the published literature on the life cycle of Lassa virus with the specific focus put on Lassa fever pathogenesis in humans and relevant animal models. Advancing knowledge significantly improves our understanding of Lassa virus biology, as well as of the mechanisms that allow the virus to evade the host’s immune system. However, further investigations are required in order to design improved diagnostic tools, an effective vaccine, and therapeutic agents.

  16. Pathogenesis of Lassa fever. (United States)

    Yun, Nadezhda E; Walker, David H


    Lassa virus, an Old World arenavirus (family Arenaviridae), is the etiological agent of Lassa fever, a severe human disease that is reported in more than 100,000 patients annually in the endemic regions of West Africa with mortality rates for hospitalized patients varying between 5-10%. Currently, there are no approved vaccines against Lassa fever for use in humans. Here, we review the published literature on the life cycle of Lassa virus with the specific focus put on Lassa fever pathogenesis in humans and relevant animal models. Advancing knowledge significantly improves our understanding of Lassa virus biology, as well as of the mechanisms that allow the virus to evade the host's immune system. However, further investigations are required in order to design improved diagnostic tools, an effective vaccine, and therapeutic agents.

  17. Familial Mediterranean Fever

    Directory of Open Access Journals (Sweden)

    Adem Kucuk


    Full Text Available Familial Mediterranean Fever is an autosomal recessive inherited disease with a course of autoinflammation, which is characterized by the episodes of fever and serositis. It affects the populations from Mediterranean basin. Genetic mutation of the disease is on MEFV gene located on short arm of Chromosome 16. The disease is diagnosed based on clinical evaluation. Amyloidosis is the most important complication. The only agent that decreases the development of amyloidosis and the frequency and severity of the episodes is colchicine, which has been used for about 40 years. In this review, we aimed to discuss especially the most recent advances about Familial Mediterranean Fever which is commonly seen in our population.

  18. Hereditary periodic fever syndromes

    NARCIS (Netherlands)

    McDermott, MF; Frenkel, J

    Hereditary periodic fever syndromes are defined by recurrent attacks of generalised inflammation for which no infectious or auto-immune cause can be identified. For most of these disorders, the molecular basis has recently been elucidated. This has opened the prospect of novel therapeutic

  19. Fever of unknown origin

    NARCIS (Netherlands)

    Mulders-Manders, C.; Simon, A.; Bleeker-Rovers, C.P.


    More than 50 years after the first definition of fever of unknown origin (FUO), it still remains a diagnostic challenge. Evaluation starts with the identification of potential diagnostic clues (PDCs), which should guide further investigations. In the absence of PDCs a standardised diagnostic

  20. Breathing Valley Fever

    Centers for Disease Control (CDC) Podcasts


    Dr. Duc Vugia, chief of the Infectious Diseases Branch in the California Department of Public Health, discusses Valley Fever.  Created: 2/4/2014 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 2/5/2014.

  1. Ebola haemorrhagic fever (United States)

    Feldmann, Heinz; Geisbert, Thomas W


    Ebola viruses are the causative agents of a severe form of viral haemorrhagic fever in man, designated Ebola haemorrhagic fever, and are endemic in regions of central Africa. The exception is the species Reston Ebola virus, which has not been associated with human disease and is found in the Philippines. Ebola virus constitutes an important local public health threat in Africa, with a worldwide effect through imported infections and through the fear of misuse for biological terrorism. Ebola virus is thought to also have a detrimental effect on the great ape population in Africa. Case-fatality rates of the African species in man are as high as 90%, with no prophylaxis or treatment available. Ebola virus infections are characterised by immune suppression and a systemic inflammatory response that causes impairment of the vascular, coagulation, and immune systems, leading to multiorgan failure and shock, and thus, in some ways, resembling septic shock. PMID:21084112

  2. Scarlet Macaw (Ara macao (Psitaciformes: Psittacidae Parental Nest Visitation in Costa Rica: Implications for Research and Conservation

    Directory of Open Access Journals (Sweden)

    Christopher Vaughan


    Full Text Available We studied temporal parental visitation of Scarlet Macaws (Ara macao to six active nests in the Central Pacific Conservation Region of Costa Rica. Total parental time in the nest decreased significantly as the nestlings aged. Results provide guidelines to scientists for planning invasive activities to nestlings, such as placement of radio collars, or biological sample collection. These activities should be performed close to the end of the nesting period for minimal disturbance of parents and nestlings. Our results also provide information to aid wildlife guards in protecting active nests from poachers when chicks are close to fledging. Rev. Biol. Trop. 57 (1-2: 395-400. Epub 2009 June 30.Estudiamos las visitas temporales de padres de la lapa roja (Ara macao a seis nidos activos en el Área de Conservación del Pacifico Central (Costa Rica. El tiempo total que pasaron los padres en los nidos bajó en forma significativa en relación con el crecimiento de los pichones. Estos resultados pueden ayudar a los científicos a planear sus actividades "invasivas", tales como colocación de radio collares o colección de muestras biológicas. Las actividades deben coincidir con el final de la época de anidación para molestar menos a las aves. Nuestros resultados proveen información que puede ayudar a los guardaparques a proteger nidos activos cuando los pichones estan casi listos para salir.

  3. Ebola hemorrhagic Fever. (United States)

    Burnett, Mark W


    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.

  4. Perehdytysopas, Fashion Fever Oy


    Schwartz-Kröger, Matilda


    Tässä toiminnallisessa opinnäytetyössä keskityttiin perehdyttämisen teoriaan ja perehdyttämisoppaan kokoamiseen. Tavoitteena oli tuottaa toimiva perehdyttämisopas Porin, Vaasan, Turun ja Seinäjoen Vila-myymälöiden tarpeisiin. Toimeksiantajana toimi Fashion Fever Oy. Perehdyttämisopas oli hyvä valinta opinnäytetyön aiheeksi, koska yritys oli kasvanut sen kokoiseksi, että kaikkien toimipisteiden rutiinit oli tärkeä yhtenäistää. Sen avulla voitiin varmistaa, että kaikki aloittavat työntekijät...

  5. relapsing fever, a disappearing cause of fever and maternal death

    African Journals Online (AJOL)


    Apr 1, 2013 ... by various Borrelia spirochetes transmitted either by lice (epidemic relapsing fever) or ticks (endemic relapsing fever, caused by Borrelia Duttoni). Clinically, these spirochetes all produce an undulating febrile disease in humans, with signs and symptoms often indistinguishable from those of malaria (3,4) .

  6. Relapsing fever, a disappearing cause of fever and maternal death ...

    African Journals Online (AJOL)

    Objective: To study the incidence of tick borne relapsing fever (TBRF) during the last 50 years, once like malaria an endemic disease in Sengerema, Tanzania. Design: By analyzing the annual reports, focusing on the number of admissions, maternal deaths, blood smears of patients with fever for Borrelia.

  7. Desempenho agronômico da cenoura adubada com jitirana antes de sua semeadura Agronomic performance of carrot fertilized with scarlet starglory before sowing

    Directory of Open Access Journals (Sweden)

    Mychelle Karla Teixeira de Oliveira


    Full Text Available A jitirana é uma planta herbácea nativa que se apresenta como uma fonte potencial para adubação verde no nordeste semi-árido do Brasil e gera inúmeros benefícios, com destaque para o aumento da disponibilidade de nutrientes para as culturas. O objetivo do presente trabalho foi avaliar o desempenho agronômico da cenoura adubada com jitirana antes de sua semeadura. Um experimento foi conduzido na horta didática do Departamento de Ciências Vegetais da Universidade Federal Rural do Semi-Árido (UFERSA, Mossoró-RN, no período de setembro a dezembro de 2008. O delineamento experimental usado foi em blocos completos casualizados com os tratamentos arranjados em esquema fatorial 4 x 4 + 1, com três repetições. O primeiro fator foi constituído pelas quantidades de jitirana incorporadas ao solo (5,4; 8,8; 12,2 e 15,6 t ha-1 em base seca e o segundo fator pelos tempos de incorporação da jitirana (0; 10; 20 e 30 dias antes da semeadura da cenoura - DAS. O tratamento adicional (testemunha foi de 80 t ha-1 de esterco bovino. As características avaliadas na cenoura foram: altura das plantas, número de folhas por planta, massa seca da parte aérea, produtividade comercial, produtividade refugo e produtividade classificada. Não houve interação significativa entre os fatores quantidades de jitirana incorporadas ao solo e seus tempos de incorporação antes da semeadura da cenoura em nenhuma das características avaliadas. O melhor desempenho produtivo da cenoura foi obtido na quantidade de 15,6 t ha-1 de jitirana incorporada ao solo e no tempo de 20 dias antes de sua semeadura.The scarlet starglory is an herbaceous plant native that is presented as a potential source for green manure in the semi-arid northeast of Brazil, and generates many benefits, especially the increased availability of nutrients for crops. The objective of this present study was to evaluate the agronomic performance of carrot fertilized with scarlet starglory before

  8. Febre amarela Yellow fever

    Directory of Open Access Journals (Sweden)

    Pedro Fernando da Costa Vasconcelos


    Full Text Available A febre amarela é doenca infecciosa não-contagiosa causada por um arbovírus mantido em ciclos silvestres em que macacos atuam como hospedeiros amplificadores e mosquitos dos gêneros Aedes na África, e Haemagogus e Sabethes na América, são os transmissores. Cerca de 90% dos casos da doença apresentam-se com formas clínicas benignas que evoluem para a cura, enquanto 10% desenvolvem quadros dramáticos com mortalidade em torno de 50%. O problema mostra-se mais grave em África onde ainda há casos urbanos. Nas Américas, no período de 1970-2001, descreveram-se 4.543 casos. Os países que mais diagnosticaram a doença foram o Peru (51,5%, a Bolívia (20,1% e o Brasil (18,7%. Os métodos diagnósticos utilizados incluem a sorologia (IgM, isolamento viral, imunohistoquímica e RT-PCR. A zoonose não pode ser erradicada, mas, a doença humana é prevenível mediante a vacinação com a amostra 17D do vírus amarílico. A OMS recomenda nova vacinação a cada 10 anos. Neste artigo são revistos os principais conceitos da doença e os casos de mortes associados à vacina.Yellow fever is an infectious and non-contagious disease caused by an arbovirus, the yellow fever virus. The agent is maintained in jungle cycles among primates as vertebrate hosts and mosquitoes, especially Aedes in Africa, and Haemagogus and Sabethes in America. Approximately 90% of the infections are mild or asymptomatic, while 10% course to a severe clinical picture with 50% case-fatality rate. Yellow fever is largely distributed in Africa where urban epidemics are still reported. In South America, between 1970-2001, 4,543 cases were reported, mostly from Peru (51.5%, Bolivia (20.1% and Brazil (18.7%. The disease is diagnosed by serology (detection of IgM, virus isolation, immunohistochemistry and RT-PCR. Yellow fever is a zoonosis and cannot be eradicated, but it is preventable in man by using the 17D vaccine. A single dose is enough to protect an individual for at least

  9. Q fever: the Dutch policy

    NARCIS (Netherlands)

    Bruschke, C. J. M.; Roest, H. I. J.; Coutinho, R. A.


    Between 2007 and 2010, the Netherlands experienced an unprecedented outbreak of Q fever of more than 4000 human cases. Q fever infections of dairy goats, leading to abortion waves, were considered to be the cause of this outbreak. Measures to combat the outbreak had to be taken based on limited

  10. Q fever: The Dutch Policy

    NARCIS (Netherlands)

    Bruschke, C.J.M.; Roest, H.I.J.; Coutinho, R.A.


    Between 2007 and 2010, the Netherlands experienced an unprecedented outbreak of Q fever of more than 4000 human cases. Q fever infections of dairy goats, leading to abortion waves, were considered to be the cause of this outbreak. Measures to combat the outbreak had to be taken based on limited

  11. Borrelia hispanica Relapsing Fever, Morocco (United States)

    Sarih, M’hammed; Garnier, Martine; Boudebouch, Najma; Bouattour, Ali; Rihani, Abdelaziz; Hassar, Mohammed; Gern, Lise; Postic, Danièle


    We found that 20.5% of patients with an unexplained fever in northwestern Morocco had tick-borne relapsing fever. Molecular detection specific for the 16S rRNA gene identified Borrelia hispanica. The noncoding intergenic spacer sequence domain showed high sensitivity and good resolution for this species. PMID:19861058

  12. ETIOLOGY OF YELLOW FEVER (United States)

    Noguchi, Hideyo


    Analysis of the records of instances in which non-immune persons contracted yellow fever notwithstanding vaccination shows that the onset of disease occurs soon after vaccination, the longest period being 13 days. Since the average incubation period in yellow fever is 6 days, it seems that infection must have taken place in some instances during the period while protection was developing. These instances led to a study of the possibility of immediate protection by means of the anti-icteroides serum. It had already been shown that the immune serum protects at once against experimental Leptospira icteroides infection, but it remained to determine how long the protection would last. Guinea pigs were given different quantities of the immune serum and subsequently injected, at various intervals, with a virulent strain of Leptospira icteroides. Complete protection enduring 5 days was obtained with as minute a quantity of serum as 0.002 cc. per 1,000 gm. of body weight. After 5 days, however, the immune substance rapidly diminished, and to keep the animal protected for as long as 10 days it was necessary to give 100 times as much, or 0.2 cc. For a man weighing 80 kilos, 0.16 cc. (0.002 x 80) would theoretically be sufficient to protect for at least 5 days, 1.6 cc. for 7 days, and 16 cc. for 10 days. This temporary protection may be a valuable antecedent to that furnished by vaccination, since the final effect of the latter cannot be expected until at least 9 to 10 days have passed. PMID:19868677

  13. Rhombencephalitis associated with Dengue fever. (United States)

    Verma, Rajesh; Bharti, Kavita; Mehta, Mannan; Bansod, Amrit


    Dengue infection is gradually disseminating throughout the world in alarming proportions. It is a arbovirus infection,transmitted by aedes mosquitoes. It is a multi-systemic disorder associated with varied neurological complications. There is increased trend of development of neurological complications in dengue fever. The neurological complications arising due to dengue infection can be categorized into central and neuromuscular complications. The central nervous system disorders reported with dengue fever are encephalopathy,encephalitis and myelitis.Here we report a case of rhombencephalitis associated with dengue fever. The literature does not mention rhombencephalitis occurring with dengue illness. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Laboratory Diagnosis of Lassa Fever. (United States)

    Raabe, Vanessa; Koehler, Jeffrey


    Lassa virus remains an important cause of illness in West Africa and among the travelers returning from this region with an acute febrile illness. The symptoms of Lassa fever can be nonspecific and mimic those of other endemic infections, especially early in illness, making a clinical diagnosis difficult; therefore, laboratory testing is needed to confirm the diagnosis. An early identification of Lassa fever is crucial for maximizing the benefit of available antiviral therapy, as treatment efficacy rapidly decreases following the clinical onset of the disease. This minireview provides an overview of the currently available diagnostic tests for Lassa fever and their strengths and weaknesses. Copyright © 2017 American Society for Microbiology.

  15. Fever in Infants and Children (United States)

    ... quickly lead to dehydration. Give your child an oral rehydration solution to prevent it. For the fever, give ... doctor or take your child to the emergency room right away.Start OverDiagnosisThese may be symptoms of ...

  16. Discriminating fever behavior in house flies.

    Directory of Open Access Journals (Sweden)

    Robert D Anderson

    Full Text Available Fever has generally been shown to benefit infected hosts. However, fever temperatures also carry costs. While endotherms are able to limit fever costs physiologically, the means by which behavioral thermoregulators constrain these costs are less understood. Here we investigated the behavioral fever response of house flies (Musca domestica L. challenged with different doses of the fungal entomopathogen, Beauveria bassiana. Infected flies invoked a behavioral fever selecting the hottest temperature early in the day and then moving to cooler temperatures as the day progressed. In addition, flies infected with a higher dose of fungus exhibited more intense fever responses. These variable patterns of fever are consistent with the observation that higher fever temperatures had greater impact on fungal growth. The results demonstrate the capacity of insects to modulate the degree and duration of the fever response depending on the severity of the pathogen challenge and in so doing, balance the costs and benefits of fever.

  17. Experimental therapies for yellow fever


    Julander, Justin G.


    A number of viruses in the family Flaviviridae are the focus of efforts to develop effective antiviral therapies. Success has been achieved with inhibitors for the treatment of hepatitis C, and there is interest in clinical trials of drugs against dengue fever. Antiviral therapies have also been evaluated in patients with Japanese encephalitis and West Nile encephalitis. However, no treatment has been developed against the prototype flavivirus, yellow fever virus (YFV). Despite the availabili...

  18. Crimean-Congo hemorrhagic fever


    Ergonul, O.


    Crimean Congo hemorrhagic fever virus (CCHFV) is a geographically widespread pathogen that causes severe hemorrhagic fever with high mortality. Although it is primarily zoonosis, sporadic cases and outbreaks of CCHF affecting humans do occur. The disease is endemic in many countries in Africa, Europe and Asia, and during 2002-2006, is has been reported in Turkey. People become infected through tick bites (especially Hyalomma spp.), by crushing infected ticks, after contact with a patient with...

  19. Treatment of dengue fever

    Directory of Open Access Journals (Sweden)

    Rajapakse S


    Full Text Available Senaka Rajapakse,1,2 Chaturaka Rodrigo,1 Anoja Rajapakse31Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka; 2Lincoln County Hospital, United Lincolnshire NHS Trust, Lincoln, UK; 3Kings Mill Hospital, Sherwood Forest NHS Foundation Trust, Mansfield, UKAbstract: The endemic area for dengue fever extends over 60 countries, and approximately 2.5 billion people are at risk of infection. The incidence of dengue has multiplied many times over the last five decades at an alarming rate. In the endemic areas, waves of infection occur in epidemics, with thousands of individuals affected, creating a huge burden on the limited resources of a country's health care system. While the illness passes off as a simple febrile episode in many, a few have a severe illness marked by hypovolemic shock and bleeding. Iatrogenic fluid overload in the management may further complicate the picture. In this severe form dengue can be fatal. Tackling the burden of dengue is impeded by several issues, including a lack of understanding about the exact pathophysiology of the infection, inability to successfully control the vector population, lack of specific therapy against the virus, and the technical difficulties in developing a vaccine. This review provides an overview on the epidemiology, natural history, management strategies, and future directions for research on dengue, including the potential for development of a vaccine.Keywords: dengue, treatment, fluid resuscitation

  20. [Ebola and Marburg fever--outbreaks of viral haemorrhagic fever]. (United States)

    Chlíbek, R; Smetana, J; Vacková, M


    With an increasing frequency of traveling and tourism to exotic countries, a new threat-import of rare, very dangerous infections-emerges in humane medicine. Ebola fever and Marburg fever, whose agents come from the same group of Filoviridae family, belong among these diseases. The natural reservoir of these viruses has not yet been precisely determined. The pathogenesis of the diseases is not absolutely clear, there is neither a possibility of vaccination, nor an effective treatment. Fever and haemorrhagic diathesis belong to the basic symptoms of the diseases. Most of the infected persons die, the death rate is 70-88 %. The history of Ebola fever is relatively short-30 years, Marburg fever is known almost 40 years. Hundreds of people have died of these diseases so far. The study involves epidemics recorded in the world and their epidemiological relations. Not a single case has been recorded in the Czech Republic, nevertheless a sick traveler or infected animals are the highest risk of import these diseases. In our conditions, the medical staff belong to a highly endangered group of people because of stringent isolation of patients, strict rules of barrier treatment regime and high infectivity of the diseases. For this reason, the public should be prepared for possible contact with these highly virulent infections.

  1. 17DD yellow fever vaccine (United States)

    Martins, Reinaldo M.; Maia, Maria de Lourdes S.; Farias, Roberto Henrique G.; Camacho, Luiz Antonio B.; Freire, Marcos S.; Galler, Ricardo; Yamamura, Anna Maya Yoshida; Almeida, Luiz Fernando C.; Lima, Sheila Maria B.; Nogueira, Rita Maria R.; Sá, Gloria Regina S.; Hokama, Darcy A.; de Carvalho, Ricardo; Freire, Ricardo Aguiar V.; Filho, Edson Pereira; Leal, Maria da Luz Fernandes; Homma, Akira


    Objective: To verify if the Bio-Manguinhos 17DD yellow fever vaccine (17DD-YFV) used in lower doses is as immunogenic and safe as the current formulation. Results: Doses from 27,476 IU to 587 IU induced similar seroconversion rates and neutralizing antibodies geometric mean titers (GMTs). Immunity of those who seroconverted to YF was maintained for 10 mo. Reactogenicity was low for all groups. Methods: Young and healthy adult males (n = 900) were recruited and randomized into 6 groups, to receive de-escalating doses of 17DD-YFV, from 27,476 IU to 31 IU. Blood samples were collected before vaccination (for neutralization tests to yellow fever, serology for dengue and clinical chemistry), 3 to 7 d after vaccination (for viremia and clinical chemistry) and 30 d after vaccination (for new yellow fever serology and clinical chemistry). Adverse events diaries were filled out by volunteers during 10 d after vaccination. Volunteers were retested for yellow fever and dengue antibodies 10 mo later. Seropositivity for dengue was found in 87.6% of volunteers before vaccination, but this had no significant influence on conclusions. Conclusion: In young healthy adults Bio-Manguinhos/Fiocruz yellow fever vaccine can be used in much lower doses than usual. International Register ISRCTN 38082350. PMID:23364472

  2. Managing Rocky Mountain spotted fever. (United States)

    Minniear, Timothy D; Buckingham, Steven C


    Rocky Mountain spotted fever is caused by the tick-borne bacterium Rickettsia rickettsii. Symptoms range from moderate illness to severe illness, including cardiovascular compromise, coma and death. The disease is prevalent in most of the USA, especially during warmer months. The trademark presentation is fever and rash with a history of tick bite, although tick exposure is unappreciated in over a third of cases. Other signature symptoms include headache and abdominal pain. The antibiotic therapy of choice for R. rickettsii infection is doxycycline. Preventive measures for Rocky Mountain spotted fever and other tick-borne diseases include: wearing long-sleeved, light colored clothing; checking for tick attachment and removing attached ticks promptly; applying topical insect repellent; and treating clothing with permethrin.

  3. Fever of unknown origin: subacute thyroiditis versus typhoid fever. (United States)

    Cunha, Burke A; Thermidor, Marjorie; Mohan, Sowjanya; Valsamis, Ageliki S; Johnson, Diane H


    Fever of unknown origin (FUO) is not infrequently a diagnostic dilemma for clinicians. Common infectious causes include endocarditis and abscesses in adults, and noninfectious causes include neoplasms and certain collagen vascular diseases, for example, polymyalgia rheumatica, various vasculitides, and juvenile rheumatoid arthritis (adult Still's disease). Subacute thyroiditis is a rare cause of FUO. Among the infectious causes of FUO, typhoid fever is relatively uncommon. We present a case of FUO in a traveler returning from India whose initial complaints were that of left-sided neck pain and angle of the jaw pain, which initially suggested the diagnosis of subacute thyroiditis. After an extensive FUO workup, when typhoid fever is a likely diagnostic possibility, an empiric trial of anti- Salmonella therapy has diagnostic and therapeutic significance. The presence of relative bradycardia, and response to quinolone therapy, was the basis of the clinical diagnosis of typhoid fever as the explanation for this patients FUO. This case illustrates the diagnostic difficulties in assessing patients with FUO with few diagnostic findings.

  4. relapsing fever, a disappearing cause of fever and maternal death

    African Journals Online (AJOL)


    Apr 1, 2013 ... labor, puerperal sepsis, post-partum haemorrhage, complications of abortion, and pre-eclampsia. There were few reports of abortions and abortion-related mortality. Relapsing fever or Borrelia infection was an indirect cause of death common to the region and particularly hazardous to pregnant women and ...

  5. Overview of Classical Swine Fever (Hog Cholera, Classical Swine fever) (United States)

    Classical swine fever is a contagious often fatal disease of pigs clinically characterized by high body temperature, lethargy, yellowish diarrhea, vomits and purple skin discoloration of ears, lower abdomen and legs. It was first described in the early 19th century in the USA. Later, a condition i...

  6. What about My Child and Rheumatic Fever? (United States)

    ... occur after a streptococcal infection of the throat (“strep throat”). Most strep throat infections don’t lead to rheumatic fever. When they do, the time between the strep throat and rheumatic fever is about two to four ...

  7. Typhoid fever: the experience of last decade


    A. N. Kovalenko; A. M. Ivanov; N. S. Odynaev; M. I. Rachmanov; A. A. Murachev


    This article is about analyses of diagnostics and treatment of the modern typhoid fever. In the past typhoid fever was critical and lifethreatening inflectional disease. But nowadays thanks to using of chloramphenicol and other antimicrobial preparations, typhoid fever is serious but well curable disease. In the second part of the 20th century the number of typhoid fever cases has decreased. As a result a new generation of physicians, who has never come across this disease, appeared. Nowadays...

  8. Abdominal Disturbances Among Dengue Fever Patients


    Harahap, Arnold Hasahatan; Simadibrata, Marcellus; Makmun, Dadang; Hasan, Irsan


    Background: Abdominal disturbances are common symptoms found in approximately 40% of patients with dengue fever, which frequently cause significant morbidity. This study was developed as an attempt to understand the effect of plasma leakage in dengue hemorrhagic fever; particularly on ab dominal problems. Method: The study was conducted in hospitalized patients who were diagnosed with dengue fever and dengue hemorrhagic fever (based on the 1997 WHO criteria for DHF) at Fatmawati hospital, Ja...

  9. Mothers' Perception of Fever Management in Children

    African Journals Online (AJOL)

    Alasia Datonye

    Results: A total of 151 mothers participated with age range 19 years to 54 years with mean of 31.4±5.7SD. One hundred and thirteen (74.8%) defined fever as hotness of the body. Commonest associated symptom with fever was loss of appetite (71.5%). Commonest identified cause of fever was malaria (71 (47%) mothers).

  10. Yellow Fever Outbreak, Southern Sudan, 2003 (United States)

    Onyango, Clayton O.; Grobbelaar, Antoinette A.; Gibson, Georgina V.F.; Sang, Rosemary C.; Sow, Abdourahmane; Swanepoel, Robert


    In May 2003, an outbreak of fatal hemorrhagic fever, caused by yellow fever virus, occurred in southern Sudan. Phylogenetic analysis showed that the virus belonged to the East African genotype, which supports the contention that yellow fever is endemic in East Africa with the potential to cause large outbreaks in humans. PMID:15498174

  11. First Outbreak of Dengue Hemorrhagic Fever, Bangladesh


    Rahman, Mahbubur; Rahman, Khalilur; Siddque, A. K.; Shoma, Shereen; Kamal, A.H.M.; Ali, K.S.; Nisaluk, Ananda; Robert F Breiman


    During the first countrywide outbreak of dengue hemorrhagic fever in Bangladesh, we conducted surveillance for dengue at a hospital in Dhaka. Of 176 patients, primarily adults, found positive for dengue, 60.2% had dengue fever, 39.2% dengue hemorrhagic fever, and 0.6% dengue shock syndrome. The Dengue virus 3 serotype was detected in eight patients.

  12. Fever, sore throat and myalgia

    African Journals Online (AJOL)

    a continual significant fever daily. Shotty cervical lymphadenopathy was noted. The relevant laboratory investigations are shown in Table 1. On admission to tertiary care, an aetiological differential diagnosis for the pyrexia of unknown origin (PUO)[1] (Table 2) included retropharyngeal abscess, Lemierre's syndrome, HIV ...

  13. Haemorrhagic fevers and ecological perturbations. (United States)

    Le Guenno, B


    Hemorrhagic fever is a clinical and imprecise definition for several different diseases. Their main common point is to be zoonoses. These diseases are due to several viruses which belong to different families. The Flaviviridae have been known for the longest time. They include the Amaril virus that causes yellow fever and is transported by mosquitoes. Viruses that have come to light more recently belong to three other families: Arenaviridae, Bunyaviridae, and Filoviridae. They are transmitted by rodents (hantaviruses and arenaviruses) or from unknown reservoirs (Ebola Marburg). The primary cause of most outbreaks of hemorrhagic fever viruses is ecological disruption resulting from human activities. The expansion of the world population perturbs ecosystems that were stable a few decades ago and facilitates contacts with animals carrying viruses pathogenic to humans. Another dangerous human activity is the development of hospitals with poor medical hygiene. Lassa, Crimean-Congo or Ebola outbreaks are mainly nosocomial. There are also natural environmental changes: the emergence of Sin Nombre in the U.S. resulted from heavier than usual rain and snow during spring 1993 in the Four Corners. Biological industries also present risks. In 1967, collection of organs from monkeys allowed the discovery in Marburg of a new family of viruses, the Filoviridae. Hemorrhagic fever viruses are cause for worry, and the avenues to reduce their toll are still limited.

  14. Sandfly Fever Sicilian Virus, Algeria (United States)

    Izri, Arezki; Temmam, Sarah; Moureau, Grégory; Hamrioui, Boussad; de Lamballerie, Xavier


    To determine whether sandfly fever Sicilian virus (SFSV) is present in Algeria, we tested sandflies for phlebovirus RNA. A sequence closely related to that of SFSV was detected in a Phlebotomus ariasi sandfly. Of 60 human serum samples, 3 contained immunoglobulin G against SFSV. These data suggest SFSV is present in Algeria. PMID:18439364

  15. Diarrhea associated with typhoid fever

    NARCIS (Netherlands)

    Roy, S. K.; Speelman, P.; Butler, T.; Nath, S.; Rahman, H.; Stoll, B. J.


    To study the pathogenesis of diarrhea occurring with typhoid fever, we selected 42 patients with diarrhea and blood cultures positive for Salmonella typhi or Salmonella paratyphi A, but without diarrheal copathogens, for measurement of stool output and examination of fecal composition. The mean

  16. Behavioral fever in newborn rabbits (United States)

    Satinoff, E.; Mcewen, G. N., Jr.; Williams, B. A.


    New Zealand white rabbit pups aged 12 to 72 hr were divided into three groups and given an intraperitoneal injection of Pseudomonas polysaccharide, a saline vehicle alone, and no treatment, respectively. The animals injected with pyrogen and maintained at an ambient temperature of 32 C for 2 hr did not develop fever. When placed in a thermally graded alleyway, the animals injected with pyrogen selected gradient positions that represented significantly higher temperatures than controls injected with saline. Further stay at selected positions for 5 min caused a considerable increase in the rectal temperature of the pyrogen-injected pups but not that of controls. The results support the hypothesis that newborn rabbits will develop a fever by behavioral means after a single injection of an exogenous pyrogen if the opportunity for thermoregulatory behavior is present. No fever develops if the pups must rely solely on internal thermoregulatory mechanisms. The behavioral system for producing a fever is mature at birth, but an adequate system of internal reflexes does not appear to develop for some days.


    Davis, Nelson C.


    1. Saimiri sciureus has been infected with yellow fever virus, both by the inoculation of infectious blood and by the bites of infective mosquitoes. Some of the monkeys have died, showing lesions, including hepatic necrosis, suggesting yellow fever as seen in human beings and in rhesus monkeys. Virus has been transferred back to M. rhesus from infected Saimiri both by blood inoculation and by mosquito bites. The virus undoubtedly has been maintained through four direct passages in Saimiri. Reinoculations of infectious material into recovered monkeys have not given rise to invasion of the blood stream by virus. Sera from recovered animals have protected M. rhesus against the inoculation of virus. 2. It has been possible to pass the virus to and from Ateleus ater by the injection of blood or liver and by the bites of mosquitoes. The livers from two infected animals have shown no necrosis. The serum from one recovered monkey proved to be protective for M. rhesus. 3. Only three out of twelve Lagothrix lagotricha have reacted to yellow fever virus by a rise in temperature. Probably none have died as a result of the infection. In only one instance has the virus been transferred back to M. rhesus. The sera of recovered animals have had a protective action against yellow fever virus. PMID:19869721

  18. Rheumatic fever prophylaxis: Gisborne experience. (United States)

    Frankish, J D


    There were 300 admissions to the Cook Hospital with rheumatic fever in 1958-83. During 1958-73 oral penicillin was used for secondary prophylaxis and 77 (35%) of 223 admissions were recurrences. From 1974-83 when parenteral benzathine penicillin was increasingly used there were 77 admissions of which 14 (18%) were readmissions. An effective programme of secondary prophylaxis using benzathine penicillin and co-ordination of hospital and community health services is outlined. One hundred and eight patients with a first attack of rheumatic fever were seen in 1968-82. The chance of a recurrence in patients in whom oral prophylaxis was instituted was 15% two years after the initial attack and 35% after six years. Institution of parenteral prophylaxis significantly reduced the risk of recurrence (p = 0.0009) which was 2% six years after the first attack.

  19. Yellow Fever: A Reemerging Threat (United States)

    Gardner, Christina L.; Ryman, Kate D.


    Yellow fever (YF) is a viral disease, endemic to tropical regions of Africa and the Americas. YF principally affects humans and nonhuman primates, and is transmitted via the bite of infected mosquitoes. The agent of YF, yellow fever virus (YFV), can cause devastating epidemics of potentially fatal, hemorrhagic disease. We rely on mass vaccination campaigns to prevent and control these outbreaks. However, the risk of major YF epidemics, especially in densely populated, poor urban settings, both in Africa and South America, has greatly increased due to: (1) reinvasion of urban settings by the mosquito vector of YF, Aedes aegypti; (2) rapid urbanization, particularly in parts of Africa, with populations shifting from rural to predominantly urban; and (3) waning immunization coverage. Consequently, YF is considered an emerging, or reemerging disease of considerable importance. PMID:20513550

  20. Imported chikungunya fever in Madrid. (United States)

    Richi Alberti, Patricia; Steiner, Martina; Illera Martín, Óscar; Alcocer Amores, Patricia; Cobo Ibáñez, Tatiana; Muñoz Fernández, Santiago


    Chikungunya Fever is a mosquito-transmitted viral disease that causes fever, rash and musculoskeletal complaints. The latest may persist for several months, or even years or developed a relapsing course, that deserve an adequate treatment. Due to the large outbreak declared in the Caribbean in 2013, imported cases of Chikungunya as well as the risk of autochthonous transmission in case of available vectors have increased in non-endemic countries, like Spain. We described four cases of Chikungunya treated in our clinic. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  1. Dengue fever complicated by hemophagocytosis


    Koshy, Maria; Mishra, Ajay Kumar; Agrawal, Bhumi; Kurup, Akhil Rajendra; Hansdak, Samuel George


    Dengue is a common acute viral febrile illness in the tropics. Although the usual presentation is that of a self-limiting illness, its complications are protean. We report a 29-year-old man who presented with an acute febrile illness and was diagnosed with dengue hemorrhagic fever. Despite appropriate supportive therapy, the patient initially improved, but subsequently had clinical deterioration. Evaluation revealed features of hemophagocytic lymphohistiocytosis. He was successfully treated w...

  2. [Crimean-Congo hemorrhagic fever]. (United States)

    Saijo, Masayuki; Moriikawa, Shigeru; Kurane, Ichiro


    Crimean-Congo hemorrhagic fever (CCHF) is an acute infectious disease caused by CCHF virus (CCHFV), a member of the family Bunyaviridae, genus Nairovirus. The case fatality rate of CCHF ranges from 10-40%. Because CCHF is not present in Japan, many Japanese virologists and clinicians are not very familiar with this disease. However, there remains the possibility of an introduction of CCHFV or other hemorrhagic fever viruses into Japan from surrounding endemic areas. Development of diagnostic laboratory capacity for viral hemorrhagic fevers is necessary even in countries without these diseases. At the National Institute of Infectious Diseases, Tokyo, Japan, laboratory-based systems such as recombinant protein-based antibody detection, antigen-capture and pathological examination have been developed. In this review article, epidemiologic and clinical data on CCHF in the Xinjiang Uygur Autonomous Region, compiled through field investigations and diagnostic testing utilizing the aforementioned laboratory systems, are presented. CCHFV infections are closely associated with the environmental conditions, life styles, religion, occupation, and human economic activities. Based on these data, preventive measures for CCHFV infections are also discussed.

  3. Azathioprine-induced fever in autoimmune hepatitis (United States)

    Khoury, Tawfik; Ollech, Jacob E; Chen, Shmuel; Mizrahi, Meir; Shalit, Meir


    Underdiagnosis of drug-induced fever leads to extensive investigation and prolongation of hospitalization, and may lead to multiple unnecessary invasive procedures and a wrong diagnosis. Azathioprine is a widely used immunosuppressive drug. We report a case of a 53-year-old female patient diagnosed with autoimmune hepatitis treated with azathioprine, who presented to the emergency room with a 6-wk history of fever and chills without other associated symptoms. Since the patient’s fever was of unknown origin, she was hospitalized. All treatment was stopped and an extensive workup to explore the source of fever and chills was performed. Results of chest X-ray, viral, urine, and blood cultures, autoimmune serology, transthoracic and transesophageal echocardiography, and abdominal ultrasound revealed no source of infection. A rechallenge test of azathioprine was performed and the fever and chills returned within a few hours. Azathioprine was established as the definite cause following rechallenge. Fever as an adverse drug reaction is often unrecognized. Azathioprine has been reported to cause drug-induced fever in patients with inflammatory bowel disease, rheumatoid arthritis, and sarcoidosis. To the best of our knowledge there have been no previous reports documenting azathioprine-induced fever in patients with autoimmune hepatitis. The occurrence of fever following the readministration of azathioprine suggests the diagnosis of drug-induced fever, particularly after the exclusion of other causes. A careful rechallenge is recommended to confirm the diagnosis. PMID:23840156

  4. Fever and signs of shock: the essential dangerous fever. (United States)

    Reifel Saltzberg, Jennifer M


    A common cause of fever with signs of shock is sepsis. Sepsis describes the spectrum of illness caused by severe infection. The incidence of sepsis is increasing and mortality can be high. Diagnosing the disease and implementing treatment early can decrease mortality. Early treatment includes empirical antibiotics and resuscitation. The diverse physiology present in sepsis can make the resuscitation complex; many different types of hemodynamic monitoring may be necessary. Even with this complexity, an organized approach can improve patient outcomes. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. NNDSS - Table II. Salmonellosis (excluding typhoid fever and paratyphoid fever) to Shigellosis (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Salmonellosis (excluding typhoid fever and paratyphoid fever) to Shigellosis - 2018. In this Table, provisional cases of selected notifiable...

  6. Hepatic involvement in dengue Fever in children

    National Research Council Canada - National Science Library

    Jagadishkumar, Kalenahalli; Jain, Puja; Manjunath, Vaddambal G; Umesh, Lingappa


    .... 110 children with serologically positive dengue fever aged between 2 months - 14 years were studied for their hepatic functions both clinically and biochemically after excluding malaria, enteric...

  7. Describing the Breakbone Fever: IDODEN, an Ontology for Dengue Fever (United States)

    Mitraka, Elvira; Topalis, Pantelis; Dritsou, Vicky; Dialynas, Emmanuel; Louis, Christos


    Background Ontologies represent powerful tools in information technology because they enhance interoperability and facilitate, among other things, the construction of optimized search engines. To address the need to expand the toolbox available for the control and prevention of vector-borne diseases we embarked on the construction of specific ontologies. We present here IDODEN, an ontology that describes dengue fever, one of the globally most important diseases that are transmitted by mosquitoes. Methodology/Principal Findings We constructed IDODEN using open source software, and modeled it on IDOMAL, the malaria ontology developed previously. IDODEN covers all aspects of dengue fever, such as disease biology, epidemiology and clinical features. Moreover, it covers all facets of dengue entomology. IDODEN, which is freely available, can now be used for the annotation of dengue-related data and, in addition to its use for modeling, it can be utilized for the construction of other dedicated IT tools such as decision support systems. Conclusions/Significance The availability of the dengue ontology will enable databases hosting dengue-associated data and decision-support systems for that disease to perform most efficiently and to link their own data to those stored in other independent repositories, in an architecture- and software-independent manner. PMID:25646954

  8. Fever-Induced Brugada Syndrome

    Directory of Open Access Journals (Sweden)

    Sandhya Manohar MD


    Full Text Available Brugada syndrome is increasingly recognized as a cause of sudden cardiac death. Many of these patients do not get diagnosed due its dynamic and often hidden nature. We have come a long way in understanding the disease process, and its electrophysiology appears to be intimately linked with sodium channel mutations or disorders. The cardiac rhythm in these patients can deteriorate into fatal ventricular arrhythmias. This makes it important for the clinician to be aware of the conditions in which arrhythmogenicity of Brugada syndrome is revealed or even potentiated. We present such an instance where our patient’s Brugada syndrome was unmasked by fever.

  9. Dengue fever complicated by hemophagocytosis (United States)

    Koshy, Maria; Mishra, Ajay Kumar; Agrawal, Bhumi; Kurup, Akhil Rajendra; Hansdak, Samuel George


    Dengue is a common acute viral febrile illness in the tropics. Although the usual presentation is that of a self-limiting illness, its complications are protean. We report a 29-year-old man who presented with an acute febrile illness and was diagnosed with dengue hemorrhagic fever. Despite appropriate supportive therapy, the patient initially improved, but subsequently had clinical deterioration. Evaluation revealed features of hemophagocytic lymphohistiocytosis. He was successfully treated with glucocorticoids and had an uneventful recovery. This case adds to the limited adult cases of virus-associated hemophagocytic syndrome in the literature and the need for prompt recognition and treatment of this rare complication. PMID:27274854

  10. [Myocarditis in severe typhoid fever]. (United States)

    Bobin, A N; Antukh, E A; Parkhomenko, Iu G; Makanin, M A


    The article explains the development of toxic infective myocarditis and, in many cases, pancarditis, in patients with severe typhoid fever (TF) with lethal outcome. The authors present the most frequently found symptoms and ECG signs, the main histological features and possibilities of clinical diagnostics of myocarditis. The latter is of special importance, because a significant number of patients do not have typical clinical presentation. The work is based on the data from 109 autopsy records and 42 case histories as well as the results of morphological study of the heart in archive samples received from 47 military men who died of TF.

  11. Fever During Pregnancy Tied to Autism in Study (United States)

    ... study cannot prove that a fever during pregnancy causes autism, only that there appears to be an association. ... it's the fever that's predisposing the baby to autism or the cause of the fever or the body's immune response ...

  12. Pancreatic disturbances and typhoid fever. (United States)

    Hermans, P; Gerard, M; van Laethem, Y; de Wit, S; Clumeck, N


    During an 8-year period, 14 adult patients were hospitalized with typhoid fever confirmed by positive blood cultures for Salmonella typhi. Among these patients, we have retrospectively (n = 7) and prospectively (n = 7) evaluated pancreatic disturbance by serum amylase and lipase measurements at the time of admission. In 7 (50%) biological signs of pancreatitis were noted: mean amylase level 81 IU (range 30-201 IU, normal value less than 40 IU), mean lipase level 949 IU (range 468-2,000 IU, normal value less than 300 IU). Clinical signs of pancreatitis were observed in 4 cases, one of whom had a concomitant salmonella biliary tract infection and gall stones demonstrated by laparotomy and the others a normal biliary ultrasonographic examination with a swelling of the pancreas. No alcohol or drug use or other infection were noted before admission. This study suggests that biological or clinical pancreatitis should be considered as a frequent complication of typhoid fever. S. typhi should therefore be added to the list of pathogens implicated in the pathogenesis of non-alcoholic or non-lithiasic pancreatitis.

  13. Leptospirosis presenting as honeymoon fever. (United States)

    de Sainte Marie, B; Delord, M; Dubourg, G; Gautret, P; Parola, P; Brouqui, P; Lagier, J C


    An increasing number of travelers from western countries visit tropical regions, questioning western physicians on the prophylaxis, the diagnosis and the therapeutic management of patients with travel-associated infection. In July 2014, a French couple stayed for an adventure-travel in Columbia without malaria prophylaxis. A week after their return the woman presented with fever, myalgia, and retro-orbital pain. Three days later, her husband presented similar symptoms. In both patients, testing for malaria, arboviruses and blood cultures remained negative. An empirical treatment with doxycycline and ceftriaxone was initiated for both patients. Serum collected from the female patient yielded positive IgM for leptospirosis but was negative for her husband. Positive Real-Time PCR were observed in blood and urine from both patients, confirming leptospirosis. Three lessons are noteworthy from this case report. First, after exclusion of malaria, as enteric fever, leptospirosis and rickettsial infection are the most prevalent travel-associated infections, empirical treatment with doxycycline and third generation cephalosporin should be considered. In addition, the diagnosis of leptospirosis requires both serology and PCR performed in both urine and blood samples. Finally, prophylaxis using doxycycline, also effective against leptospirosis, rickettsial infections or travellers' diarrhea should be recommended for adventure travelers in malaria endemic areas. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. Educational Fever and South Korean Higher Education (United States)

    Lee, Jeong-Kyu


    This paper examines the influence of educational fever on the development of the Republic of Korea education and economy in the context of the cultural history of this country. In order to examine this study, the author explains the concept of educational fever and discusses the relation between Confucianism and education zeal. Educational fever…

  15. Rocky Mountain spotted fever in children. (United States)

    Woods, Charles R


    Rocky Mountain spotted fever is typically undifferentiated from many other infections in the first few days of illness. Treatment should not be delayed pending confirmation of infection when Rocky Mountain spotted fever is suspected. Doxycycline is the drug of choice even for infants and children less than 8 years old. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Typhoid Fever: Misdiagnosis or Overdiagnosis | Onyekwere ...

    African Journals Online (AJOL)

    Recently there has been a public panic about an increase in cases of typhoid fever. Typhoid fever caused by salmonella typhi is common and constitutes a major public health problem in developing countries including sub-Saharan Africa, South America and parts of Asia. Its clinical features are non-specific and available ...

  17. Chronic Q fever in The Netherlands

    NARCIS (Netherlands)

    Kampschreur, L.M.|info:eu-repo/dai/nl/344824497


    From 2007-2010, during the recent Q fever epidemic in the Netherlands, over 4000 cases of acute Q fever were registered, which is an underestimation of the total amount of Coxiella burnetii infections due to a high amount of asymptomatic primary infections. In the literature it is stated that 1-5%

  18. The immune response in Q fever

    NARCIS (Netherlands)

    Schoffelen, T.


    Q fever is an infection caused by the bacterium Coxiella burnetii. A large outbreak of Q fever occurred in the Netherlands between 2007 and 2010, in which infected goats and sheep were the source of human infections. In some people, so-called ‘chronic Q fever’ develops, which mainly manifests as

  19. Educational Fever and South Korean Higher Education

    Directory of Open Access Journals (Sweden)

    Jeong-Kyu Lee


    Full Text Available This paper examines the influence of educational fever on the development of the Republic of Korea education and economy in the context of the cultural history of this country. In order to examine this study, the author explains the concept of educational fever and discusses the relation between Confucianism and education zeal. Educational fever and human capitalization in South Korean higher education are analyzed from a comparative viewpoint. The study evaluates the effects and problems of education fever this country’s current higher education, and it concludes that Koreans’ educational fever has been a core factor by which to achieve the development of the national economy as well as the rapid expansion of higher education.

  20. Rat Bite Fever Resembling Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Ripa Akter


    Full Text Available Rat bite fever is rare in Western countries. It can be very difficult to diagnose as blood cultures are typically negative and a history of rodent exposure is often missed. Unless a high index of suspicion is maintained, the associated polyarthritis can be mistaken for rheumatoid arthritis. We report a case of culture-positive rat bite fever in a 46-year-old female presenting with fever and polyarthritis. The clinical presentation mimicked rheumatoid arthritis. Infection was complicated by discitis, a rare manifestation. We discuss the diagnosis and management of this rare zoonotic infection. We also review nine reported cases of rat bite fever, all of which had an initial presumptive diagnosis of a rheumatological disorder. Rat bite fever is a potentially curable infection but can have a lethal course if left untreated.

  1. Typhoid fever: the experience of last decade

    Directory of Open Access Journals (Sweden)

    A. N. Kovalenko


    Full Text Available This article is about analyses of diagnostics and treatment of the modern typhoid fever. In the past typhoid fever was critical and lifethreatening inflectional disease. But nowadays thanks to using of chloramphenicol and other antimicrobial preparations, typhoid fever is serious but well curable disease. In the second part of the 20th century the number of typhoid fever cases has decreased. As a result a new generation of physicians, who has never come across this disease, appeared. Nowadays typhoid fever is still actual for practical public health in Russia. There are two causes: first, there is a risk of delivery of infections with tourists and immigrants. Second, the small number of physicians, who possess well knowledge of clinical features and modern therapy.

  2. The geographical distribution of Q fever. (United States)



    The results of a WHO-assisted survey of the distribution of Q fever in 32 countries and an analysis of reports published to date indicate that Q fever exists in 51 countries on five continents. Q-fever infection was most often reported in man and the domestic ruminants, such as cattle, sheep, and goats.The disease was found to exist in most countries where investigations were carried out. Notable exceptions were Ireland, the Netherlands, New Zealand, Poland, and the Scandinavian countries. With the exception of Poland, where the results were inconclusive, all these countries import relatively few domestic ruminants-the most important animal reservoirs of human Q-fever infection. It seems, therefore, that the traffic of infected ruminants may be one of the most important, if not the most important, means for the geographical spread of Q fever. The importance, if any, of ticks associated with such traffic needs to be defined.

  3. Sensibilidad antimicrobiana y caracterización de cepas de Streptococcus pyogenes aisladas de un brote de escarlatina Antimicrobial sensitivity and typing of Streptococcus pyogenes strains isolated during a scarlet fever outbreak


    Alberto González Pedraza-Avilés; Catalina Ortiz-Zaragoza; Ricardo Mota-Vázquez; Ma Eloísa Dickinson-Bannack; Rocío Dávila-Mendoza; Miguel Angel Fernández-Ortega


    Objetivo. Evaluar la actividad in vitro de 13 antibióticos contra 47 Streptococcus pyogenes grupo A (SGA). Determinar la presencia de genes que codifican para exotoxina pirogénica estreptocóccica A (SpeA) y serotipos con base en proteína M. Material y métodos. Estudio transversal hecho en el Centro de Salud Dr. José Castro Villagrana sobre un brote de escarlatina en el Colegio Espíritu de América, entre diciembre de 1999 y enero de 2000. El número de niños estudiados fue 137. Se extrajeron po...

  4. Fever in pregnancy and offspring head circumference. (United States)

    Dreier, Julie Werenberg; Strandberg-Larsen, Katrine; Uldall, Peter Vilhelm; Nybo Andersen, Anne-Marie


    To examine whether maternal fever during pregnancy is associated with reduced head circumference and risk of microcephaly at birth. A prospective study of 86,980 live-born singletons within the Danish National Birth Cohort was carried out. Self-reported maternal fever exposure was ascertained in two interviews during pregnancy and information on head circumference at birth was extracted from the Danish Medical Birth Registry. Fever in pregnancy was reported by 27% of the mothers, and we identified 3370 cases of microcephaly (head circumference less than or equal to third percentile for sex and gestational age) and 1140 cases of severe microcephaly (head circumference less than or equal to first percentile for sex and gestational age). In this study, maternal fever exposure was not associated with reduced head circumference (adjusted β = 0.03, 95% confidence intervals [CI]: 0.01-0.05), increased risk of microcephaly (odds ratio: 0.95, 95% CI: 0.88-1.03) nor severe microcephaly (odds ratio: 1.01, 95% CI: 0.88-1.15) in the offspring. These findings were consistent for increasing numbers of fever episodes, for increasing fever severity, and for exposure in both early pregnancy and midpregnancy. In this most comprehensive study to date, we found no indication that maternal fever in pregnancy is associated with small head size in the offspring. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Fluoroquinolones for treating typhoid and paratyphoid fever (enteric fever). (United States)

    Effa, Emmanuel E; Lassi, Zohra S; Critchley, Julia A; Garner, Paul; Sinclair, David; Olliaro, Piero L; Bhutta, Zulfiqar A


    Typhoid and paratyphoid are febrile illnesses, due to a bacterial infection, which remain common in many low- and middle-income countries. The World Health Organization (WHO) currently recommends the fluoroquinolone antibiotics in areas with known resistance to the older first-line antibiotics. To evaluate fluoroquinolone antibiotics for treating children and adults with enteric fever. We searched The Cochrane Infectious Disease Group Specialized Register (February 2011); Cochrane Central Register of Controlled Trials (CENTRAL), published in The Cochrane Library (2011, Issue 2); MEDLINE (1966 to February 2011); EMBASE (1974 to February 2011); and LILACS (1982 to February 2011). We also searched the metaRegister of Controlled Trials (mRCT) in February 2011. Randomized controlled trials examining fluoroquinolone antibiotics, in people with blood, stool or bone marrow culture-confirmed enteric fever. Two authors independently assessed the trial's methodological quality and extracted data. We calculated risk ratios (RR) for dichotomous data and mean difference for continuous data with 95% confidence intervals (CI).Comparative effectiveness has been interpreted in the context of; length of treatment, dose, year of study, known levels of antibiotic resistance, or proxy measures of resistance such as the failure rate in the comparator arm. Twenty-six studies, involving 3033 patients, are included in this review.Fluoroquinolones versus older antibiotics (chloramphenicol, co-trimoxazole, amoxicillin and ampicillin)In one study from Pakistan in 2003-04, high clinical failure rates were seen with both chloramphenicol and co-trimoxazole, although resistance was not confirmed microbiologically. A seven-day course of either ciprofloxacin or ofloxacin were found to be superior. Older studies of these comparisons failed to show a difference (six trials, 361 participants).In small studies conducted almost two decades ago, the fluoroquinolones were demonstrated to have fewer

  6. Anterior ischemic optic neuropathy following dengue fever. (United States)

    Ramakrishnan, Reshma; Shrivastava, Saurabh; Deshpande, Shrikant; Patkar, Priyanka


    Dengue fever is caused by a flavivirus. This infection is endemic in the tropics and warm temperate regions of the world. Ocular manifestations of dengue fever include subconjunctival, vitreous, and retinal haemorrhages; posterior uveitis; optic neuritis; and maculopathies, haemorrhage, and oedema. However anterior ischemic optic neuropathy is a rare presentation. Optic nerve ischemia most frequently occurs at the optic nerve head, where structural crowding of nerve fibers and reduction of the vascular supply may combine to impair perfusion to a critical degree and produce optic disc oedema. Here we present a case of anterior ischemic optic neurapathy associated with dengue fever.

  7. Appendicular perforation in dengue fever: our experience

    Directory of Open Access Journals (Sweden)

    Gunjan Desai


    Full Text Available Dengue viral infections have become one of major emerging infectious diseases in the tropics. Acute abdomen occurring in dengue viral infection is not uncommon. The spectrums of acute surgical emergencies which raise suspicion of an abdominal catastrophe in patients presenting with dengue fever include acute pancreatitis, acute acalculous cholecystitis, non-specific peritonitis and very rarely acute appendicitis. The presence of low white cell count and platelet count can raise suspicion of a diagnosis of dengue in a patient presenting with acute abdominal pain, during a dengue epidemic. We herein report three patients with dengue fever who had appendicular perforation during the course of their viral fever.

  8. Lassa fever: another threat from West Africa. (United States)

    Brosh-Nissimov, Tal


    Lassa fever, a zoonotic viral infection, is endemic in West Africa. The disease causes annual wide spread morbidity and mortality in Africa, and can be imported by travelers. Possible importation of Lassa fever and the potential for the use of Lassa virus as an agent of bioterrorism mandate clinicians in Israel and other countries to be vigilant and familiar with the basic characteristics of this disease. The article reviews the basis of this infection and the clinical management of patients with Lassa fever. Special emphasis is given to antiviral treatment and infection control.

  9. Epidural Labor Analgesia and Maternal Fever. (United States)

    Sharpe, Emily E; Arendt, Katherine W


    Women receiving an epidural for labor analgesia are at increased risk for intrapartum fever. This relationship has been supported by observational, before and after, and randomized controlled trials. The etiology is not well understood but is likely a result of noninfectious inflammation as studies have found women with fever have higher levels of inflammatory markers. Maternal pyrexia may change obstetric management and women are more likely to receive antibiotics or undergo cesarean delivery. Maternal pyrexia is associated with adverse neonatal outcomes. With these consequences, understanding and preventing maternal fever is imperative.

  10. Clinical Features Of Malaria And Typhoid Fever | Mba | Journal of ...

    African Journals Online (AJOL)

    Features to distinguish Malaria from Typhoid fever. These can be discerned from a good and detailed clinical history, in addition to a thorough physical examination. The following would help. The paroxysms of malaria fever as against the step ladder pattern fever of typhoid fever. The prominence of headaches in typhoid ...

  11. Transfusion support in patients with dengue fever. (United States)

    Kaur, Paramjit; Kaur, Gagandeep


    Dengue fever has emerged as a global public health problem in the recent decades. The clinical spectrum of the disease ranges from dengue fever to dengue hemorrhagic fever and dengue shock syndrome. The disease is characterized by increased capillary permeability, thrombocytopenia and coagulopathy. Thrombocytopenia with hemorrhagic manifestations warrants platelet transfusions. There is lack of evidence-based guidelines for transfusion support in patients with dengue fever. This contributes to inappropriate use of blood components and blood centers constantly face the challenge of inventory management during dengue outbreaks. The current review is aimed to highlight the role of platelets and other blood components in the management of dengue. The review was performed after searching relevant published literature in PubMed, Science Direct, Google scholar and various text books and journal articles.

  12. Rocky Mountain Spotted Fever (For Parents) (United States)

    ... Safety for the Whole Family Evaluate Your Child's Lyme Disease Risk Lyme Disease Lyme Disease Hey! A Tick Bit Me! Bug Bites and Stings Rocky Mountain Spotted Fever Lyme Disease Contact Us Print Resources Send to a Friend ...

  13. Acute cerebellar ataxia in enteric fever. (United States)

    Sawhney, I M; Prabhakar, S; Dhand, U K; Chopra, J S


    Acute cerebellar ataxia as an isolated neurological manifestation of enteric fever is very rare. Three cases of acute cerebellar ataxia associated with enteric fever are reported. The diagnosis of enteric fever was confirmed by positive blood culture, strongly positive Widal test and rising antibody titres. The major clinical features were rapid development of gait ataxia, limb ataxia and dysarthria. None of the patients had altered sensorium. The cerebellar involvement was noticed on the second or third day of fever which progressed for one to two days. The symptoms remained static for one to two weeks and thereafter all the patients showed gradual recovery in a few weeks. Acute onset of cerebellar lesion, self limiting course and cerebrospinal fluid pleocytosis suggest par- or post-infectious demyelinating pathology in these patients, who were not related to each other.


    Directory of Open Access Journals (Sweden)

    A. S. Polyakova


    Full Text Available Fever is a normal physiological response to illness in young children and it is often associated with a self-limiting viral infection. Fever is not a diagnosis, but a symptom of illness. A diagnosis of the underlying illness is essential to institute appropriate treatment. Although it is a normal response, that facilitates and accelerates recovery, some people, including many doctors, believe that fever should be treated to reduce temperature without determining the underlying illness causing the fever. Antipyretics should be used to make the child more comfortable and not used routinely with the sole aim of reducing the temperature. This article aims to acquaint primary healthcare workers and general practitioners with last guidelines to assist the measurement of body temperature, deciding on when to refer and the appropriate use of antipyretic medication in children, efficacy and safety of paracetamol and ibuprofen in oral and rectal forms. 

  15. Biological control of cattle fever ticks (United States)

    Cattle fever ticks (CFT) Rhipicephalus microplus and Rhipicephalus annulatus are invasive livestock pests that are endemic to Mexico and invasive along the Texas – Mexico border. Acaricide resistance, alternate wildlife hosts, and pathogenic landscape forming weeds present challenges for sustainable...

  16. Causes of Fever in Rural Southern Laos. (United States)

    Mayxay, Mayfong; Sengvilaipaseuth, Onanong; Chanthongthip, Anisone; Dubot-Pérès, Audrey; Rolain, Jean-Marc; Parola, Philippe; Craig, Scott B; Tulsiani, Suhella; Burns, Mary-Anne; Khanthavong, Maniphone; Keola, Siamphay; Pongvongsa, Tiengkham; Raoult, Didier; Dittrich, Sabine; Newton, Paul N


    The etiology of fever in rural Lao People's Democratic Republic (Laos) has remained obscure until recently owing to the lack of laboratory facilities. We conducted a study to determine the causes of fever among 229 patients without malaria in Savannakhet Province, southern Laos; 52% had evidence of at least one diagnosis (45% with single and 7% with apparent multiple infections). Among patients with only one diagnosis, dengue (30.1%) was the most common, followed by leptospirosis (7.0%), Japanese encephalitis virus infection (3.5%), scrub typhus (2.6%), spotted fever group infection (0.9%), unspecified flavivirus infection (0.9%), and murine typhus (0.4%). We discuss the empirical treatment of fever in relation to these findings. © The American Society of Tropical Medicine and Hygiene.

  17. Airborne Dust Models in Valley Fever Research (United States)

    Sprigg, W. A.; Galgiani, J. N.; Vujadinovic, M.; Pejanovic, G.; Vukovic, A. J.; Prasad, A. K.; Djurdjevic, V.; Nickovic, S.


    Dust storms (haboobs) struck Phoenix, Arizona, in 2011 on July 5th and again on July 18th. One potential consequence: an estimated 3,600 new cases of Valley Fever in Maricopa County from the first storm alone. The fungi, Coccidioides immitis, the cause of the respiratory infection, Valley Fever, lives in the dry desert soils of the American southwest and southward through Mexico, Central America and South America. The fungi become part of the dust storm and, a few weeks after inhalation, symptoms of Valley Fever may appear, including pneumonia-like illness, rashes, and severe fatigue. Some fatalities occur. Our airborne dust forecast system predicted the timing and extent of the storm, as it has done with other, often different, dust events. Atmosphere/land surface models can be part of public health services to reduce risk of Valley Fever and exacerbation of other respiratory and cardiovascular illness.

  18. Typhoid Fever: The Challenges of Medical Management

    African Journals Online (AJOL)

    Typhoid Fever: The Challenges of Medical Management. Dr J A Otegbayo. Gastrointeslinal/ Liver Unit, Department of Medicine,. University oflbaa'an/ University College Hospital, Ibadan, Nigeria. Keywords: Typhoid, medical management, challenges. INTRODUCTION. Salmonella enterica serotype typhi is the aetiological.

  19. A case of ADEM following Chikungunya fever. (United States)

    Maity, Pranab; Roy, Pinaki; Basu, Arindam; Das, Biman; Ghosh, U S


    Chikungunya most often is a self-limiting febrile illness with polyarthritis and the virus is not known to be neurotropic. We are reporting a case of chikugunya fever presenting as acute demyelinating encephalomyelitis(ADEM) which is very rare.

  20. Fever of unknown origin in rheumatic diseases. (United States)

    Zenone, Thierry


    Noninfectious inflammatory diseases (connective tissue diseases, vasculitis syndromes, granulomatous diseases) emerged as the most frequent cause of fever of unknown origin in western countries. Among these diseases, giant cell arteritis and polymyalgia rheumatica are the most frequent specific diagnosis in the elderly and adult-onset Still's disease the most frequent in younger patients. This article focuses on noninfectious inflammatory diseases as a cause of classic fever of unknown origin (mainly rheumatic diseases, such as vasculitis and connective tissue diseases).

  1. Acute atrial fibrillation during dengue hemorrhagic fever

    Directory of Open Access Journals (Sweden)

    Veloso Henrique Horta


    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.


    Davis, Nelson C.; Shannon, Raymond C.


    Yellow fever virus from M. rhesus has been inoculated into a South American monkey (Cebus macrocephalus) by blood injection and by bites of infected mosquitoes. The Cebus does not develop the clinical or pathological signs of yellow fever. Nevertheless, the virus persists in the Cebus for a time as shown by the typical symptoms and lesions which develop when the susceptible M. rhesus is inoculated from a Cebus by direct transfer of blood or by mosquito (A. aegypti) transmission. PMID:19869607

  3. The challenge of enteric fever. (United States)

    Waddington, Claire S; Darton, Thomas C; Pollard, Andrew J


    Enteric fever, a non-specific, systemic infection caused by S. Typhi or Paratyphi A, B or C, is common in resource-limited regions of the world, where poor sanitation infrastructure facilitates faeco-oral transmission. Prompt treatment with appropriate antibiotics minimises illness severity, but presentation to health care facilities is often delayed because of the non-specific nature of the symptoms and the lack of reliable diagnostic tests. Disease prevention requires significant investment in provision of clean water and sanitation in the long term; vaccination offers a more realistic strategy for medium term control. However, implementation of existing vaccines and development of more efficacious vaccines has been hindered by the lack of an established correlate of protection and under appreciation of the true disease burden. Human microbial infection studies could provide a vehicle for the rapid evaluation of novel vaccines and investigation of the immunobiology of enteric infection. Copyright © 2013 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  4. Typhoid fever: clinical diagnosis versus laboratory confirmation. (United States)

    Ngwu, B A; Agbo, J A


    Recently there has been an increase in the clinically diagnosed typhoid fever in various parts of Nigeria with subsequent increase in public fear of possible epidemics of the disease. In this study the accuracy of clinically diagnosed typhoid fever were investigated. Blood and stool specimens from 260 patients clinically diagnosed typhoid fever were investigated using Widal test and bacteriological culture methods respectively. One hundred and thirty-four (51.5%) of the cases investigated were positive and that there was a significant difference (P clinically diagnosed and bacteriologically confirmed typhoid fever cases. Causative organisms were Salmonella typhi 46 (34.3%); S paratyphi B 34 (25.4%); S paratyphi A 24 (17.9%); S paratyphi C 20 (14.9%); other Salmonella spp 10 (7.5%). Young adults and males were predominantely affected. Most of the clinically diagnosed typhoid cases were misdiagnosis and the hue and cry by the general public on the epidemic of typhoid fever could not be justified. It is recommended that careful detailed history taking, meticulous clinical examination and prompt bacteriological culturing of specimens from suspected typhoid cases will improve the accuracy of clinically diagnosed typhoid fever.

  5. Tick bite fever and Q fever — a South African perspective

    African Journals Online (AJOL)

    infection, and a post—Q fever chronic fatigue syndrome has been described. The molecular pathophysiology of ... Chronic Q fever remains challenging to treat. The genera Rickettsia and Coxiella are aerobic ... gene nucleotide sequence homologies have allowed more than. 30 species and subspecies of rickettsiae to be ...

  6. Yellow fever vaccination in the Americas. (United States)


    Outbreaks of yellow fever in recent years in the Americas have prompted concern about the possible urbanization of jungle fever. Vaccination, using the 17D strain of yellow fever virus, provides an effective, practical method of large scale protection against the disease. Because yellow fever can reappear in certain areas after a 2-year dormancy period, some countries maintain routine vaccination programs in areas where jungle yellow fever is endemic. The size of the endemic area (approximately half of South America), transportation and communication difficulties, and the inability to ensure a reliable cold chain are problems facing these programs. In addition, the problem of reaching dispersed and isolated populations has been addressed by the use of mobile teams, radio monitoring, and educational methods. During yellow fever outbreaks, many countries institute massive vaccination campaigns, targeted at temporary workers and migrants. Because epidemics in South America may involve extensive areas, these campaigns may not effectively address the problem. The ped-o-jet injector method, used in Brazil and Colombia, should be used in outbreak situations, as it is effective for large-scale vaccination. Vaccine by needle, suggested for maintenance programs, should be administered to those above 1 year of age. An efficient monitoring method to avoid revaccination, and to assess immunity, should be developed. The 17D strain produces seroconversion in 95% of recipients, and most is prepared in Brazil and Colombia. But, problems with storage methods, instability in seed lots, and difficulties in large-scale production were identified in 1981 by the Pan American Health Organization and WHO. The group recommended modernization of current production techniques and further research to develop a vaccine that could be produced in cell cultures. Brazil and Colombia have acted on these recommendations, modernizing vaccine production and researching thermostabilizing media for

  7. Chronic Q fever in the Netherlands 5 years after the start of the Q fever epidemic: results from the Dutch chronic Q fever database

    NARCIS (Netherlands)

    Kampschreur, L.M.; Delsing, C.E.; Groenwold, R.H.; Wegdam-Blans, M.C.; Bleeker-Rovers, C.P.; Jager-Leclercq, M.G. De; Hoepelman, A.I.; Kasteren, M.E.E. van; Buijs, J.; Renders, N.H.; Nabuurs-Franssen, M.H.; Oosterheert, J.J.; Wever, P.C.


    Coxiella burnetii causes Q fever, a zoonosis, which has acute and chronic manifestations. From 2007 to 2010, the Netherlands experienced a large Q fever outbreak, which has offered a unique opportunity to analyze chronic Q fever cases. In an observational cohort study, baseline characteristics and

  8. Context dependency and generality of fever in insects. (United States)

    Stahlschmidt, Z R; Adamo, S A


    Fever can reduce mortality in infected animals. Yet, despite its fitness-enhancing qualities, fever often varies among animals. We used several approaches to examine this variation in insects. Texas field crickets (Gryllus texensis) exhibited a modest fever (1 °C increase in preferred body temperature, T pref) after injection of prostaglandin, which putatively mediates fever in both vertebrates and invertebrates, but they did not exhibit fever during chronic exposure to heat-killed bacteria. Further, chronic food limitation and mating status did not affect T pref or the expression of behavioural fever, suggesting limited context dependency of fever in G. texensis. Our meta-analysis of behavioural fever studies indicated that behavioural fever occurs in many insects, but it is not ubiquitous. Thus, both empirical and meta-analytical results suggest that the fever response in insects 'is widespread, although certainly not inevitable' (Moore 2002). We highlight the need for future work focusing on standardizing an experimental protocol to measure behavioural fever, understanding the specific mechanism(s) underlying fever in insects, and examining whether ecological or physiological costs often outweigh the benefits of fever and can explain the sporadic nature of fever in insects.

  9. Fever of unknown origin (FUO) revised. (United States)

    Unger, Manuel; Karanikas, Georgios; Kerschbaumer, Andreas; Winkler, Stefan; Aletaha, Daniel


    Fever of unknown origin (FUO) was originally characterised in 1961 by Petersdorf and Beeson as a disease condition of temperature exceeding 38.3 °C on at least three occasions over a period of at least three weeks, with no diagnosis made despite one week of inpatient investigation. However, since underlying diseases are often reported for classical FUO, these presentations may not be considered to be of "unknown origin". Rather, the aetiology of prolonged fever may resolve, or not resolve. The definition of fever with unresolved cause (true FUO) is difficult, as it is a moving target, given the constant advancement of imaging and biomarker analysis. Therefore, the prevalence of fever with unresolved cause (FUO) is unknown.In this review, we report such a case of prolonged fever, which initially has presented as classical FUO, and discuss current literature. Furthermore, we will give an outlook, how a prospective study on FUO will allow to solve outstanding issues like the utility of different diagnostic investigations, and the types and prevalence of various underlying diseases.

  10. Optimal Repellent Usage to Combat Dengue Fever. (United States)

    Dorsett, Chasity; Oh, Hyunju; Paulemond, Marie Laura; Rychtář, Jan


    Dengue fever is one of the most important vector-borne diseases. It is transmitted by Aedes Stegomyia aegypti, and one of the most effective strategies to combat the disease is the reduction of exposure to bites of these mosquitoes. In this paper, we present a game-theoretical model in which individuals choose their own level of protection against mosquito bites in order to maximize their own benefits, effectively balancing the cost of protection and the risk of contracting the dengue fever. We find that even when the usage of protection is strictly voluntary, as soon as the cost of protection is about 10,000 times less than the cost of contracting dengue fever, the optimal level of protection will be within 5 % of the level needed for herd immunity.

  11. Hemophagocytic syndrome in classic dengue fever

    Directory of Open Access Journals (Sweden)

    Sayantan Ray


    Full Text Available A 24-year-old previously healthy girl presented with persistent fever, headache, and jaundice. Rapid-test anti-dengue virus IgM antibody was positive but anti-dengue IgG was nonreactive, which is suggestive of primary dengue infection. There was clinical deterioration during empiric antibiotic and symptomatic therapy. Bone marrow examination demonstrated the presence of hemophagocytosis. Diagnosis of dengue fever with virus-associated hemophagocytic syndrome was made according to the diagnostic criteria of the HLH 2004 protocol of the Histiocyte Society. The patient recovered with corticosteroid therapy. A review of literature revealed only a handful of case reports that showed the evidence that this syndrome is caused by dengue virus. Our patient is an interesting case of hemophagocytic syndrome associated with classic dengue fever and contributes an additional case to the existing literature on this topic. This case highlights the need for increased awareness even in infections not typically associated with hemophagocytic syndrome.

  12. Milk fever control principles: a review

    DEFF Research Database (Denmark)

    Thilsing-Hansen, T; Jørgensen, R J; Østergaard, S


    with sufficient magnesium to fulfil its needs, and to prevent the dry cows from being too fat. Available information on the influence of carbohydrate intake, and on the effect of the length of the dry period and prepartum milking, is at present insufficient to include these factors in control programmes....... prevention as well as prevention of milk fever relapse after intravenous treatment with calcium solutions. However, some drenches have been shown to cause lesions in the forestomacs. When using the DCAD (dietary cation-anion difference) principle, feeding rations with a negative DCAD (measured as (Na + K...... is a palatability problem. The principle of feeding rations low in calcium is highly efficient in milk fever prevention provided the calcium intake in the dry period is kept below 20 g per day. Calculating the relative risk (RR) of developing milk fever from controlled experiments results in a very low mean RR...

  13. [Rocky Mountain spotted fever in Brazil]. (United States)

    del Sá DelFiol, Fernando; Junqueira, Fábio Miranda; da Rocha, Maria Carolina Pereira; de Toledo, Maria Inês; Filho, Silvio Barberato


    Although the number of confirmed cases of spotted fever has been declining in Brazil since 2005, the mortality rate (20% to 30%) is still high in comparison to other countries. This high mortality rate is closely related to the difficulty in making the diagnosis and starting the correct treatment. Only two groups of antibiotics have proven clinical effectiveness against spotted fever: chloramphenicol and tetracyclines. Until recently, the use of tetracyclines was restricted to adults because of the associated bone and tooth changes in children. Recently, however, the American Academy of Pediatrics and various researchers have recommended the use of doxycycline in children. In more severe cases, chloramphenicol injections are often preferred in Brazil because of the lack of experience with injectable tetracycline. Since early diagnosis and the adequate drug treatment are key to a good prognosis, health care professionals must be better prepared to recognize and treat spotted fever.

  14. Clara Maass, yellow fever and human experimentation. (United States)

    Chaves-Carballo, Enrique


    Clara Louise Maass, a 25-year-old American nurse, died of yellow fever on August 24, 1901, following experimental inoculation by infected mosquitoes in Havana, Cuba. The human yellow fever experiments were initially conducted by MAJ Walter Reed, who first used written informed consent and proved the validity of Finlay's mosquito-vector hypothesis. Despite informed consent form and an incentive of $100 in U.S. gold, human subjects were exposed to a deadly virus. The deaths of Clara Maass and two Spanish immigrants resulted in a public outcry and the immediate cessation of yellow fever human experiments in Cuba. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

  15. Lost trust: a yellow fever patient response. (United States)

    Runge, John S


    In the 19th century, yellow fever thrived in the tropical, urban trade centers along the American Gulf Coast. Industrializing and populated, New Orleans and Memphis made excellent habitats for the yellow fever-carrying Aedes aegypti mosquitoes and the virulence they imparted on their victims. Known for its jaundice and black, blood-filled vomit, the malady terrorized the region for decades, sometimes claiming tens of thousands of lives during the near annual summertime outbreaks. In response to the failing medical community, a small, pronounced population of sick and healthy laypeople openly criticized the efforts to rid the Gulf region of yellow jack. Utilizing newspapers and cartoons to vocalize their opinions, these critics doubted and mocked the medical community, contributing to the regional and seasonal dilemma yellow fever posed for the American South. These sentient expressions prove to be an early example of patient distrust toward caregivers, a current problem in clinical heath care.

  16. Effect of (social) media on the political figure fever model: Jokowi-fever model (United States)

    Yong, Benny; Samat, Nor Azah


    In recent years, political figures begin to utilize social media as one of alternative to engage in communication with their supporters. Publics referred to Jokowi, one of the candidates in Indonesia presidential election in 2014, as the first politician in Indonesia to truly understand the power of social media. Social media is very important in shaping public opinion. In this paper, effect of social media on the Jokowi-fever model in a closed population will be discussed. Supporter population is divided into three class sub-population, i.e susceptible supporters, Jokowi infected supporters, and recovered supporters. For case no positive media, there are two equilibrium points; the Jokowi-fever free equilibrium point in which it locally stable if basic reproductive ratio less than one and the Jokowi-fever endemic equilibrium point in which it locally stable if basic reproductive ratio greater than one. For case no negative media, there is only the Jokowi-fever endemic equilibrium point in which it locally stable if the condition is satisfied. Generally, for case positive media proportion is positive, there is no Jokowi-fever free equilibrium point. The numerical result shows that social media gives significantly effect on Jokowi-fever model, a sharp increase or a sharp decrease in the number of Jokowi infected supporters. It is also shown that the boredom rate is one of the sensitive parameters in the Jokowi-fever model; it affects the number of Jokowi infected supporters.

  17. Chikungunya fever: current status in Mexico

    Directory of Open Access Journals (Sweden)

    Margarita Nava-Frías


    Full Text Available Chikungunya fever is a tropical vector-borne disease that has been spreading rapidly around the world during the last 10 years, and which has been usually misdiagnosed as dengue. Nowadays, this disease is increasing in Mexico, mainly in the southern and central zones of the country, being significantly more common in women, children and young adults (28% in < 20 years of age. The classical presentation includes fever, arthralgia, polyarthritis, back-pain, and skin rashes. Although symptoms and treatment are similar to those for dengue, there are key clinical features to differentiate these two diseases.

  18. Milk Fever Control Principles: A Review

    Directory of Open Access Journals (Sweden)

    Østergaard S


    Full Text Available Three main preventive principles against milk fever were evaluated in this literature review, and the efficacy of each principle was estimated from the results of controlled investigations. Oral calcium drenching around calving apparently has a mean efficacy of 50%–60% in terms of milk fever prevention as well as prevention of milk fever relapse after intravenous treatment with calcium solutions. However, some drenches have been shown to cause lesions in the forestomacs. When using the DCAD (dietary cation-anion difference principle, feeding rations with a negative DCAD (measured as (Na + K – (Cl + S significantly reduce the milk fever incidence. Calculating the relative risk (RR of developing milk fever from controlled experiments results in a mean RR between 0.19 and 0.35 when rations with a negative versus positive DCAD are compared. The main drawback from the DCAD principle is a palatability problem. The principle of feeding rations low in calcium is highly efficient in milk fever prevention provided the calcium intake in the dry period is kept below 20 g per day. Calculating the relative risk (RR of developing milk fever from controlled experiments results in a very low mean RR (between 0 and 0.20 (daily calcium intake below versus above 20 g/d. The main problem in implementing the low-Ca principle is difficulties in formulating rations sufficiently low in calcium when using commonly available feeds. The use of large doses of vitamin D metabolites and analogues for milk fever prevention is controversial. Due to toxicity problems and an almost total lack of recent studies on the subject this principle is not described in detail. A few management related issues were discussed briefly, and the following conclusions were made: It is important to supply the periparturient cow with sufficient magnesium to fulfil its needs, and to prevent the dry cows from being too fat. Available information on the influence of carbohydrate intake, and on the

  19. Yellow fever vaccine-associated viscerotropic disease. (United States)

    Rowland, Michael; Plackett, Timothy P; Smith, Richard


    Yellow fever is a mosquito-transmitted hemorrhagic viral disease that is endemic to tropical regions in South America and Africa. It remains a significant health concern for deploying military personnel, accordingly vaccination is frequently performed on troops. Although the vaccine is generally administered with only minor complications, rare severe complications are also reported. Herein, we report a mild case of yellow fever vaccine-associated viscerotropic disease 4 days after administration of the vaccine. The various complications of the vaccine and their pathogenesis are also reviewed.

  20. Fever in pregnancy and offspring head circumference

    DEFF Research Database (Denmark)

    Dreier, Julie Werenberg; Strandberg-Larsen, Katrine; Uldall, Peter Vilhelm


    was ascertained in two interviews during pregnancy and information on head circumference at birth was extracted from the Danish Medical Birth Registry. RESULTS: Fever in pregnancy was reported by 27% of the mothers, and we identified 3370 cases of microcephaly (head circumference less than or equal to third...... percentile for sex and gestational age) and 1140 cases of severe microcephaly (head circumference less than or equal to first percentile for sex and gestational age). In this study, maternal fever exposure was not associated with reduced head circumference (adjusted β = 0.03, 95% confidence intervals [CI]: 0...

  1. Zika Fever: Basic Facts About the Infection

    Directory of Open Access Journals (Sweden)

    Elena I. Kalinina


    Full Text Available At the beginning of 2016, the World Health Organization announced the spread of Zika virus to be a global threat. Serious concerns about the little-known up to the present time Zika fever are caused by the growth of neurological complications of this disease. There is no strong evidence yet, but more and more often this infection is associated with congenital skull and brain malformations, development of Guillain-Barre syndrome. The article presents the basic information on the epidemiology, clinical manifestations and diagnosis of viral Zika fever, and modern possibilities of its prevention.

  2. Molecular Epidemiology of Rift Valley Fever Virus (United States)

    Grobbelaar, Antoinette A.; Weyer, Jacqueline; Leman, Patricia A.; Kemp, Alan; Paweska, Janusz T.


    Phylogenetic relationships were examined for 198 Rift Valley fever virus isolates and 5 derived strains obtained from various sources in Saudi Arabia and 16 countries in Africa during a 67-year period (1944–2010). A maximum-likelihood tree prepared with sequence data for a 490-nt section of the Gn glycoprotein gene showed that 95 unique sequences sorted into 15 lineages. A 2010 isolate from a patient in South Africa potentially exposed to co-infection with live animal vaccine and wild virus was a reassortant. The potential influence of large-scale use of live animal vaccine on evolution of Rift Valley fever virus is discussed. PMID:22172568

  3. Mayaro fever in an HIV-infected patient suspected of having Chikungunya fever. (United States)

    Estofolete, Cássia Fernanda; Mota, Mânlio Tasso Oliveira; Vedovello, Danila; Góngora, Delzi Vinha Nunes de; Maia, Irineu Luiz; Nogueira, Maurício Lacerda


    Arboviruses impose a serious threat to public health services. We report a case of a patient returning from a work trip to the Amazon basin with myalgia, arthralgia, fever, and headache. During this travel, the patient visited riverside communities. Both dengue and Chikungunya fevers were first suspected, tested for, and excluded. Mayaro fever was then confirmed by reverse transcription polymerase chain reaction followed by next-generation sequencing and phylogenetic reconstruction. The increased awareness of physicians and consequent detection of Mayaro virus in this case was only possible due a previous surveillance program with specific health personnel training about these neglected arboviruses.

  4. Yellow Fever Vaccine: What You Need to Know (United States)

    ... travel to a yellow fever area should discuss vaccination with their doctor. They might be at increased risk for severe ... yellow fever. If travel cannot be avoided, discuss vaccination with your doctor. If you cannot get the vaccine for medical ...

  5. Lassa fever presenting as acute abdomen: a case series

    National Research Council Canada - National Science Library

    Dongo, Andrew E; Kesieme, Emeka B; Iyamu, Christopher E; Okokhere, Peter O; Akhuemokhan, Odigie C; Akpede, George O


    .... When fever and abdominal pain are the main presenting symptoms, and a diagnosis of acute abdomen is entertained, Lassa fever is rarely considered in the differential diagnosis, even in endemic areas...

  6. Lassa fever - full recovery without ribavarin treatment: a case report. (United States)

    Ajayi, Nnennaya A; Ukwaja, Kingsley N; Ifebunandu, Ngozi A; Nnabu, Richard; Onwe, Francis I; Asogun, Danny A


    Lassa fever is a rodent-borne zoonosis that clinically manifests as an acute hemorrhagic fever. It is treated using ribavarin. Surviving Lassa fever without receiving the antiviral drug ribavarin is rare. Only few cases have been documented to date. We report a case of a 59-year old female with fever who was initially thought to have acute pyelonephritis and sepsis syndrome with background malaria. Further changes in her clinical state and laboratory tests led to a suspicion of Lassa fever. However at the time her laboratory confirmatory test for Lassa fever returned, her clinical state had improved and she made full recovery without receiving ribavarin. Her close contacts showed no evidence of Lassa virus infection. 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.

  7. Immunization against east coast fever by infection and treatment ...

    African Journals Online (AJOL)

    Immunization against east coast fever by infection and treatment method in. Uganda. Nsubuga -Mutaka ... Key words: East Cost Fever. tick horne, immunisation. Introduction. The disease" ... interval acaricide application. However, this has not.

  8. Education Fever and Happiness in Korean Higher Education (United States)

    Lee, Jeong-Kyu


    This article discusses relevance between education fever and happiness from the viewpoint of Korean higher education. To review this study systematically, three research questions are addressed. First, what is education fever from the viewpoint of the Korean people? Second, what are relations between education fever and happiness? Last, can…


    Directory of Open Access Journals (Sweden)



    Full Text Available INTRODUCTION: Fever is the cardinal manifestation of infection. Platelets are necessary to prevent bleeding manifestations. Certain infections cause thrombocytopenia and bleeding manifestations. AIMS AND OBJECTIVES: To study the incidence of bleeding manifestations in i nfections which cause fever and thrombocytopenia. MATERIALS AND METHODS: INCLUSION CRITERIA: Patients who were admitted with fever and thrombocytopenia, aged above 12 years, in S.V.R.R.G.G.H, Tirupati were taken for the study. EXCLUSION CRITERIA: Patients who are admitted with thrombocytopenia and without fever were excluded. Patients who are admitted with fever and normal platelet count were excluded. RESULTS AND CONCLUSI ON: Fever with thrombocytopenia is the commonest presenting problem in the medical war ds. In the present study the commonest infectious etiology of fever with thrombocytopenia was malaria fever (36%, followed by undiagnosed fevers (28%, dengue fever (26%, typhoid fever (6% and scrub typhus (4%. In the present study bleeding manifestati ons were seen in 16 cases (32% and bleeding manifestations were not seen in 34 cases (68%. The commonest bleeding manifestation was cutaneous, followed by hematemesis, malena, bleeding gums, hematuria and epistaxis. Bleeding manifestation was commonly se en in thrombocytopenia with dengue fever (14%, followed by malaria (8%, undiagnosed cases (8% and typhoid (2%.

  10. Response to childhood fevers among Mbaise parents and ...

    African Journals Online (AJOL)

    ... mothers were often the first to recognize fever in the children, followed by the other caregivers and then the fathers.The response to childhood fever was faster when a male child was sick (P < 0.001). The longer the delay the poorer the outcomes of the first action taken in response to childhood fevers (R2change = 0.011).

  11. Surveillance of viral haemorrhagic fevers in Ghana: entomological ...

    African Journals Online (AJOL)

    Results: A total of 2804 households were surveyed to estimate larval indices and man-vector contacts of potential vectors of viral haemorrhagic fevers such as Yellow fever and ... variations and the dry season was identified as the high-risk period for transmission of viral haemorrhagic fevers and possible disease outbreaks.

  12. Medical cost of Lassa fever treatment in Irrua Specialist Teaching ...

    African Journals Online (AJOL)

    This cross-sectional study sought to estimate the direct medical cost of Lassa fever treatment on patients in South-South Nigeria. All the 73 confirmed Lassa fever cases admitted in the isolation ward of the Institute Of Lassa Fever Research and Control, Irrua Specialist Teaching Hospital (ISTH) Irrua, in Edo State, Nigeria, ...

  13. Lassa fever: A case report | Chundusu | Research Journal of Health ...

    African Journals Online (AJOL)

    Objective: Severe Lassa fever with high mortality among health care providers is usually a human to human infection that requires high index of suspicion to diagnose. This case report is to describe a peculiar case of Lassa fever among health worker. Result: A severe form of Lassa fever was diagnosed early in a healthcare ...

  14. Mothers' Perception of Fever Management in Children | Alex-Hart ...

    African Journals Online (AJOL)

    Background: Fever is a common problem in childhood. Most febrile episodes are managed at home before consultation in a health facility. Caregivers' response to fever will depend on their perception of its cause and knowledge of its management. This study aimed to evaluate mothers' perceptions of fever and its ...

  15. Frequency of mutations in Mediterranean fever gene, with gender ...

    Indian Academy of Sciences (India)

    Familial Mediterranean fever (FMF) is the most common hereditary inflammatory periodic disease, characterized by recurrent episodes of fever, abdominal pain, synovitis and pleurisy. The aim of this study was to determine the frequency and distri- bution of Mediterranean fever (MEFV) gene mutations and to investigate the ...

  16. Mevalonate kinase deficiency and Dutch type periodic fever

    NARCIS (Netherlands)

    Frenkel, J.; Houten, S. M.; Waterham, H. R.; Wanders, R. J.; Rijkers, G. T.; Kimpen, J. L.; Duran, R.; Poll-The, B. T.; Kuis, W.


    Dutch type periodic fever (DPF) is an autosomal recessive hereditary fever syndrome. Cases have been reported worldwide, the majority from France and The Netherlands. From infancy the patients suffer fever attacks that recur every 2-8 weeks, often precipitated by immunizations, infections or

  17. Dengue and dengue haemorrhagic fever: Indian perspective

    Indian Academy of Sciences (India)


    problems of dengue is presented here. [Chaturvedi U C and Nagar R 2008 Dengue and dengue haemorrhagic fever: Indian perspective; J. Biosci. ..... crisis management. We need dedicated teams to solve the problems and minimize the human suffering. Acknowledgements. We thank Dr. Cecilia Dayaraj, Division of ...

  18. immunisation fever amongst infants receiving Diphtheria

    African Journals Online (AJOL)



    Aug 6, 2013 ... Methods: A prospective study was conducted on a cohort of 710 in- fants who received ... immunisation, especially in infants and young children. Although generally benign and self-limiting, fever is ..... Although this method might minimise recall bias because of the short duration of memory re- call required ...

  19. Fever and sickness behavior: Friend or foe? (United States)

    Harden, L M; Kent, S; Pittman, Q J; Roth, J


    Fever has been recognized as an important symptom of disease since ancient times. For many years, fever was treated as a putative life-threatening phenomenon. More recently, it has been recognized as an important part of the body's defense mechanisms; indeed at times it has even been used as a therapeutic agent. The knowledge of the functional role of the central nervous system in the genesis of fever has greatly improved over the last decade. It is clear that the febrile process, which develops in the sick individual, is just one of many brain-controlled sickness symptoms. Not only will the sick individual appear "feverish" but they may also display a range of behavioral changes, such as anorexia, fatigue, loss of interest in usual daily activities, social withdrawal, listlessness or malaise, hyperalgesia, sleep disturbances and cognitive dysfunction, collectively termed "sickness behavior". In this review we consider the issue of whether fever and sickness behaviors are friend or foe during: a critical illness, the common cold or influenza, in pregnancy and in the newborn. Deciding whether these sickness responses are beneficial or harmful will very much shape our approach to the use of antipyretics during illness. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Facing dengue fever - our first experience

    Directory of Open Access Journals (Sweden)

    Cvjetković Dejan


    Full Text Available Introduction. Dengue fever is a mosquito-borne disease caused by dengue virus, endemic in tropical and subtropical regions, where it is mostly imported from. The most common clinical form is classic dengue fever. We presented the first dengue case microbiologically confirmed in Serbia. Case report. A 34-year-old male got classic dengue fever after arrival from Cuba. The disease occurred suddenly with fever, myalgias, skin rash, hepatosplenomegaly, cytopenia, abnormal aminotransferase and creatine kinase levels. The diagnosis was confirmed with virological diagnostic methods. Significant leukopenia and thrombocytopenia as well as elevation of serum creatine kinase activity were recorded from the very beginning of hospitalization, but were gradually normalized. The whole duration of hospitalization was accompanied by laboratory signs of liver lesion. The disease had favourable outcome. At hospital discharge, the patient was afebrile, asymptomatic, with discrete erythematous rash on torso and arms, normal hemathological values and creatine kinase level and moderately elevated alanine-aminotransferase level. Conclusion. Considering global climate changes and growing international traffic, our health care service needs to be ready for possible massive outbreaks of dengue and other tropical infectious diseases in forthcoming years.

  1. Dengue fever | Tavodova | South Sudan Medical Journal

    African Journals Online (AJOL)

    South Sudan Medical Journal. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 1 (2012) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Dengue fever. Milada Tavodova. Abstract. No Abstract. Full Text: EMAIL FREE ...

  2. Dengue Fever in the United States

    Centers for Disease Control (CDC) Podcasts


    Dr. Amesh Adalja, an associate at the Center for Biosecurity and clinical assistant professor at the University of Pittsburgh School, of Medicine, discusses dengue fever outbreaks in the United States.  Created: 4/9/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 4/16/2012.

  3. Chikungunya Fever | | South African Family Practice

    African Journals Online (AJOL)

    Abstract. Chikungunya fever is a viral disease transmitted to humans by the bite of infected mosquitoes. Chikungunya virus (CHIKV) is a member of the genus Alphavirus, in the family Togaviridae. CHIKV was first isolated from the blood of a febrile patient in Tanzania in 1953, and has since been identified repeatedly in west ...

  4. Enzootic transmission of yellow fever virus, Venezuela. (United States)

    Auguste, Albert J; Lemey, Philippe; Bergren, Nicholas A; Giambalvo, Dileyvic; Moncada, Maria; Morón, Dulce; Hernandez, Rosa; Navarro, Juan-Carlos; Weaver, Scott C


    Phylogenetic analysis of yellow fever virus (YFV) strains isolated from Venezuela strongly supports YFV maintenance in situ in Venezuela, with evidence of regionally independent evolution within the country. However, there is considerable YFV movement from Brazil to Venezuela and between Trinidad and Venezuela.

  5. Host-pathogen interactions in typhoid fever

    NARCIS (Netherlands)

    de Jong, H.K.


    This thesis focuses on host-pathogen interactions in Salmonella Typhi and Burkholderia pseudomallei infections and explores the interplay between these bacteria and the innate immune system. Typhoid fever is one of the most common causes of bacterial infection in low-income countries. With adequate


    Directory of Open Access Journals (Sweden)

    Dr. Smita Sulackshana Devi Goorah


    Full Text Available Chikungunya fever, an emerging mosquito-borne viral disease, has affected Mauritius with two recent outbreaks in 2005 and 2006 respectively. A study was carried out in 2007 to describe the clinical complications post-Chikungunya infection. Ethical clearance was obtained for this study. Data collection was carried out in February and March 2007 on a sample of people who had suffered from Chikungunya fever by means of a comprehensive questionnaire. Participants comprised 77 people; there were 41 males and 36 females. Participants ranged from 6 to 69 years. 70 participants experienced persisting joint pains for at least 6 months following the acute phase. Of these, 35 had residual joint complaints after 6 months. 44 participants suffered from psychological sequelae. 10 participants had dermatological sequelae, 6 had iatrogenic complications due to non-steroidal anti-inflammatory drug (NSAID-induced gastritis, and 3 participants with serologically confirmed Chikungunya fever had neurological manifestations and changes on CT/MRI which could correspond to demyelination. Statistical analysis demonstrated that there was a weak linear relationship between the number of complications and increasing age; there was a significant difference in the number of complications according to gender, females being more affected than males; participants with co-morbidities had more complications and psychological sequelae than previously healthy participants. This study highlights that Chikungunya fever, which causes a significant impact on health in the acute phase, can have significant sequelae months afterwards and this includes psychological sequelae.

  7. Rocky Mountain spotted fever in dogs, Brazil. (United States)

    Labruna, Marcelo B; Kamakura, Orson; Moraes-Filho, Jonas; Horta, Mauricio C; Pacheco, Richard C


    Clinical illness caused by Rickettsia rickettsii in dogs has been reported solely in the United States. We report 2 natural clinical cases of Rocky Mountain spotted fever in dogs in Brazil. Each case was confirmed by seroconversion and molecular analysis and resolved after doxycycline therapy.

  8. Ebola haemorrhagic fever among hospitalised children and ...

    African Journals Online (AJOL)

    Background : A unique feature of previous Ebola outbreaks has been the relative sparing of children. For the first time, an out break of an unusual illness-Ebola haemorrhagic fever occurred in Northern Uganda - Gulu district. Objectives : To describe the epidemiologic and clinical aspects of hospitalised children and ...

  9. [Arbovirus causing hemorrhagic fever at IMSS]. (United States)

    Navarrete-Espinosa, Joel; Gómez-Dantés, Héctor


    To know the arbovirus causing hemorrhagic fever in patients at the Mexican Institute of Social Security. A follow-up study was made in patients with probable diagnosis of hemorrhagic dengue. Blood samples were taken to look for dengue fever, yellow fever and San Luis, Tonate and Mayaro encephalitis viruses. Frequencies and proportions of the interest variables were analyzed. 35 patients were studied. Isolation and PCR results of the 13 samples were negative in 12 of them and positive to denguevirus-3 in one of them. The determination of IgM was positive for dengue fever in 25 cases; 2 were positive to Mayaro virus and 8 were negative to what was looked for. Hemorrhages and thrombocytopenia were more frequent in patients infected with dengue and Mayaro viruses; jaundice and encephalopathy were more frequent in the latter, and renal dysfunction, in patients with a negative result. Evolution was satisfactory in all cases, except for one (Mayaro), which presented hemorrhages, thrombocytopenia, jaundice and encephalopathy that lead to death. The results show the risk of appearance and dissemination of several vector-born diseases in Mexico. Thus, they require intensive epidemiological surveillance to identify them and to know their real occurrence and specific clinical profile.

  10. 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.  Created: 10/28/2010 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 11/17/2010.

  11. Rift Valley fever: A neglected zoonotic disease? (United States)

    Rift Valley fever (RVF) is a serious viral disease of animals and humans in Africa and the Middle East that is transmitted by mosquitoes. First isolated in Kenya during an outbreak in 1930, subsequent outbreaks have had a significant impact on animal and human health, as well as national economies. ...

  12. Lassa fever or lassa hemorrhagic fever risk to humans from rodent-borne zoonoses. (United States)

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


    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.

  13. Dengue Fever with rectus sheath hematoma: a case report. (United States)

    Sharma, Anurag; Bhatia, Sonia; Singh, Rajendra Pratap; Malik, Gaurav


    Dengue fever, also known as breakbone fever, is an infectious tropical disease caused by the Dengue virus. It is associated with a number of complications, which are well documented. However, Dengue fever associated with rectus sheath hematoma (RSH) is a very rare complication. Only one case report has been published prior supporting the association of Dengue fever with RSH. We report a case of Dengue fever who presented with RSH and was successfully treated conservatively. RSH is also an uncommon cause of acute abdominal pain. It is accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear.

  14. Unusual Presentation of Dengue Fever Leading to Unnecessary Appendectomy. (United States)

    Kumar, Lovekesh; Singh, Mahendra; Saxena, Ashish; Kolhe, Yuvraj; Karande, Snehal K; Singh, Narendra; Venkatesh, P; Meena, Rambabu


    Dengue fever is the most important arbovirus illness with an estimated incidence of 50-100 million cases per year. The common symptoms of dengue include fever, rash, malaise, nausea, vomiting, and musculoskeletal pain. Dengue fever may present as acute abdomen leading to diagnostic dilemma. The acute surgical complications of dengue fever include acute pancreatitis, acute acalculous cholecystitis, nonspecific peritonitis, and acute appendicitis. We report a case of dengue fever that mimicked acute appendicitis leading to unnecessary appendectomy. A careful history examination for dengue-related signs, and serial hemogram over the first 3-4 days of disease may prevent unnecessary appendectomy.

  15. Dengue hemorrhagic fever and acute hepatitis: a case report

    Directory of Open Access Journals (Sweden)

    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.

  16. Q Fever: an old but still a poorly understood disease. (United States)

    Honarmand, Hamidreza


    Q fever is a bacterial infection affecting mainly the lungs, liver, and heart. It is found around the world and is caused by the bacteria Coxiella burnetii. The bacteria affects sheep, goats, cattle, dogs, cats, birds, rodents, and ticks. Infected animals shed this bacteria in birth products, feces, milk, and urine. Humans usually get Q fever by breathing in contaminated droplets released by infected animals and drinking raw milk. People at highest risk for this infection are farmers, laboratory workers, sheep and dairy workers, and veterinarians. Chronic Q fever develops in people who have been infected for more than 6 months. It usually takes about 20 days after exposure to the bacteria for symptoms to occur. Most cases are mild, yet some severe cases have been reported. Symptoms of acute Q fever may include: chest pain with breathing, cough, fever, headache, jaundice, muscle pains, and shortness of breath. Symptoms of chronic Q fever may include chills, fatigue, night sweats, prolonged fever, and shortness of breath. Q fever is diagnosed with a blood antibody test. The main treatment for the disease is with antibiotics. For acute Q fever, doxycycline is recommended. For chronic Q fever, a combination of doxycycline and hydroxychloroquine is often used long term. Complications are cirrhosis, hepatitis, encephalitis, endocarditis, pericarditis, myocarditis, interstitial pulmonary fibrosis, meningitis, and pneumonia. People at risk should always: carefully dispose of animal products that may be infected, disinfect any contaminated areas, and thoroughly wash their hands. Pasteurizing milk can also help prevent Q fever.

  17. Q Fever: An Old but Still a Poorly Understood Disease

    Directory of Open Access Journals (Sweden)

    Hamidreza Honarmand


    Full Text Available Q fever is a bacterial infection affecting mainly the lungs, liver, and heart. It is found around the world and is caused by the bacteria Coxiella burnetii. The bacteria affects sheep, goats, cattle, dogs, cats, birds, rodents, and ticks. Infected animals shed this bacteria in birth products, feces, milk, and urine. Humans usually get Q fever by breathing in contaminated droplets released by infected animals and drinking raw milk. People at highest risk for this infection are farmers, laboratory workers, sheep and dairy workers, and veterinarians. Chronic Q fever develops in people who have been infected for more than 6 months. It usually takes about 20 days after exposure to the bacteria for symptoms to occur. Most cases are mild, yet some severe cases have been reported. Symptoms of acute Q fever may include: chest pain with breathing, cough, fever, headache, jaundice, muscle pains, and shortness of breath. Symptoms of chronic Q fever may include chills, fatigue, night sweats, prolonged fever, and shortness of breath. Q fever is diagnosed with a blood antibody test. The main treatment for the disease is with antibiotics. For acute Q fever, doxycycline is recommended. For chronic Q fever, a combination of doxycycline and hydroxychloroquine is often used long term. Complications are cirrhosis, hepatitis, encephalitis, endocarditis, pericarditis, myocarditis, interstitial pulmonary fibrosis, meningitis, and pneumonia. People at risk should always: carefully dispose of animal products that may be infected, disinfect any contaminated areas, and thoroughly wash their hands. Pasteurizing milk can also help prevent Q fever.

  18. Severe Dengue Fever Outbreak in Taiwan (United States)

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


    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. PMID:26572871

  19. Disturbances of cellular immunity in rheumatic fever. (United States)

    Georgescu, C; Gheorghiu, M


    The alteration of cellular reactivity was investigated in 20 patients with rheumatic fever at the first rheumatic attack or in relapse with confirmed heart damage. The results obtained by studying in parallel ESR, the ASLO titer, IDR to streptococci and the degree of leukocyte migration inhibition proved that the onset of rheumatic attack was preceded by a deep disturbance of the cellular immunity. The migration inhibition values were between 50 and 60% (as compared with 10% in the normal controls) in over 85% of the patients investigated. It is emphasized that the selection of cases of streptococcal angina should be made very carefully and that sometimes it is necessary to use a more specific method for the detection of rheumatic fever in its preclinical stage.

  20. Dengue fever in pregnancy: a case report

    Directory of Open Access Journals (Sweden)

    Phupong Vorapong


    Full Text Available Abstract Background Dengue, a mosquito-borne flavivirus infection, is endemic in Southeast Asia. Currently, the incidence has been increasing among adults. Case presentation A 26-year-old Thai woman, G1P0 31 weeks pregnancy, presented with epigastric pain for 1 day. She also had a high-grade fever for 4 days. The physical examination, complete blood counts as well as serology confirmed dengue fever. The patient was under conservative treatment despite severe thrombocytopenia. She was well at the 3rd day of discharge and 1-week follow-up. The pregnancy continued until term without any complication and she delivered vaginally a healthy female baby. Conclusions More cases of dengue infection in pregnancy can be found due to the increasing incidence during adulthood. It should be suspected when a pregnant woman presents with symptoms and signs like in a non-pregnant. Conservative treatment should be conducted unless there are any complications.

  1. Crimean-Congo hemorrhagic fever in Tajikistan. (United States)

    Tishkova, Farida H; Belobrova, Evgeniya A; Valikhodzhaeva, Matlyuba; Atkinson, Barry; Hewson, Roger; Mullojonova, Manija


    Crimean-Congo hemorrhagic fever (CCHF) is a pathogenic tick-borne disease caused by a single-stranded negative-sense RNA virus classified within the Nairovirus genus of the family Bunyaviridae. Cases of CCHF have been registered in Tajikistan since the disease was first brought to medical attention in 1944. However, historical Tajik manuscripts describe the features of hemorrhagic fever associated with ticks, indicating that the disease might have been known in this region for many years before it was officially characterized. Here we review the historical context of CCHF in Tajikistan, much of which has been described over several decades in the Russian literature, and include reports of recent outbreaks in Tajikistan.

  2. An update on crimean congo hemorrhagic fever

    Directory of Open Access Journals (Sweden)

    Suma B Appannanavar


    Full Text Available Crimean Congo hemorrhagic fever (CCHF is one of the deadly hemorrhagic fevers that are endemic in Africa, Asia, Eastern Europe, and the Middle East. It is a tick-borne zoonotic viral disease caused by CCHF virus of genus Nairovirus (family Bunyaviridae. CCHF not only forms an important public health threat but has a significant effect on the healthcare personnel, especially in resource-poor countries. India was always a potentially endemic area until an outbreak hit parts of Gujarat, taking four lives including the treating medical team. The current review is an attempt to summarize the updated knowledge on the disease particularly in modern era, with special emphasis on nosocomial infections. The knowledge about the disease may help answer certain questions regarding entry of virus in India and future threat to community.

  3. Infection control during filoviral hemorrhagic fever outbreaks

    Directory of Open Access Journals (Sweden)

    N Raabe Vanessa


    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.


    Davis, Nelson C.; Shannon, Raymond C.


    1. Batches of Aëdes (Stegomyia) aegypti which had fed on monkeys in the early febrile stage of yellow fever and which has subsequently passed the usually accepted extrinsic incubation period for the virus, failed to transmit the disease to normal monkeys in approximately fifty per cent of the experiments. During the same time over eighty per cent of blood transfers were successful. 2. The monkeys which failed to show fever following mosquito bites later proved resistant to the inoculation of blood or tissues containing virus. 3. The incubation, or afebrile, period in monkeys following the bites of infected mosquitoes varied from less than twenty-four hours to fifteen days. It averaged somewhat longer in non-fatal than in fatal infections. PMID:19869665

  5. Cases of typhoid fever in Copenhagen region

    DEFF Research Database (Denmark)

    Barrett, Freja Cecille; Knudsen, Jenny Dahl; Johansen, Isik Somuncu


    Typhoid fever is a systemic illness which in high-income countries mainly affects travellers. The incidence is particularly high on the Indian subcontinent. Travellers who visit friends and relatives (VFR) have been shown to have a different risk profile than others. We wished to identify main ch...... characteristics for travellers infected with S. Typhi considering both clinical and laboratory findings in order to provide for faster and better diagnostics in the future. The outcome of treatment, especially concerning relapse, was evaluated as well.......Typhoid fever is a systemic illness which in high-income countries mainly affects travellers. The incidence is particularly high on the Indian subcontinent. Travellers who visit friends and relatives (VFR) have been shown to have a different risk profile than others. We wished to identify main...

  6. Chikungunya fever presenting with acute optic neuropathy. (United States)

    Mohite, Abhijit Anand; Agius-Fernandez, Adriana


    Chikungunya fever is a vector borne virus that typically causes a self-limiting systemic illness with fever, skin rash and joint aches 2 weeks after infection. We present the case of a 69-year-old woman presenting with an acute unilateral optic neuropathy as a delayed complication of Chikungunya virus (CHIKV) infection contracted during a recent trip to the West Indies. She presented to our ophthalmology department with acute painless visual field loss in the right eye and a recent flu-like illness. She was found to have a right relative afferent pupillary defect (RAPD) with unilateral optic disc swelling. Serology confirmed recent CHIKV infection. Treatment with intravenous methylprednisolone was delayed while awaiting MRI scans and serology results. At 5-month follow-up, there was a persistent right RAPD and marked optic atrophy with a corresponding inferior scotoma in the visual field. 2015 BMJ Publishing Group Ltd.

  7. Fever of unknown origin in elderly patients. (United States)

    Knockaert, D C; Vanneste, L J; Bobbaers, H J


    To describe the spectrum of diseases that may give rise to fever of unknown origin in elderly patients and to delineate the diagnostic approach in these patients. Subgroup analysis of a prospectively collected case series followed more than 2 years. General Internal Medicine Service based at University hospital, Leuven, Belgium. Forty-seven consecutive patients, older than 65 years, meeting the classic criteria of fever of unknown origin. The final diagnosis established and the clinical value of diagnostic procedures. Infections, tumors and multisystem diseases (encompassing rheumatic diseases, connective tissue disorders, vasculitis including temporal arteritis, polymyalgia rheumatica, and sarcoidosis) were found in 12 (25%), six (12%) and 15 patients (31%), respectively. Drug-related fever was the cause in three patients (6%), miscellaneous conditions were found in five patients (10%), and six patients (12%) remained undiagnosed. Microbiologic investigations were diagnostic in eight cases (16%), serologic tests yielded one diagnosis, immunologic investigations had a diagnostic value in four cases, standard X-rays yielded a diagnostic contribution in 10 cases, ultrasonography and computed tomography were diagnostic in 11 cases, Gallium scintigraphy had a diagnostic contribution in 17 cases, and biopsies yielded the final diagnosis in 18 cases. Multisystem diseases emerged as the most frequent cause of fever of unknown origin in the elderly, and temporal arteritis was the most frequent specific diagnosis. Infections, particularly tuberculosis, remain an important group. The percentage of tumors was higher in our elderly patients than in the younger ones but still clearly lower than in other recent series of FUO in adults. The number of undiagnosed cases was significantly lower in elderly patients than in younger individuals (P < or = 0.01). The investigation of elderly patients with FUO should encompass routine temporal artery biopsy and extensive search for

  8. Crimean-Congo Hemorrhagic Fever, Sudan, 2008

    Centers for Disease Control (CDC) Podcasts


    This podcast describes the emergence of the first human cases of Crimean-Congo Hemorrhagic Fever in Sudan in 2008. CDC epidemiologist Dr. Stuart Nichol discusses how the disease was found in Sudan and how it spread in a hospital there.  Created: 4/15/2010 by National Center for Emerging and Zoonotic Infections (proposed).   Date Released: 4/15/2010.

  9. Argentine hemorrhagic fever: a primate model. (United States)

    Weissenbacher, M C; Calello, M A; Colillas, O J; Rondinone, S N; Frigerio, M J


    Experimental Junin virus infection of a New World primate, Callithrix jacchus, was evaluated. The virus produced anorexia, loss of weight, thrombocytopenia, leukopenia, and hemorrhagic and neurological symptoms and terminated in death. Virus was recovered from urine, blood samples and all tissues taken at autopsy. These preliminary observations show that several aspects of the experimental disease in C. jacchus are quite similar to severe natural Argentine hemorrhagic fever of man.

  10. Familial Mediterranean fever, review of the literature. (United States)

    Alghamdi, Mansour


    Familial Mediterranean fever (FMF) is the most common monogenic periodic fever syndrome and characterized by recurrent episodes of fever, serositis, arthritis, dermal manifestations, and long-term renal complications. The MEFV gene was described in 1997 as the gene responsible for FMF and is inherited in autosomal recessive manner. It encodes mutated protein pyrin, an important player in the innate immune system and the component of inflammasome which leads to exaggerated inflammatory response through uncontrolled production of interleukin-1. The recent progress in molecular genetics and understanding of pathogenesis showed a more complicated picture of FMF inheritance, penetrance, and pathogenesis. The pathogenesis is not completely understood although the gene responsible for FMF has been identified. Whether the pyrin mutation effect in FMF is due to a loss of function or a gain of function is still controversial. The diagnosis is mainly clinical and the genetic testing is indicated to support it. Colchicine remains the mainstay of treatment of FMF since 1972. It decreases the attacks, improves quality of life, and prevents amyloidosis. The recent advances in genetic testing and molecular studies has led to the development of new therapies of interleukin-1 inhibitors; anakinra, canakinumab, and rilonacept.

  11. Advanced Vaccine Candidates for Lassa Fever

    Directory of Open Access Journals (Sweden)

    Igor S. Lukashevich


    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.

  12. Recurrent acute rheumatic fever: a forgotten diagnosis? (United States)

    Kadir, Isaac S; Barker, Thomas A; Clarke, Bernard; Denley, Helen; Grötte, Geir J


    The incidence of acute rheumatic fever has seen a dramatic decline over the last 15 to 20 years in most developed countries and treatment of this disease has changed little since. The ease of travel and immigration and the cosmopolitan nature of many cities mean that occasionally the disease will come to the attention of clinicians not familiar with its presentation, resulting in delayed diagnosis and treatment. We present a case of recurrent acute rheumatic fever in a patient who was initially thought to be suffering from acute bacterial endocarditis on her previously diseased rheumatic aortic valve. This culminated in her undergoing urgent aortic valve replacement during a phase of the illness that should have been treated with high dose anti-inflammatory medication. Therefore, clinicians should be aware of this condition and include it in their differential diagnosis of the febrile patient with a previous history of rheumatic fever. We briefly discuss the diagnostic dilemma of patients suffering from this condition and in differentiating it from acute endocarditis.

  13. Pathogenesis of lassa fever in cynomolgus macaques

    Directory of Open Access Journals (Sweden)

    Fritz Elizabeth A


    Full Text Available Abstract Background Lassa virus (LASV infection causes an acute and sometimes fatal hemorrhagic disease in humans and nonhuman primates; however, little is known about the development of Lassa fever. Here, we performed a pilot study to begin to understand the progression of LASV infection in nonhuman primates. Methods Six cynomolgus monkeys were experimentally infected with LASV. Tissues from three animals were examined at an early- to mid-stage of disease and compared with tissues from three animals collected at terminal stages of disease. Results Dendritic cells were identified as a prominent target of LASV infection in a variety of tissues in all animals at day 7 while Kupffer cells, hepatocytes, adrenal cortical cells, and endothelial cells were more frequently infected with LASV in tissues of terminal animals (days 13.5-17. Meningoencephalitis and neuronal necrosis were noteworthy findings in terminal animals. Evidence of coagulopathy was noted; however, the degree of fibrin deposition in tissues was less prominent than has been reported in other viral hemorrhagic fevers. Conclusion The sequence of pathogenic events identified in this study begins to shed light on the development of disease processes during Lassa fever and also may provide new targets for rational prophylactic and chemotherapeutic interventions.

  14. Advanced vaccine candidates for Lassa fever. (United States)

    Lukashevich, Igor S


    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.

  15. [Chikungunya fever - A new global threat]. (United States)

    Montero, Antonio


    The recent onset of epidemics caused by viruses such as Ebola, Marburg, Nipah, Lassa, coronavirus, West-Nile encephalitis, Saint Louis encephalitis, human immunodeficiency virus, dengue, yellow fever and Venezuelan hemorrhagic fever alerts about the risk these agents represent for the global health. Chikungunya virus represents a new threat. Surged from remote African regions, this virus has become endemic in the Indic ocean basin, the Indian subcontinent and the southeast of Asia, causing serious epidemics in Africa, Indic Ocean Islands, Asia and Europe. Due to their epidemiological and biological features and the global presence of their vectors, chikungunya represents a serious menace and could become endemic in the Americas. Although chikungunya infection has a low mortality rate, its high attack ratio may collapse the health system during epidemics affecting a sensitive population. In this paper, we review the clinical and epidemiological features of chikungunya fever as well as the risk of its introduction into the Americas. We remark the importance of the epidemiological control and mosquitoes fighting in order to prevent this disease from being introduced into the Americas. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  16. Quantidades e tempos de decomposição da jitirana no desempenho agronômico do coentro Amounts and times of decomposition of scarlet starglory on agronomic performance of cilandro

    Directory of Open Access Journals (Sweden)

    Paulo César Ferreira Linhares


    Full Text Available A prática da adubação verde promove benefícios aos sistemas de produção de hortaliças. Este trabalho foi conduzido na fazenda experimental Rafael Fernandes do Departamento de Ciências Vegetais da Universidade Federal Rural do Semi-Árido (UFERSA, Mossoró-RN, no período de junho a outubro de 2009, com o objetivo de avaliar o desempenho agronômico do coentro da cultivar 'Verdão' sob diferentes quantidades e tempos de incorporação da jitirana ao solo. O delineamento experimental usado foi de blocos completos casualizados com os tratamentos arranjados em esquema fatorial 4x4, com três repetições, com 144 plantas por parcela, sendo o primeiro fator constituído pelas quantidades de jitirana (5,4; 8,8; 12,2 e 15,6Mg ha-1 em base seca, o segundo pelos tempos de sua incorporação ao solo (0, 10, 20 e 30 dias antes a semeadura - DAS. A cultivar de coentro plantado foi a 'Verdão'. As características avaliadas foram: altura e número de hastes por planta, matéria fresca e massa da matéria seca da parte aérea. Foi observada interação significativa para número de hastes por planta. O melhor desempenho agronômico do coentro foi obtido na quantidade de 15,6Mg ha-1 de jitirana incorporada ao solo, no tempo de 30 dias.The practice of green manuring promotes benefits to production systems of hortals. One experiment was carried out at experimental farm of Departament of plant Sciences, Federal Rural University of the Semi-Arid (UFERSA, Mossoró-RN, in the period from June to October 2009, with the aim of evaluating the agronomic performance of coriander under different amounts and decomposition times of and scarlet starglory incorporated into the soil. The experimental design was a randomized complete block with treatments arranged in a 4x4, with three replications, and 144 plants per plot, where the first factor consisted of the amounts of scarlet starglory (5.4, 8.8, 12.2 and 15.6Mg ha-1 dry matter, the second one by the times of soil

  17. Chikungunya Fever Presenting as a Systemic Disease with Fever. Arthritis and Rash: Our Experience in Israel. (United States)

    Tanay, Amir


    Chikungunya fever (CHIK-F) has been increasingly documented among Western travelers returning from areas with chikungunya virus transmission, which are also popular tourist sites. We present three Israeli travelers who developed fever, maculopapular rash and long-standing arthralgias while visiting northern Indian states not known to be involved in the chikungunya fever epidemic. We also present an epidemiological review of the chikungunya epidemic over the past decades. Rare systemic manifestations of this disorder, like catastrophic antiphospholipid syndrome (CAPS) and adult-onset Still's syndrome, are discussed. The present era of international travel poses a new diagnostic and epidemiologic challenge that demands increased awareness to the possibility of an exotic tropical infectious disease.

  18. Study on the possible use of Vi polysaccharide typhoid fever vaccine to control endemic typhoid fever in Nepal

    Directory of Open Access Journals (Sweden)

    Surendra Karki


    Full Text Available This review of literature was conducted to explore the various aspects of typhoid fever in Nepal and to identify the factors concerned in the possible use of the Vi polysaccharide typhoid fever vaccine in Nepal as the tool for prevention and control. There are hotspots of Typhoid fever in developing countries, urban areas and slums, where poor conditions of safe drinking water and sanitation prevail. The use of currently available typhoid fever vaccines, especially the Vi polysaccharide vaccine has been recommended by World Health Organization to control typhoid fever in endemic areas. However, factors like, the burden and the changing epidemiological pattern of the disease, efficacy of the vaccines, ease for intervention, cost effectiveness, financing, and programmatic issues should be considered in local settings before the introduction of vaccines as a public health tool for prevention. We concluded that the possible use of currently available Vi polysaccharide vaccine to control endemic typhoid fever in Nepal might not have the same positive impact as reported in trials from different Asian countries. The major issues to be considered are emergence of Salmonella Paratyphi A as a major cause of enteric fever, no difference in prevalence of typhoid fever in preschool and school children, similar clinical profiles and severity of typhoid and paratyphoid fever. So, an ideal vaccine that can provide the protection both to typhoid and paratyphoid fever, and the vaccination programs that also includes preschool children would be the best option for Nepal.

  19. Doxycycline-induced drug fever: a case report. (United States)

    Yuan, Hai-Ling; Lu, Ning-Wei; Xie, Hua; Zheng, Yuan-Yuan; Wang, Qiu-Hong


    Drug fever is a febrile reaction induced by a drug without additional clinical symptoms. This adverse reaction is not rare but under diagnosed and under reported. Doxycycline is a tetracycline compound with broad-spectrum antibiotic activity. Drug fever induced by doxycycline is rarely reported. In this study, we describe a patient in whom doxycycline induced drug fever after 17 days of therapy for brucellosis.

  20. Clinical and laboratory diagnosis of Zika fever: an update


    Xavier,Analúcia R.; Kanaan,Salim; Bozzi,Ronielly P.; Amaral,Luiza V.


    ABSTRACT Zika fever can be defined as an acute febrile viral illness, mainly transmitted by the mosquito of the genus Aedes. It makes a differential diagnosis from diseases caused by other flaviviruses, such as chikungunya and dengue fever. Many people with Zika virus (ZIKV) infection will not have symptoms or will only have mild clinical symptoms. The clinical conditions are nonspecific and characterized by low-grade fever, pruritic erythematous maculopapular rash, non-purulent conjunctival ...

  1. Acute viscerotropic disease following vaccination against yellow fever. (United States)

    Hayes, Edward B


    Acute viscerotropic disease following yellow fever vaccination (YEL-AVD) is a rare but serious complication of vaccination with 17D yellow fever vaccine. This paper reviews the existing literature regarding YEL-AVD and discusses possible etiologic mechanisms. A greater understanding of this condition is essential to assuring safe and effective prevention of yellow fever and vaccination against other arboviral diseases for which 17D-based vaccines are being developed.

  2. Yellow Fever Outbreaks in Unvaccinated Populations, Brazil, 2008–2009


    Alessandro Pecego Martins Romano; Zouraide Guerra Antunes Costa; Daniel Garkauskas Ramos; Maria Auxiliadora Andrade; Valéria de Sá Jayme; Marco Antônio Barreto de Almeida; Kátia Campomar Vettorello; Melissa Mascheretti; Brendan Flannery


    Author Summary Yellow fever is a viral hemorrhagic disease transmitted by mosquitos, endemic in tropical regions of Africa and South America. Large urban outbreaks of yellow fever have been eliminated in the Americas, where most yellow fever cases result from human exposure to jungle or forested environments. Vaccination is effective but carries a risk of potentially fatal adverse events in a small number of vaccinees. In a large country such as Brazil, vaccination is recommended only in area...

  3. Yellow fever in China is still an imported disease. (United States)

    Chen, Jun; Lu, Hongzhou


    Yellow fever is a vector-borne disease endemic to tropical regions of Africa and South America. A recent outbreak in Angola caused hundreds of deaths. Six cases of yellow fever imported from Angola were reported recently in China. This raised the question of whether it will spread in China and how it can be prevented. This article discusses the possibility of yellow fever transmission in China and the strategies to counter it.

  4. Influences on parents' fever management: beliefs, experiences and information sources. (United States)

    Walsh, Anne; Edwards, Helen; Fraser, Jenny


    To identify parents' knowledge, beliefs, management and sources of information about fever management. Despite numerous studies exploring parents' management of childhood fever; negative beliefs about fever and overuse of antipyretics and health services for mild fevers and self-limiting viral illnesses continue to be reported. Qualitative design using semi-structured interviews and discussions. Fifteen metropolitan parents whose children were aged six months to five years, volunteered to participate in individual interviews or group discussions. Recruitment was through Playgroup Queensland's online newsletter and letters from two childcare centres to all parents. Verbatim and audio data were collected by an experienced moderator using a semi-structured interview guide. Two transcripts were independently analysed by two researchers; categories, sub-headings and codes were independently developed, crosschecked and found comparable. Remaining transcripts were analysed using developed categories and codes. Fever, determined through behavioural changes, was perceived as 'good', a warning that something was wrong. High fever, reported as 38.0-39.1 degrees C, was considered harmful; it must be prevented or reduced irrespective of concerns about antipyretics. Positive febrile experiences reduced concern about fever. Negative experiences such as febrile convulsions, media reports of harm, not receiving a definitive diagnosis, inaccessibility to regular doctors and receiving conflicting information about fever management increased the concerns. Parents seek information about fever from multiple sources such as doctors, books and other parents. Parents' experiences with and information sources about fever and fever management influenced their knowledge, beliefs and practices. Positive experiences reduce concerns, health service usage and sometimes antipyretic usage. Negative experiences increase concerns, monitoring and antipyretic and health service usage. Health

  5. Seir Model for Transmission of Dengue Fever in Selangor Malaysia (United States)

    Syafruddin, S.; Noorani, M. S. M.

    In this paper, we study a system of differential equations that models the population dynamics of SEIR vector transmission of dengue fever. The model studied breeding value based on the number of reported cases of dengue fever in Selangor because the state had the highest case in Malaysia. The model explains that maximum level of human infection rate of dengue fever achieved in a very short period. It is also revealed that there existed suitability result between theoretical and empirical calculation using the model. The result of SEIR model will hopefully provide an insight into the spread of dengue fever in Selangor Malaysia and basic form for modeling this area.

  6. Anesthesia experience along with familial Mediterranean fever and celiac disease

    Directory of Open Access Journals (Sweden)

    Mehmet Sargın


    Full Text Available (Anesthetic management in patient with Familial Mediterranean Fever and Celiac Disease Familial Mediterranean Fever is an autosomal recessive transmitted disease which often seen at Mediterranean origin society and it goes by deterioration at inflammation control. Celiac disease is a proximal small intestine disease which develops gluten intolerance by autoimmune mechanism in sensitive people. Association of Familial Mediterranean Fever and Celiac disease is a rare situation. In this article we present our anesthesia experience on a bilateral septic arthritis case who also have Familial Mediterranean Fever and Celiac disease association.

  7. Sensorineural hearing loss in Lassa fever: two case reports

    Directory of Open Access Journals (Sweden)

    Okokhere Peter O


    Full Text Available Abstract Introduction Lassa fever is an acute arena viral haemorrhagic fever with varied neurological sequelae. Sensorineural hearing loss is one of the rare complications which occur usually during the convalescent stage of the infection. Case presentation The cases of two female patients aged 19 and 43 years old, respectively, with clinical features suggestive of Lassa fever and confirmed by immunoserological/Lassa-virus-specific reverse transcriptase polymerase chain reaction are presented. Both patients developed severe sensorineural hearing loss at acute phases of the infections. Conclusion Sensorineural hearing loss from Lassa fever infections can occur in both acute and convalescent stages and is probably induced by an immune response.

  8. Lassa fever presenting as acute abdomen: a case series. (United States)

    Dongo, Andrew E; Kesieme, Emeka B; Iyamu, Christopher E; Okokhere, Peter O; Akhuemokhan, Odigie C; Akpede, George O


    Lassa fever, an endemic zoonotic viral infection in West Africa, presents with varied symptoms including fever, vomiting, retrosternal pain, abdominal pain, sore-throat, mucosal bleeding, seizures and coma. When fever and abdominal pain are the main presenting symptoms, and a diagnosis of acute abdomen is entertained, Lassa fever is rarely considered in the differential diagnosis, even in endemic areas. Rather the diagnosis of Lassa fever is suspected only after surgical intervention. Therefore, such patients often undergo unnecessary surgery with resultant delay in the commencement of ribavirin therapy. This increases morbidity and mortality and the risk of nosocomial transmission to hospital staff. We report 7 patients aged between 17 months and 40 years who had operative intervention for suspected appendicitis, perforated typhoid ileitis, intussuception and ruptured ectopic pregnancy after routine investigations. All seven were post-operatively confirmed as Lassa fever cases. Four patients died postoperatively, most before commencement of ribavirin, while the other three patients eventually recovered with appropriate antibiotic treatment including intravenous ribavirin. Surgeons working in West Africa should include Lassa fever in the differential diagnosis of acute abdomen, especially appendicitis. The presence of high grade fever, proteinuria and thrombocytopenia in patients with acute abdomen should heighten the suspicion of Lassa fever. Prolonged intra-operative bleeding should not only raise suspicion of the disease but also serve to initiate precautions to prevent nosocomial transmission.

  9. Orthopnea and fever in an elderly woman

    Directory of Open Access Journals (Sweden)

    Claudio Tana


    Full Text Available Orthopnea is a sensation of shortness of breath, which occurs in recumbent position and is usually improved by standing or sitting. The authors report a case of an 81-year-old woman presented to the Emergency Department with a two-week history of orthopnea, fever and low back pain resistant to analgesics. Radiological findings confirm the presence of a diafragmatic hernia, and clinicians should pay attention to any history of trauma, because their absence in symptomatic adult patients directs towards a congenital cause. A surgical repair should be promptly obtained to avoid further general and respiratory deterioration.

  10. What's new in Rocky Mountain spotted fever? (United States)

    Chen, Luke F; Sexton, Daniel J


    Rocky Mountain spotted fever (RMSF) remains an important illness despite an effective therapy because it is difficult to diagnose and is capable of producing a fatal outcome. The pathogenesis of RMSF remains, in large part, an enigma. However, recent research has helped shed light on this mystery. Importantly, the diagnosis of RMSF must be considered in all febrile patients who have known or possible exposure to ticks, especially if they live in or have traveled to endemic regions during warmer months. Decisions about giving empiric therapy to such patients are difficult and require skill and careful judgement.

  11. Fever, jaundice and acute renal failure. (United States)

    O'Toole, Sam M; Pathak, Neha; Toms, Graham C; Gelding, Susan V; Sivaprakasam, Venkat


    Leptospirosis is an uncommon infectious disease that has protean clinical manifestations ranging from an innocuous 'flu-like' illness to potentially life-threatening multi-organ failure. Here we describe a case of Weil's disease that presented on the acute medical take with fever, jaundice and acute renal failure. We highlight the importance of careful history taking at the time of admission and how understanding the epidemiology and pathophysiology of leptospirosis enables a definitive diagnosis to be reached. © 2015 Royal College of Physicians.

  12. Chikungunya fever in Los Angeles, California. (United States)

    Harter, Katherine R; Bhatt, Sanjay; Kim, Hyung T; Mallon, William K


    We report the case of a 33-year-old woman returning from Haiti, presenting to our emergency department (ED) with fever, rash and arthralgia. Following a broad workup that included laboratory testing for dengue and malaria, our patient was diagnosed with Chikungunya virus, which was then reported to the Centers for Disease Control and Prevention for initiation of infection control. This case demonstrates the importance of the ED for infectious disease case identification and initiation of public health measures. This case also addresses public health implications of Chikungunya virus within the United States, and issues related to the potential for local spread and autochthonous cases.

  13. Crimean-Congo Hemorrhagic Fever and Hemorrhagic Fever with Renal Syndrome in Greece. (United States)


    illness with anuria , .. conjuctivitis and large ecchymosis on left arm, but his general condition was satisfactory. Management: Peritoneal dialysis was...right lung with- no fever, followed by gradual confusion and stupor with meningism. Apart from passing 50 ml of blood stained urine, anuria persisted

  14. Causes and consequences of fever complicating critical surgical illness. (United States)

    Barie, Philip S; Hydo, Lynn J; Eachempati, Soumitra R


    Fever may have malign consequences in the postoperative period. This study was performed to determine the causes and consequences of fever in critically ill surgical patients. The specific hypothesis tested is that postoperative fever is associated with adverse clinical outcomes, including increased organ dysfunction and risk of death. Inception-cohort study of critically ill surgical patients who manifested a core temperature of >/=38.2 degrees C for the first time. The episode of fever was monitored until resolution, which was defined as a core temperature of Durbin-Watson statistic. Cases where both non-infectious and infectious causes of fever were present were analyzed as part of the infectious group, whereas the cumulative MOD score was dichotomized (/=5 points) at a value known to be associated with increased mortality. Among 2,419 screened patients, 626 patients (26%) developed fever. Febrile patients were older, sicker, more likely to have undergone emergency surgery, more likely to develop organ dysfunction, and more likely to die (all, p < 0.0001). The mean day of onset of fever was day 1 and the mean peak temperature for the episode was 39.1 +/- 0.1 degrees C. For most patients, it was their only episode of fever, with a mean of 1.4 +/- 0.1 episodes/patient. Forty-six percent of febrile patients were found to have an infectious cause of fever. Nearly all patients had SIRS, and nearly all developed organ dysfunction to some degree. By logistic regression, the presence of SIRS (as opposed to fever in isolation), emergency status, higher APACHE III score and the peak temperature were associated with increased mortality, with peak temperature being the most powerful predictor in the model (OR 2.20, 95% Cl 1.57-3.19). Gender had no bearing on outcome, and there was a trend toward a protective effect from an infectious etiology of fever. Postoperative fever is deleterious to critically ill patients. The magnitude of fever is a determinant of mortality

  15. Behaviors associated with fever in children with autism spectrum disorders. (United States)

    Curran, Laura K; Newschaffer, Craig J; Lee, Li-Ching; Crawford, Stephen O; Johnston, Michael V; Zimmerman, Andrew W


    Clinical case reports have suggested that the behaviors of children with autism spectrum disorders may improve with fever. The purpose of this study was to investigate the effect of illness on behaviors of children with autism spectrum disorders. Understanding the role of fever, if any, may be informative regarding causative mechanisms of and treatment opportunities for autism. We conducted a prospective study of 30 children (aged 2-18 years) with autism spectrum disorders during and after an episode of fever. Parent responses to the Aberrant Behavior Checklist were collected during fever (body temperature > or = 38.0 degrees C/100.4 degrees F), when fever had abated and the child was asymptomatic, and when the child had been fever-free for 7 days. Data were compared with those collected from parents of 30 age-, gender-, and language skills-matched afebrile children with autism spectrum disorders during similar time intervals. Fewer aberrant behaviors were recorded for febrile patients on the Aberrant Behavior Checklist subscales of irritability, hyperactivity, stereotypy, and inappropriate speech compared with control subjects. Per expectation, lethargy scores were greater during fevers, and all improvements were transient. Data from patients with fever were stratified on variables related to illness severity. In the majority of these subgroup comparisons, the data suggested that effects from fever persisted in the less sick patients as well as in those with more severe illness. We documented behavior change among children with autism spectrum disorders during fever. The data suggest that these changes might not be solely the byproduct of general effects of sickness on behavior; however, more research is needed to prove conclusively fever-specific effects and elucidate their underlying biological mechanisms (possibly involving immunologic and neurobiological pathways, intracellular signaling, and synaptic plasticity).

  16. Fever after aneurysmal subarachnoid hemorrhage: relation with extent of hydrocephalus and amount of extravasated blood

    NARCIS (Netherlands)

    Dorhout Mees, Sanne M.; Luitse, Merel J. A.; van den Bergh, Walter M.; Rinkel, Gabriel J. E.


    BACKGROUND AND PURPOSE: Fever after aneurysmal subarachnoid hemorrhage is associated with poor outcome. Because hydrocephalus and extravasated blood may influence thermoregulation, we determined whether these factors increase the risk for fever after subarachnoid hemorrhage. METHODS: Fever within 14

  17. Q fever and animal abortion in Cyprus. (United States)

    Spicer, A J; Crowther, R W; Vella, E E; Bengtsson, E; Miles, R; Pitzolis, G


    Seventy-eight British soldiers stationed in the Eastern Sovereign Base Area (ESBA) in Cyprus contracted Q fever in the period December 1974 to June 1975. Pneumonia developed in 59% of cases. Of 31 patients tested, 81% had biochemical evidence of hepatitis although only one became clinically jaundiced. Three patients (4%) suffered pericarditis. Treatment with tetracycline had no apparent effect on the course of the disease. Investigation revealed an abortion epidemic involving 21 mixed flocks of sheep and goats in the south-eastern coastal region. 11 of the flocks grazed in and around the ESBA. A serological survey of 10 affected flocks, and evidence collected from previous years, indicated that the abortion epidemic was the result of infection with Coxiella burneti. Infection in the humans was almost certainly acquired by inhalation of dust from brush contaminated with rickettsial parturition products of the aborting flocks. A human serological survey revealed a number of cases of subclinical Q fever in a susceptivle military population, and an asymptomatic epidemic in a largely immune local position.

  18. The thermal stability of yellow fever vaccines. (United States)

    Ishak, R; Howard, C R


    The assessment of yellow fever vaccine thermostability both in lyophilized form and after reconstitution were analyzed. Two commercial yellow fever vaccines were assayed for their thermal stability. Vaccines were exposed to test temperatures in the range of 8 degrees C to 45 degrees C. Residual infectivity was measured by a plaque assay using Vero cells. The titre values were used in an accelerated degradation test that follows the Arrhenius equation and the minimum immunizing dose was assumed to be 10(3) particles forming unit (pfu)/dose. Some of the most relevant results include that (i) regular culture medium show the same degradation pattern of a reconstituted 17D-204 vaccine; (ii) reconstituted YF-17D-204 showed a predictable half life of more than six days if kept at 0 degrees C; (iii) there are differences in thermostability between different products that are probably due to both presence of stabilizers in the preparation and the modernization in the vaccine production; (iv) it is important to establish a proper correlation between the mouse infectivity test and the plaque assay since the last appears to be more simple, economical, and practical for small laboratories to assess the potency of the vaccine, and (v) the accelerated degradation test appears to be the best procedure to quantify the thermostability of biological products.

  19. Acetaminophen: beyond pain and fever-relieving

    Directory of Open Access Journals (Sweden)

    Eric eBlough


    Full Text Available Acetaminophen, also known as APAP or paracetamol, is one of the most widely used analgesics (pain reliever and antipyretics (fever reducer. According to the U.S. Food and Drug Administration (FDA, currently there are 235 approved prescription and over-the-counter drug products containing acetaminophen as an active ingredient. When used as directed, acetaminophen is very safe and effective; however when taken in excess or ingested with alcohol hepatotoxicity and irreversible liver damage can arise. In addition to well known use pain relief and fever reduction, recent laboratory and pre-clinical studies have demonstrated that acetaminophen may also have beneficial effects on blood glucose levels, skeletal muscle function, and potential use as cardioprotective and neuroprotective agents. Extensive laboratory and pre-clinical studies have revealed that these off label applications may be derived from the ability of acetaminophen to function as an antioxidant. Herein, we will highlight these novel applications of acetaminophen, and attempt, where possible, to highlight how these findings may lead to new directions of inquiry and clinical relevance of other disorders.

  20. Dengue Fever: Causes, Complications, and Vaccine Strategies

    Directory of Open Access Journals (Sweden)

    Niyati Khetarpal


    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.

  1. Dengue Fever: Causes, Complications, and Vaccine Strategies. (United States)

    Khetarpal, Niyati; Khanna, Ira


    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.

  2. [Molecular epidemiology of Xinjiang hemorrhagic fever viruses]. (United States)

    Tang, Qing; Zhao, Xiu-qin; Wang, Huan-yu; Simayi, Bawudong; Zhang, Yu-zhen; Saijo, Masayuki; Morikawa, Shigeru; Liang, Guo-dong; Kurane, Ichiro


    To study the molecular biology of Xinjiang hemorrhagic fever (XHF) viruses, to explore its relationship with other Crimean-Congo hemorrhagic fever viruses, analyzing the epidemic origin and the tendency of geographic distribution of XHF. The S partial segment from the patient and tick samples collected in 2001 and 2002 was tested by RT-PCR, the positive samples were sequenced directly. The nucleotide homology of S partial segment as well as the whole segments were analyzed and the phylogenetic tree of S and M gene segments was drawn by computer. All compared sequences of S partial segments from the patient and tick samples showed a high homology of nucleotide sequences. Phylogenetic tree divided all the analyzed viruses into three groups; Europe, African and Asian group. The Asian group can be divided further into another two branches: the middle Asian branch and the Chinese branch. All the Chinese isolates were clustered into one single group and was easy to be discriminated from the other isolates. The dividing of M segments seemed not completely related to the geographic origin of the viruses. M segment classification was not consistent to the geographic distribution of the viruses. S segments analysis showed the close relationship of genetic background between the patient isolates and the tick isolates. Besides, all the Chinese isolates have the common evolution route and the gene structure characteristics displayed the regional distribution pattern.

  3. Tick-Borne Relapsing Fever in Dogs. (United States)

    Piccione, J; Levine, G J; Duff, C A; Kuhlman, G M; Scott, K D; Esteve-Gassent, M D


    In the United States, Tick-Borne Relapsing Fever (TBRF) in dogs is caused by the spirochete bacteria Borrelia turicatae and Borrelia hermsii, transmitted by Ornithodoros spp. ticks. The hallmark diagnostic feature of this infection is the visualization of numerous spirochetes during standard blood smear examination. Although the course of spirochetemia has not been fully characterized in dogs, in humans infected with TBRF the episodes of spirochetemia and fever are intermittent. To describe TBRF in dogs by providing additional case reports and reviewing the disease in veterinary and human medicine. Five cases of privately-owned dogs naturally infected with TBRF in Texas are reviewed. Case series and literature review. All dogs were examined because of lethargy, inappetence, and pyrexia. Two dogs also had signs of neurologic disease. All dogs had thrombocytopenia and spirochetemia. All cases were administered tetracyclines orally. Platelet numbers improved and spirochetemia and pyrexia resolved in 4 out of 5 dogs, where follow-up information was available. TBRF is likely underdiagnosed in veterinary medicine. In areas endemic to Ornithodoros spp. ticks, TBRF should be considered in dogs with thrombocytopenia. Examination of standard blood smears can provide a rapid and specific diagnosis of TBRF when spirochetes are observed. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  4. Classical Swine Fever Virus-Rluc Replicons

    DEFF Research Database (Denmark)

    Risager, Peter Christian; Belsham, Graham J.; Rasmussen, Thomas Bruun

    Classical swine fever virus (CSFV) is the etiologic agent of the severe porcine disease, classical swine fever. Unraveling the molecular determinants of efficient replication is crucial for gaining proper knowledge of the pathogenic traits of this virus. Monitoring the replication competence with...... type CSFV-Paderborn strain, as judged by qRT-PCR, was picked as the candidate and could potentially be useful as a tool for further downstream applications including investigation of CSFV non-structural proteins involvement in viral replication....... cells can be achieved using autonomously replicating genome constructs (replicons) containing a reporter gene that expresses a readily quantifiable enzyme. Here, a newly implemented cloning technique was applied to genome modification of the full-length CSFV cDNA previously inserted into a single......-copy bacterial artificial chromosome (BAC). This technique, the Red/ET counter-selection method, is based upon homologous recombination, thus obviating the need for internal restriction sites. Several CSFV replicons with deletions in regions encoding structural viral proteins considered non-essential for RNA...

  5. [Phenylbutazone-induced sialadenitis fever simulating angioedema]. (United States)

    Viseux, V; Béguin, L; Poulain, J F; Sarraj, A; Mayeux, I; Carmi, E; Lafon, B; Lok, C


    Drug-induced sialadenitis is uncommon and unrecognized. Drugs such as nitrofurantoïn, nifedipine and methimazole have been reported to induce sialadenitis. However, phenylbutazone and oxyphenbutazone are the most frequently implicated agents. We describe a case of phenylbutazone-induced parotitis and submaxillitis with cutaneous and hepatic involvement. A 51 year-old woman who had received phenylbutazone for the past 6 days was hospitalized for diagnosis of Quincke's oedema. Clinical examination in fact revealed bilateral parotitis and submaxillitis. The patient had contracted mumps in infancy. Improvement was noticed 8 days after stopping the drug and treatment by glucocorticosteroid. Nevertheless a pruritic eruption with fever appeared. Laboratory data showed leukocytosis with neutrophilia, ESR of 75 mm/hr, hepatic cholestasis and cytolysis. Infectious and autoimmune causes were ruled out. The eruption spontaneously disappeared after 5 days. Laboratory studies 3 weeks later were normal. Quincke's edema diagnosis had been established too fast on "allergic past history" and patient interrogation. Complete clinical examination revealed the correct diagnosis of sialadenitis. This observation shows similarities with other publications: unbearable xerostomia appearing before sialadenitis and with a long course, parotitis with sub-maxillitis, 6 days delay after the first administration of phenylbutazone before fever, local evolution without complication, inflammatory biological syndrome with neutrophilia and absence of infectious cause. Pruritic maculo-papulous eruption and biological hepatic abnormalities are however rare. An hypersensibility mechanism is discussed.

  6. Typhoid fever in Fiji: a reversible plague? (United States)

    Thompson, Corinne N; Kama, Mike; Acharya, Shrish; Bera, Una; Clemens, John; Crump, John A; Dawainavesi, Aggie; Dougan, Gordon; Edmunds, W John; Fox, Kimberley; Jenkins, Kylie; Khan, M Imran; Koroivueta, Josefa; Levine, Myron M; Martin, Laura B; Nilles, Eric; Pitzer, Virginia E; Singh, Shalini; Raiwalu, Ratu Vereniki; Baker, Stephen; Mulholland, Kim


    The country of Fiji, with a population of approximately 870 000 people, faces a growing burden of several communicable diseases including the bacterial infection typhoid fever. Surveillance data suggest that typhoid has become increasingly common in rural areas of Fiji and is more frequent amongst young adults. Transmission of the organisms that cause typhoid is facilitated by faecal contamination of food or water and may be influenced by local behavioural practices in Fiji. The Fijian Ministry of Health, with support from Australian Aid, hosted a meeting in August 2012 to develop comprehensive control and prevention strategies for typhoid fever in Fiji. International and local specialists were invited to share relevant data and discuss typhoid control options. The resultant recommendations focused on generating a clearer sense of the epidemiology of typhoid in Fiji and exploring the contribution of potential transmission pathways. Additionally, the panel suggested steps such as ensuring that recommended ciprofloxacin doses are appropriate to reduce the potential for relapse and reinfection in clinical cases, encouraging proper hand hygiene of food and drink handlers, working with water and sanitation agencies to review current sanitation practices and considering a vaccination policy targeting epidemiologically relevant populations. © 2014 The Authors. Tropical Medicine & International Health published by John Wiley & Sons Ltd.

  7. Dengue fever mimicking acute appendicitis: A case report. (United States)

    McFarlane, M E C; Plummer, J M; Leake, P A; Powell, L; Chand, V; Chung, S; Tulloch, K


    Dengue fever is an acute viral disease, which usually presents as a mild febrile illness. Patients with severe disease present with dengue haemorrhagic fever or dengue toxic shock syndrome. Rarely, it presents with abdominal symptoms mimicking acute appendicitis. We present a case of a male patient presenting with right iliac fossa pain and suspected acute appendicitis that was later diagnosed with dengue fever following a negative appendicectomy. A 13-year old male patient presented with fever, localized right-sided abdominal pain and vomiting. Abdominal ultrasound was not helpful and appendicectomy was performed due to worsening abdominal signs and an elevated temperature. A normal appendix with enlarged mesenteric nodes was found at surgery. Complete blood count showed thrombocytopenia with leucopenia. Dengue fever was now suspected and confirmed by IgM enzyme-linked immunosorbent assay against dengue virus. This unusual presentation of dengue fever mimicking acute appendicitis should be suspected during viral outbreaks and in patients with atypical symptoms and cytopenias on blood evaluation in order to prevent unnecessary surgery. This case highlights the occurrence of abdominal symptoms and complications that may accompany dengue fever. Early recognition of dengue fever mimicking acute appendicitis will avoid non-therapeutic operation and the diagnosis may be aided by blood investigations indicating a leucopenia, which is uncommon in patients with suppurative acute appendicitis. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Parental beliefs and practices regarding childhood fever in Turkish ...

    African Journals Online (AJOL)

    Background: Fever is a very common problem in pediatric age and is one of the most common reasons parents seek medical attention. We aimed to investigate beliefs, habits, and concerns of Turkish parents regarding their children's fever. Materials and Methods: We performed a cross‑sectional survey which was ...

  9. Public health importance of lassa fever epidemiology, clinical ...

    African Journals Online (AJOL)

    The public health importance of Lassa fever can not be over emphasized if one considers the high infectivity and mortality rates associated with the disease. This study dealt extensively on the epidemiology, clinical features and current management of Lassa fever through literature review. The aim of this study is to sensitise ...

  10. Blackwater fever: An insight into a controversy | Chiabi | Clinics in ...

    African Journals Online (AJOL)

    Blackwater fever: An insight into a controversy. A Chiabi, C Mbarga, G Mbonda, E Deungwe, MT Obama, J Minkande Ze, Xiao Yan Yang, PF Tchokoteu. Abstract. The authors present a comprehensive review of the possible pathogenetic mechanisms, pathophysiology and therapeutic options of blackwater fever. The review ...

  11. Guidelines for the genetic diagnosis of hereditary recurrent fevers

    DEFF Research Database (Denmark)

    Shinar, Y; Obici, L; Aksentijevich, I


    Hereditary recurrent fevers (HRFs) are a group of monogenic autoinflammatory diseases characterised by recurrent bouts of fever and serosal inflammation that are caused by pathogenic variants in genes important for the regulation of innate immunity. Discovery of the molecular defects responsible ...

  12. Fever. The Variety of Causes and Complexity of Decision

    Directory of Open Access Journals (Sweden)

    V.M. Delyagin


    Full Text Available The paper presents the principles of thermometry in children, interpretation of the measurement results, as well as the biological mechanisms of fever and the principles of its treatment. It is shown that the drug of choice in the symptomatic treatment of fever in children is ibuprofen (Nurofen for children.

  13. Rationalizing the approach to children with fever in neutropenia

    NARCIS (Netherlands)

    Ammann, Roland A.; Tissing, Wim J. E.; Phillips, Bob

    Purpose of review Fever in neutropenia is the most frequent potentially life-threatening complication of chemotherapy in children and adolescents with cancer. This review summarizes recent studies that refine our knowledge of how to manage pediatric fever in neutropenia, and their implications for

  14. Molecular characterization of African swine fever virus in apparently ...

    African Journals Online (AJOL)

    African swine fever (ASF) is a highly lethal and economically significant disease of domestic pigs in Uganda where outbreaks regularly occur. There is neither a vaccine nor treatment available for ASF control. Twenty two African swine fever virus (ASFV) genotypes (I - XXII) have been identified based on partial sequencing ...

  15. Genotyping of African swine fever virus (ASFV) isolates associated ...

    African Journals Online (AJOL)

    Samples from infected domestic pigs associated with an outbreak of African swine fever (ASF) in three districts of central Uganda in 2007 were confirmed as being infected with African swine fever virus (ASFV) using a P72 gene-based polymerase chain reaction amplification (PCR) assay combined with restriction analysis.

  16. Dengue as a cause of acute undifferentiated fever in Vietnam

    NARCIS (Netherlands)

    Phuong, H.L.; de Vries, P.J.; Nga, T.T.T.; Giao, P.T.; Hung, L.Q.; Binh, T.Q.; Nam, N.V.; Nagelkerke, N.; Kager, P.A.


    Background: Dengue is a common cause of fever in the tropics but its contribution to the total burden of febrile illnesses that is presented to primary health facilities in endemic regions such as Vietnam, is largely unknown. We aimed to report the frequency of dengue as a cause of fever in Binh

  17. Surveillance of viral haemorrhagic fevers in Ghana: entomological ...

    African Journals Online (AJOL)

    Results: A total of 2804 households were surveyed to estimate larval indices and man-vector contacts of potential vectors of viral haemorrhagic fevers such as Yellow fever and Dengue. Over 56% households in each study site were positive for Aedes larvae. Relatively higher Breteaux index (BI) and Container index (CI) ...

  18. Dengue as a cause of acute undifferentiated fever in Vietnam

    NARCIS (Netherlands)

    Phuong, Hoang Lan; de Vries, Peter J.; Nga, Tran T. T.; Giao, Phan T.; Hung, Le Q.; Binh, Tran Q.; Nam, Nguyen V.; Nagelkerke, Nico; Kager, Piet A.


    BACKGROUND: Dengue is a common cause of fever in the tropics but its contribution to the total burden of febrile illnesses that is presented to primary health facilities in endemic regions such as Vietnam, is largely unknown. We aimed to report the frequency of dengue as a cause of fever in Binh

  19. Louseborne Relapsing Fever among East African Refugees, Italy, 2015. (United States)

    Lucchini, Anna; Lipani, Filippo; Costa, Cecilia; Scarvaglieri, Mariaelisabetta; Balbiano, Rosanna; Carosella, Sinibaldo; Calcagno, Andrea; Audagnotto, Sabrina; Barbui, Anna Maria; Brossa, Silvia; Ghisetti, Valeria; Dal Conte, Ivano; Caramello, Pietro; Di Perri, Giovanni


    During June 9-September 30, 2015, five cases of louseborne relapsing fever were identified in Turin, Italy. All 5 cases were in young refugees from Somalia, 2 of whom had lived in Italy since 2011. Our report seems to confirm the possibility of local transmission of louse-borne relapsing fever.

  20. Louseborne relapsing fever among East African refugees, Italy, 2015


    Lucchini, Anna; Lipani, Filippo; Costa, Cecilia; Scarvaglieri, Mariaelisabetta; Balbiano, Rosanna; Carosella, Sinibaldo; Calcagno, Andrea; Audagnotto, Sabrina; Barbui, Anna Maria; Brossa, Silvia; Ghisetti, Valeria; Dal Conte, Ivano; Caramello, Pietro; di Perri, Giovanni


    During June 9?September 30, 2015, five cases of louseborne relapsing fever were identified in Turin, Italy. All 5 cases were in young refugees from Somalia, 2 of whom had lived in Italy since 2011. Our report seems to confirm the possibility of local transmission of louse-borne relapsing fever.

  1. A mathematical model for Lassa fever | Okuonghae | Journal of the ...

    African Journals Online (AJOL)

    A mathematical model for the dynamics of Lassa fever is presented. Contributions from regular contact with the species of rats that carry the virus that cause Lassa fever and infectious contact with those suffering from the disease is seen as significant in the spread of the disease. Steady states of the model are examined for ...

  2. Acute Q fever in febrile patients in northwestern of Iran. (United States)

    Esmaeili, Saber; Golzar, Farhad; Ayubi, Erfan; Naghili, Behrooz; Mostafavi, Ehsan


    Q fever is an endemic disease in different parts of Iran. This study aimed to investigate the prevalence of acute Q fever disease among at-risk individuals in northwestern Iran. An etiological study was carried out in 2013 in Tabriz County. A total of 116 individuals who were in contact with livestock and had a nonspecific febrile illness were enrolled in the study. IgG phase II antibodies against Coxiella burnetii were detected using ELISA. The prevalence of acute Q fever was 13.8% (95% confidence interval [CI]: 8.0, 21.0%). Headache (87.5%) and fatigue and weakness (81.3%) were the dominant clinical characteristics among patients whit acute Q fever. Acute lower respiratory tract infection and chills were poorly associated with acute Q fever. Furthermore, 32% (95% CI: 24, 41%) of participants had a history of previous exposure to Q fever agent (past infection). Consumption of unpasteurized dairy products was a weak risk factor for previous exposure to C. burnetii. This study identified patients with acute Q fever in northwestern of Iran. The evidence from this study and previous studies conducted in different regions of Iran support this fact that Q fever is one of the important endemic zoonotic diseases in Iran and needs due attention by clinical physicians and health care system.

  3. Rift Valley Fever Outbreak in Livestock, Mozambique, 2014 (United States)

    Coetzee, Peter; Mubemba, Benjamin; Nhambirre, Ofélia; Neves, Luis; Coetzer, J.A.W.; Venter, Estelle H.


    In early 2014, abortions and death of ruminants were reported on farms in Maputo and Gaza Provinces, Mozambique. Serologic analysis and quantitative and conventional reverse transcription PCR confirmed the presence of Rift Valley fever virus. The viruses belonged to lineage C, which is prevalent among Rift Valley fever viruses in southern Africa. PMID:27869589

  4. Hemorrhagic fever with renal syndrome and coexisting hantavirus pulmonary syndrome

    Directory of Open Access Journals (Sweden)

    Young Min Hong


    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.

  5. Towards an improved understanding of African swine fever virus transmission

    NARCIS (Netherlands)

    Cardoso de Carvalho Ferreira, H.


    African swine fever is a haemorrhagic disease of swine caused by African swine fever virus (ASFV). Estimates of virus transmission (direct or indirect) parameters for ASFV are necessary in order to model the spread of the virus, and to design more efficient control measures. Results presented on

  6. louse-borne relapsing fever profile at jimma hospital, ethiopia

    African Journals Online (AJOL)


    ABSTRACT. Background: Louse-borne relapsing fever has been restricted to countries with poor socio economic status, the most important foci being Burundi, Rwanda and Ethiopia. Borrelia recurrentis is the etiologic agent for louse-borne relapsing fever and occurs as epidemic under conditions of overcrowding, poverty, ...

  7. Caregivers' perceptions of childhood fever in Ilorin, North-Central ...

    African Journals Online (AJOL)

    Background: Fever remains a common clinical indicator of disease, accounting alone for over 25% of paediatric emergency rooms consultations. Perception of this important sign is a crucial prelude and determinant of outcome in febrile children. The aim was to determine knowledge and attitudes of parents regarding fever ...

  8. Fever after redo Nissen fundoplication with hiatal hernia repair. (United States)

    Sharp, Nicole E; Alemayehu, Hanna; Desai, Amita; Holcomb, George W; St Peter, Shawn D


    Fevers often arise after redo fundoplication with hiatal hernia repair. We reviewed our experience to evaluate the yield of a fever work-up in this population. We performed a retrospective review of children undergoing redo Nissen fundoplication with hiatal hernia repair between December 2001 and September 2012. Temperatures and fever evaluations of those children receiving a mesh repair were compared with those without mesh. A fever defined as temperature ≥38.4°C. Fifty one children received 46 laparoscopic, 4 open, and 1 laparoscopic converted to open procedures. Biosynthetic mesh was used in 25 children whereas 26 underwent repair without mesh. A fever occurred in 56% of those repaired with mesh compared with 23.1% without mesh (P = 0.02). A fever evaluation was conducted in 32% of those with mesh compared with 11.5% without mesh (P = 0.52). A urinary tract infection was identified in one child after mesh use and an infection was identified in two children without mesh, one pneumonia and one wound infection (P = 1). In those repaired with mesh, there was no significant difference in maximum temperature. Fever is common after redo Nissen fundoplication with hiatal hernia repair and occurs more frequently, and with higher temperatures in those with mesh. Fever work-up in these patients is unlikely to yield an infectious source and is attributed to the extensive dissection during the redo procedure. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Typhoid fever : aspects of environment, host and pathogen interaction

    NARCIS (Netherlands)

    Ali, Soegianto


    In a surveillance study in Jakarta, Indonesia, 88 typhoid and 26 paratyphoid fever patients were identified by blood culture. Risk factors for transmission of typhoid fever were mainly intra-household factors (poor hand-washing hygiene, recent household contacts), whereas paratyphoid was mainly

  10. 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 ...

  11. Mothers' perception and management of childhood fevers at the ...

    African Journals Online (AJOL)

    Background: A mother's knowledge and perception of fever may determine the degree of her anxiety and fear, and reflect on the way the fever is managed at home. This study was carried out ... convulsion while others thought it could lead to blindness, anaemia, weakness, brain damage and death. Most of the mothers used ...

  12. Fever and the electrocardiogram: What about Brugada syndrome?

    NARCIS (Netherlands)

    Postema, Pieter G.


    This editorial refers to the study of Adler, Viskin and colleagues, in which it appears that a Brugada syndrome ECG is much more prevalent in patients with fever than in afebrile patients. This does not yet warrant a widespread diagnostic effort in patients with fever but may be relevant for certain

  13. The first cases of Lassa fever in Ghana. (United States)

    Dzotsi, E K; Ohene, S-A; Asiedu-Bekoe, F; Amankwa, J; Sarkodie, B; Adjabeng, M; Thouphique, A M; Ofei, A; Oduro, J; Atitogo, D; Bonney, J H K; Paintsil, S C N; Ampofo, W


    Lassa fever is a zoonotic disease endemic in West Africa but with no previous case reported in Ghana. We describe the first two laboratory confirmed cases of Lassa fever from the Ashanti Region of Ghana detected in October and December, 2011.

  14. Typhoid fever in children presenting to paediatric medical wards of ...

    African Journals Online (AJOL)

    Typhoid fever is a systemic infection caused by the Gram-negative bacilli Salmonellae, transmitted via the feaco-oral route. It commonly affects children, leading to complications and death if untreated. This is a report of typhoid fever admissions as seen at ABU Teaching Hospital Zaria over a 13-month period. Objectives: To ...

  15. The Incidence and Management of Typhoid Fever in Nigeria ...

    African Journals Online (AJOL)

    Typhoid or enteric fever is caused by Salmonella typhi. It is largely a disease of developing nations due to their poor standard of hygiene and unavailability of potable water. It is transmitted faeco-orally through contaminated food and water. The most prominent feature of the infection is fever which gradually rises to a high ...

  16. Typhoid fever in children: Clinical presentation and risk factors ...

    African Journals Online (AJOL)

    Objective: The diagnosis of typhoid fever based on widal test is on the rise despite its set back. We prospectively reviewed over one year period, cases of typhoid fever admitted in our centre to document the pattern of clinical presentation, risk factors and the reliability of Widal test in its diagnosis. Methods: This was a ...

  17. Caregivers' Knowledge and Home Management of Fever in Children

    African Journals Online (AJOL)

    Background: Fever is one of the most common complaints presented to the Paediatric Emergency Unit (PEU). It is a sign that there is an underlying pathologic process, the most common being infection. Many childhood illnesses are accompanied by fever, many of which are treated at home prior to presentation to hospital.

  18. Valley Fever: Danger Lurking in a Dust Cloud (United States)

    Johnson, Larry; Gaab, Erin M.; Sanchez, Javier; Bui, Phuong Q.; Nobile, Clarissa J.; Hoyer, Katrina K.; Peterson, Michael W.; Ojcius, David M.


    Coccidioides immitis and Coccidioides posadasii contribute to the development of Valley Fever. The ability of these fungal pathogens to evade the host immune system creates difficulty in recognition and treatment of this debilitating infection. In this review, we describe the current knowledge of Valley Fever and approaches to improve prevention, detection, and treatment. PMID:25038397

  19. Chikungunya Fever in Traveler from Angola to Japan, 2016. (United States)

    Takaya, Saho; Kutsuna, Satoshi; Nakayama, Eri; Taniguchi, Satoshi; Tajima, Shigeru; Katanami, Yuichi; Yamamoto, Kei; Takeshita, Nozomi; Hayakawa, Kayoko; Kato, Yasuyuki; Kanagawa, Shuzo; Ohmagari, Norio


    Simultaneous circulation of multiple arboviruses presents diagnostic challenges. In May 2016, chikungunya fever was diagnosed in a traveler from Angola to Japan. Travel history, incubation period, and phylogenetic analysis indicated probable infection acquisition in Angola, where a yellow fever outbreak is ongoing. Thus, local transmission of chikungunya virus probably also occurs in Angola.

  20. caregivers' knowledge and home management of fever in children

    African Journals Online (AJOL)


    May 5, 2014 ... Adequate caregivers' knowledge and proper management of fever at home leads to ... appropriate management of febrile episodes at home, ... 2.0(1.0-3.0). 1-12. One hundred and eighty eight (75.2 %) of the caregivers defined fever correctly as the generalised body hotness, while24.8% gave an incorrect ...

  1. Notification of rheumatic fever in South Africa - evidence for ...

    African Journals Online (AJOL)

    Objective To determine whether under-reporting of rheumatic fever occurs at hospital, municipal, provincial and national levels of the South African health system. Background: Information on the incidence of rheumatic fever (RF) and the prevalence of rheumatic heart disease (RHD) is required for the prevention of valvular ...

  2. Typhoid fever in a South African in-patient population

    NARCIS (Netherlands)

    Khan, Mohammad Enayet Hossain


    In conclusion, the data presented herein show that no single clinical or paraclinical parameter is reliable in arriving at a correct clinical diagnosis of typhoid fever and that bacteriologic confirmation is necessary for the diagnosis of typhoid fever. Patients ’ age and sex influence the clinical

  3. Risk factors for typhoid and paratyphoid fever in Jakarta, Indonesia

    NARCIS (Netherlands)

    Vollaard, A.M.; Ali, S.; Asten, H.A.G.H. van; Widjaja, S.; Visser, L.G.; Surjadi, C.; Dissel, J.T. van


    CONTEXT: The proportion of paratyphoid fever cases to typhoid fever cases may change due to urbanization and increased dependency on food purchased from street vendors. For containment of paratyphoid a different strategy may be needed than for typhoid, because risk factors for disease may not

  4. Care for patients with vascular chronic Q fever

    NARCIS (Netherlands)

    Hagenaars, J.C.J.P.


    Q fever is caused by Coxiella burnetii, a Gram-negative and intracellular bacterium. From 2007 to 2010, the Netherlands was confronted with the world’s largest Q fever outbreak. Dairy goats were identified to be the source. At the end of 2009, the outbreak expanded enormously (with 1000 patients in

  5. Acute rheumatic fever and rheumatic heart disease in indigenous populations. (United States)

    Steer, Andrew C; Carapetis, Jonathan R


    Acute rheumatic fever and rheumatic heart disease are diseases of socioeconomic disadvantage. These diseases are common in developing countries and in Indigenous populations in industrialized countries. Clinicians who work with Indigenous populations need to maintain a high index of suspicion for the potential diagnosis of acute rheumatic fever, particularly in patients presenting with joint pain. Inexpensive medicines, such as aspirin, are the mainstay of symptomatic treatment of rheumatic fever; however, antiinflammatory treatment has no effect on the long-term rate of progression or severity of chronic valvular disease. The current focus of global efforts at prevention of rheumatic heart disease is on secondary prevention (regular administration of penicillin to prevent recurrent rheumatic fever), although primary prevention (timely treatment of streptococcal pharyngitis to prevent rheumatic fever) is also important in populations in which it is feasible.

  6. Outcome of Pediatric Gastroenterology Outpatients With Fever and Central Line. (United States)

    Alexander, Thomas; Blatt, Julie; Skinner, Asheley Cockrell; Jhaveri, Ravi; Jobson, Meghan; Freeman, Katherine


    Although management algorithms for fever and central venous catheters (CVCs) have been implemented for pediatric oncology (PO) patients, management of pediatric outpatients with noncancer diagnoses and CVCs lacks clear protocols. The aim of the study was to assess outcomes for pediatric outpatients with gastrointestinal disorders presenting with fever and CVC. Using a microbiology database and emergency department records, we created a database of pediatric gastroenterology (PGI) and PO outpatients with fever and a CVC who presented to our emergency department or clinics from January 2010 through December 2012. We excluded patients who had severe neutropenia (absolute neutrophil count, gastroenterology outpatients with fever and a CVC have a high prevalence of bloodstream infection. Algorithms for management need to be subspecialty specific. Pediatric gastroenterology patients presenting to emergency departments or clinics with fever and CVC require admission for monitoring and management.

  7. Nephritis and cerebellar ataxia: rare presenting features of enteric fever.

    Directory of Open Access Journals (Sweden)

    Parmar R


    Full Text Available Enteric fever is a common infectious disease of the tropical world, about 80% of these cases occur in Asian countries. Enteric fever presenting with isolated cerebellar ataxia or nephritis is rare. We report three cases of enteric fever that presented with these complications. Isolated cerebellar ataxia usually occurs in the second week, whereas in our cases it presented within first four days of fever. The common complications of enteric fever related to the urinary tract are cystitis, pyelitis, and pyelonephritis. Glomerulonephritis is uncommon. Most patients with enteric glomerulonephritis present with acute renal failure, hypertensive encephalopathy, or nephritic syndrome. In comparison, our case had milder manifestations. All three patients were treated with parenteral ceftriaxone and showed a prompt recovery.

  8. What a rheumatologist needs to know about yellow fever vaccine. (United States)

    Oliveira, Ana Cristina Vanderley; Mota, Licia Maria Henrique da; Santos-Neto, Leopoldo Luiz Dos; Tauil, Pedro Luiz


    Patients with rheumatic diseases are more susceptible to infection, due to the underlying disease itself or to its treatment. The rheumatologist should prevent infections in those patients, vaccination being one preventive measure to be adopted. Yellow fever is one of such infectious diseases that can be avoided.The yellow fever vaccine is safe and effective for the general population, but, being an attenuated live virus vaccine, it should be avoided whenever possible in rheumatic patients on immunosuppressive drugs. Considering that yellow fever is endemic in a large area of Brazil, and that vaccination against that disease is indicated for those living in such area or travelling there, rheumatologists need to know that disease, as well as the indications for the yellow fever vaccine and contraindications to it. Our paper was aimed at highlighting the major aspects rheumatologists need to know about the yellow fever vaccine to decide about its indication or contraindication in specific situations. 2013 Elsevier Editora Ltda. All rights reserved.

  9. Yellow Fever outbreaks in unvaccinated populations, Brazil, 2008-2009. (United States)

    Romano, Alessandro Pecego Martins; Costa, Zouraide Guerra Antunes; Ramos, Daniel Garkauskas; Andrade, Maria Auxiliadora; Jayme, Valéria de Sá; Almeida, Marco Antônio Barreto de; Vettorello, Kátia Campomar; Mascheretti, Melissa; Flannery, Brendan


    Due to the risk of severe vaccine-associated adverse events, yellow fever vaccination in Brazil is only recommended in areas considered at risk for disease. From September 2008 through June 2009, two outbreaks of yellow fever in previously unvaccinated populations resulted in 21 confirmed cases with 9 deaths (case-fatality, 43%) in the southern state of Rio Grande do Sul and 28 cases with 11 deaths (39%) in Sao Paulo state. Epizootic deaths of non-human primates were reported before and during the outbreak. Over 5.5 million doses of yellow fever vaccine were administered in the two most affected states. Vaccine-associated adverse events were associated with six deaths due to acute viscerotropic disease (0.8 deaths per million doses administered) and 45 cases of acute neurotropic disease (5.6 per million doses administered). Yellow fever vaccine recommendations were revised to include areas in Brazil previously not considered at risk for yellow fever.

  10. Yellow Fever Outbreaks in Unvaccinated Populations, Brazil, 2008–2009 (United States)

    Romano, Alessandro Pecego Martins; Costa, Zouraide Guerra Antunes; Ramos, Daniel Garkauskas; Andrade, Maria Auxiliadora; Jayme, Valéria de Sá; de Almeida, Marco Antônio Barreto; Vettorello, Kátia Campomar; Mascheretti, Melissa; Flannery, Brendan


    Due to the risk of severe vaccine-associated adverse events, yellow fever vaccination in Brazil is only recommended in areas considered at risk for disease. From September 2008 through June 2009, two outbreaks of yellow fever in previously unvaccinated populations resulted in 21 confirmed cases with 9 deaths (case-fatality, 43%) in the southern state of Rio Grande do Sul and 28 cases with 11 deaths (39%) in Sao Paulo state. Epizootic deaths of non-human primates were reported before and during the outbreak. Over 5.5 million doses of yellow fever vaccine were administered in the two most affected states. Vaccine-associated adverse events were associated with six deaths due to acute viscerotropic disease (0.8 deaths per million doses administered) and 45 cases of acute neurotropic disease (5.6 per million doses administered). Yellow fever vaccine recommendations were revised to include areas in Brazil previously not considered at risk for yellow fever. PMID:24625634

  11. Evaluation and treatment of fever in intensive care unit patients. (United States)

    Ferguson, Anne


    Fever is a common complaint in hospitalized patients, with estimates that more than 30% of ward patients and as much as 90% of critically ill patients will experience fever. Much of the treatment of fever, however, is based on tradition and the belief the fever is harmful to the patient rather than on scientific evidence. There is a need to determine via analysis of the literature the best evidence-based approach to the identification and treatment of fever with attention to appropriate measurement of body temperature, diagnostic evaluation, changing of indwelling catheters, administration of antipyretics, and alteration in antimicrobial therapy. The advanced practice nurse is uniquely capable of gathering this evidence and implementing a plan of care that meets the individual needs of the patient, family, nursing staff, and healthcare system.

  12. Evaluation of dengue fever reports during an epidemic, Colombia. (United States)

    Romero-Vega, Liliana; Pacheco, Oscar; de la Hoz-Restrepo, Fernando; Díaz-Quijano, Fredi Alexander


    OBJECTIVE To assess the validity of dengue fever reports and how they relate to the definition of case and severity. METHODS Diagnostic test assessment was conducted using cross-sectional sampling from a universe of 13,873 patients treated during the fifth epidemiological period in health institutions from 11 Colombian departments in 2013. The test under analyses was the reporting to the National Public Health Surveillance System, and the reference standard was the review of histories identified by active institutional search. We reviewed all histories of patients diagnosed with dengue fever, as well as a random sample of patients with febrile syndromes. The specificity and sensitivity of reports were estimated for this purpose, considering the inverse of the probability of being selected for weighting. The concordance between reporting and the findings of the active institutional search was calculated using Kappa statistics. RESULTS We included 4,359 febrile patients, and 31.7% were classified as compatible with dengue fever (17 with severe dengue fever; 461 with dengue fever and warning signs; 904 with dengue fever and no warning signs). The global sensitivity of reports was 13.2% (95%CI 10.9;15.4) and specificity was 98.4% (95%CI 97.9;98.9). Sensitivity varied according to severity: 12.1% (95%CI 9.3;14.8) for patients presenting dengue fever with no warning signs; 14.5% (95%CI 10.6;18.4) for those presenting dengue fever with warning signs, and 40.0% (95%CI 9.6;70.4) for those with severe dengue fever. Concordance between reporting and the findings of the active institutional search resulted in a Kappa of 10.1%. CONCLUSIONS Low concordance was observed between reporting and the review of clinical histories, which was associated with the low reporting of dengue fever compatible cases, especially milder cases.

  13. A retrospective review of 226 hospitalized patients with fever. (United States)

    Goto, Masashi; Koyama, Hiroshi; Takahashi, Osamu; Fukui, Tsuguya


    To describe characteristics and outcomes for patients hospitalized with fever, not only patients with fever of unknown origin (FUO). Medical records were reviewed for 226 consecutive patients hospitalized in a Japanese referral hospital with fever as one of the clinical problems. Although the majority of illnesses involved some sort of infection (54%), noninfectious inflammatory diseases, particularly adult Still's disease (n=6) and primary vasculitis syndromes (n=5) including 3 cases of Behçet's disease, represented the leading cause in patients who met the definition of FUO [16/51(31%)]. Tuberculosis (n=6) and psychological disorders (n=6) were associated with late diagnosis. However, there was only one patient meeting the definition of FUO among those with a psychological disorder. Among the patients with prolonged fever who did not strictly meet the definition of FUO, there was a considerable number of patients with critical illnesses, such as intra-abdominal abscess, polymyalgia rheumatica, sarcoidosis, ulcerative colitis, Castleman's disease, hematological and solid malignancies, and panhypopituitarism. Drug-induced fever, systemic viral infection and unspecified vasculitis were difficult to definitively diagnose, although these pathologies were suspected as causes of fever. Follow-up of patients without definitive diagnosis at discharge confirmed that the fever subsided spontaneously or the cause of fever was properly treated after diagnosis in every patient and that none died of the underlying febrile illness. The present findings, from all patients displaying fever at hospitalization, are in agreement with findings from prior FUO series. Strict use of the definition of FUO is thus unwarranted when managing patients with prolonged fever.

  14. Pontiac fever: an operational definition for epidemiological studies

    Directory of Open Access Journals (Sweden)

    Mathieu Laurence


    Full Text Available Abstract Background Pontiac fever is usually described in epidemic settings. Detection of Pontiac fever is a marker of an environmental contamination by Legionella and should thereby call for prevention measures in order to prevent outbreak of Legionnaire's disease. The objective of this study is to propose an operational definition of Pontiac fever that is amenable to epidemiological surveillance and investigation in a non epidemic setting. Methods A population of 560 elderly subjects residing in 25 nursing homes was followed during 4 months in order to assess the daily incidence of symptoms associated, in the literature, with Pontiac fever. The water and aerosol of one to 8 showers by nursing home were characterized combining conventional bacterial culture of Legionella and the Fluorescence In Situ Hybridization (FISH technique that used oligonucleotides probes specific for Legionellaceae. A definition of Pontiac fever was devised based on clinical symptoms described in epidemic investigations and on their timing after the exposure event. The association between incidence of Pontiac fever and shower contamination levels was evaluated to test the relevance of this definition. Results The proposed definition of Pontiac fever associated the following criteria: occurrence of at least one symptom among headache, myalgia, fever and shivers, possibly associated with other 'minor' symptoms, within three days after a shower contaminated by Legionella, during a maximum of 8 days (minimum 2 days. 23 such cases occurred during the study (incidence rate: 0.125 cases per person-year [95% CI: 0.122–0.127]. A concentration of Legionella in water equal to or greater than 104.L-1 (FISH method was associated with a significant increase of incidence of Pontiac fever (p = 0.04. Conclusion Once validated in other settings, the proposed definition of Pontiac fever might be used to develop epidemiological surveillance and help draw attention on sources of

  15. Diagnostic value of FDG-PET/(CT) in children with fever of unknown origin and unexplained fever during immune suppression

    NARCIS (Netherlands)

    Blokhuis, Gijsbert J.; Bleeker-Rovers, Chantal P.; Diender, Marije G.; Oyen, Wim J.G.; Draaisma, Jos M. Th.; de Geus-Oei, Lioe-Fee


    Purpose Fever of unknown origin (FUO) and unexplained fever during immune suppression in children are challenging medical problems. The aim of this study is to investigate the diagnostic value of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) and FDG-PET combined with computed

  16. Bilateral retinitis following Chikun- gunya fever

    Directory of Open Access Journals (Sweden)

    Murthy Krishna


    Full Text Available A 35-year-old male with a history of chikungunya fever, presented with diminution of vision in the right eye of one-week duration. His best corrected visual acuity (BCVA was counting fingers 2 meters and 20/20 (Snellens in the right and left eyes respectively. A diagnosis of neuroretinitis was made in the right eye while left eye showed features of retinitis. ELISA (serum and polymerase chain reaction (aqueous were positive for herpes simplex virus. The lesions did not show any response to antiviral or steroid treatment and appeared to be self-limiting. At five months follow-up, lesions had resolved well with BCVA of 20/120 and 20/20 in the right and left eyes respectively.

  17. An epidemiological model of Rift Valley fever

    Directory of Open Access Journals (Sweden)

    Nicole P. Leahy


    Full Text Available We present and explore a novel mathematical model of the epidemiology of Rift Valley Fever (RVF. RVF is an Old World, mosquito-borne disease affecting both livestock and humans. The model is an ordinary differential equation model for two populations of mosquito species, those that can transmit vertically and those that cannot, and for one livestock population. We analyze the model to find the stability of the disease-free equlibrium and test which model parameters affect this stability most significantly. This model is the basis for future research into the predication of future outbreaks in the Old World and the assessment of the threat of introduction into the New World.

  18. Hantavirus fever without pulmonary syndrome in Panama. (United States)

    Armien, Blas; Pascale, Juan M; Muñoz, Carlos; Mariñas, Jamileth; Núñez, Heydy; Herrera, Milagro; Trujillo, José; Sánchez, Deyanira; Mendoza, Yaxelis; Hjelle, Brian; Koster, Frederick


    In Panama, hantavirus pulmonary syndrome (HPS) is caused by Choclo virus, a species phylogenetically related to Andes and Maporal viruses. Up to 60% of the population has been positive for specific serum antibody in community-based surveys, but mortality is very uncommon. In four western Panama clinics, we tested individuals presenting with a severe febrile prodrome for acute hantavirus (HV) infection by immunoglobulin M enzyme-linked immunosorbent assay and reverse transcription polymerase chain reaction as well as clinically similar infections, such as dengue and leptospirosis. From 2006 to 2009, at least 21% of 117 patients diagnosed with HV infection had HV Fever (HF) with no evidence of pulmonary edema (no respiratory distress or radiographic lung infiltrates), and 44% of patients had very mild HPS (radiographic pulmonary edema but no respiratory insufficiency). HV infection caused by Choclo virus in Panama presents often as HF, which contrasts with HV in the Americas but is consistent with the high seroprevalence in endemic regions.

  19. Rift Valley Fever, Sudan, 2007 and 2010 (United States)

    Aradaib, Imadeldin E.; Erickson, Bobbie R.; Elageb, Rehab M.; Khristova, Marina L.; Carroll, Serena A.; Elkhidir, Isam M.; Karsany, Mubarak E.; Karrar, AbdelRahim E.; Elbashir, Mustafa I.


    To elucidate whether Rift Valley fever virus (RVFV) diversity in Sudan resulted from multiple introductions or from acquired changes over time from 1 introduction event, we generated complete genome sequences from RVFV strains detected during the 2007 and 2010 outbreaks. Phylogenetic analyses of small, medium, and large RNA segment sequences indicated several genetic RVFV variants were circulating in Sudan, which all grouped into Kenya-1 or Kenya-2 sublineages from the 2006–2008 eastern Africa epizootic. Bayesian analysis of sequence differences estimated that diversity among the 2007 and 2010 Sudan RVFV variants shared a most recent common ancestor circa 1996. The data suggest multiple introductions of RVFV into Sudan as part of sweeping epizootics from eastern Africa. The sequences indicate recent movement of RVFV and support the need for surveillance to recognize when and where RVFV circulates between epidemics, which can make data from prediction tools easier to interpret and preventive measures easier to direct toward high-risk areas. PMID:23347790

  20. An overview of Colorado tick fever. (United States)

    Emmons, R W


    Certain features of Colorado tick fever (CTF) virus and the disease it causes may be relevant to studies on bluetongue virus (BTV), or other orbiviruses. Rapid and easy detection of viral antigen in infected tissues and peripheral blood cells by immunofluorescence staining facilitate diagnosis of the disease. The prolonged (3-4 months) viremia is due to persistent intracellular infection, particularly of erythrocytes, in which the virus is protected from antibody or other host defense mechanisms. This results in more efficient maintenance of the virus cycle in nature, but might lead to adverse effects in the human host. Clues to understanding chronic viral infections or viral immunosuppression might be gained by further research on CTF and other orbiviruses.

  1. [Virological study of simian hemorrhagic fever]. (United States)

    Shevtosova, Z V; Karmysheva, V Ia; Chumakov, M P


    The results of a comparative study of different routes of inoculation of simian hemorrhagic fever (SHF) virus to Macaca monkeys are presented as well as the results of virological examinations of sick animals. Only the parenteral route of inoculation has been found to be effective. After virus penetration, a long-term viremia and generalization of the infection are observed. The virus is found in the brain, the spinal cord and bone marrow, the spleen, the liver, the kidneys, the cerebrospinal fluid, the urine and nasopharyngeal washings. By the fluorescent antibody technique the virus-specific antigen is demonstrated in the capillary endothelium, neurons and glial cells of the brain, and in the reticulo-endothelial and macrophagal elements of parenchymatous organs.

  2. Development of Vaccines for Chikungunya Fever. (United States)

    Erasmus, Jesse H; Rossi, Shannan L; Weaver, Scott C


    Chikungunya fever, an acute and often chronic arthralgic disease caused by the mosquito-borne chikungunya virus (CHIKV), has reemerged since 2004 to cause millions of cases. Because CHIKV exhibits limited antigenic diversity and is not known to be capable of reinfection, a vaccine could serve to both prevent disease and diminish human amplification during epidemic circulation. Here, we review the many promising vaccine platforms and candidates developed for CHIKV since the 1970s, including several in late preclinical or clinical development. We discuss the advantages and limitations of each, as well as the commercial and regulatory challenges to bringing a vaccine to market. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail

  3. Filoviral haemorrhagic fevers: A threat to Zambia?

    Directory of Open Access Journals (Sweden)

    Katendi Changula


    Full Text Available Filoviral haemorrhagic fevers (FVHF are caused by agents belonging to Filoviridae family, Ebola and Marburg viruses. They are amongst the most lethal pathogens known to infect humans. Incidence of FVHF outbreaks are increasing, with affected number of patients on the rise. Whilst there has been no report yet of FVHF in Zambia, its proximity to Angola and Democratic Republic of Congo, which have recorded major outbreaks, as well as the open borders, increased trade and annual migration of bats between these countries, puts Zambia at present and increased risk. Previous studies have indicated bats as potential reservoir hosts for filoviruses. An increasing population with an increasing demand for resources has forced incursion into previously uninhabited land, potentially bringing them into contact with unknown pathogens, reservoir hosts and/or amplifying hosts. The recent discovery of a novel arenavirus, Lujo, highlights the potential that every region, including Zambia, has for being the epicentre or primary focus for emerging and re-emerging infections. It is therefore imperative that surveillance for potential emerging infections, such as viral haemorrhagic fevers be instituted. In order to accomplish this surveillance, rapid detection, identification and monitoring of agents in patients and potential reservoirs is needed. International co-operation is the strategy of choice for the surveillance and fight against emerging infections. Due to the extensive area in which filoviral infections can occur, a regional approach to surveillance activities is required, with regional referral centres. There is a need to adopt shared policies for the prevention and control of infectious diseases. There is also need for optimisation of currently available tests and development of new diagnostic tests, in order to have robust, highly sensitive and specific diagnostic tests that can be used even where there are inadequate laboratories and diagnostic services.

  4. Heart rate variability in familial Mediterranean fever. (United States)

    Nussinovitch, Naomi; Livneh, Avi; Katz, Keren; Langevitz, Pnina; Feld, Olga; Nussinovitch, Moshe; Volovitz, Benjamin; Lidar, Merav; Nussinovitch, Udi


    Familial Mediterranean fever (FMF) is a hereditary disease, characterized by recurrent episodes of fever and polyserositis. Heart rate variability (HRV) is a powerful, simple and reliable technique to evaluate autonomic nervous system function. Previous studies of physiologic parameters during tilt-test have suggested that patients with FMF have abnormal cardiovascular reactivity and occult dysautonomia. Prompted by these findings, the present study sought to evaluate HRV in patients with FMF, at rest and in the standing position. The study sample included 34 patients with FMF and 34 sex- and age-matched control subjects. All underwent electrocardiography according to strict criteria. HRV parameters were computed with custom-made software. There was no significant difference in HRV parameters, in either the supine or standing position, between the FMF and control groups. In both groups, the upright position was associated with a significant decrease, when compared with the supine position, in maximal RR interval, minimal RR, average RR, root square of successive differences in RR interval, number of intervals differing by >50 ms from preceding interval (NN50), NN50 divided by total number of intervals (pNN50) and high-frequency components as well as a significant increase in average heart rate, very low frequency or low-frequency components, low-frequency/high-frequency components ratio and total power. In conclusion, patients with FMF who are continuously treated with low-dose colchicine have not developed amyloidosis and have normal HRV parameters in the supine and upright position. Further investigation of occult dysautonomia in FMF is needed.

  5. Vitamin D serostatus and dengue fever progression to dengue hemorrhagic fever/dengue shock syndrome. (United States)

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


    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.

  6. Risk factors for shock in children with dengue fever. (United States)

    Pothapregada, Sriram; Kamalakannan, Banupriya; Thulasingham, Mahalakshmy


    To evaluate and analyze the clinical and laboratory parameters that were predictive of the development of shock in children with dengue fever. Retrospective study carried out from August 2012 to July 2014 at a tertiary care hospital in Puducherry. Two hundred and fifty-four children were admitted with dengue fever and among them dengue fever without shock was present in 159 children (62.5%) and dengue fever with shock was present in 95 cases (37.4%). Various clinical and laboratory parameters were analyzed using univariate and multivariate logistic regression between the two groups and a P value of 20% with concomitant platelet count 6 years, hepatomegaly, pain in the abdomen, and oliguria were the most common risk factors associated with shock in children with dengue fever. There were six deaths (2.4%) and out of them four presented with impaired consciousness (66.6%) at the time of admission. Age >6 years, hepatomegaly, abdomen pain, and oliguria were the most common risk factors for shock in children with dengue fever. Impaired consciousness at admission was the most ominous sign for mortality in dengue fever. Hence, these features should be identified early, monitored closely, and managed timely.

  7. Yellow fever cases in Asia: primed for an epidemic

    Directory of Open Access Journals (Sweden)

    Sean Wasserman


    Full Text Available There is currently an emerging outbreak of yellow fever in Angola. Cases in infected travellers have been reported in a number of other African countries, as well as in China, representing the first ever documented cases of yellow fever in Asia. There is a large Chinese workforce in Angola, many of whom may be unvaccinated, increasing the risk of ongoing importation of yellow fever into Asia via busy commercial airline routes. Large parts of the region are hyperendemic for the related Flavivirus dengue and are widely infested by Aedes aegypti, the primary mosquito vector of urban yellow fever transmission. The combination of sustained introduction of viraemic travellers, an ecology conducive to local transmission, and an unimmunized population raises the possibility of a yellow fever epidemic in Asia. This represents a major global health threat, particularly in the context of a depleted emergency vaccine stockpile and untested surveillance systems in the region. In this review, the potential for a yellow fever outbreak in Asia is discussed with reference to the ecological and historical forces that have shaped global yellow fever epidemiology. The limitations of surveillance and vector control in the region are highlighted, and priorities for outbreak preparedness and response are suggested.


    Directory of Open Access Journals (Sweden)



    Full Text Available BACKGROUND : Chikungunya fever is a self - limiting viral fever spread by mosquito bite and has become an epidemic. The proportion of cases has increased in Andhra Pradesh. We report a prospective analysis of cases of c hikungunya fever referred from various primary health centers of rural, tribal and semiurban areas of Srikakulam district, Andhra Pradesh. AIMS OF STUDY: To analyse the burden of C hikungunya fever in the Srikakulam district of Andhra Pradesh . MATERIAL AND METHODS : A prospective descriptive study was under taken between January - 2013 to December - 2014 by testing clinically suspected c hikungunya fever patients attending tertiary care centre in the Srikakulam district, Andhra Pradesh. The blood collected from suspected patients was analyzed for CHIK specific IgM antibodies by ELISA method using Nivchik kit. The data was recorded and analyzed. RESULTS: During the study period the total number of samples screened with clinical suspicion of c hikungunya fever was 127, out of which 23(18.11% were positive for IgM antibodies. The number of seropositive cases referred from rural area was 3 in number and from tribal areas 20. The seasonal distribution of cases was variable. CONCLUSION: Chikungunya fever is self limiting disease . Efforts have to be made through community awareness and early institution of supportive therapy. Vector control measures should be in full swing

  9. Yellow fever cases in Asia: primed for an epidemic. (United States)

    Wasserman, Sean; Tambyah, Paul Anantharajah; Lim, Poh Lian


    There is currently an emerging outbreak of yellow fever in Angola. Cases in infected travellers have been reported in a number of other African countries, as well as in China, representing the first ever documented cases of yellow fever in Asia. There is a large Chinese workforce in Angola, many of whom may be unvaccinated, increasing the risk of ongoing importation of yellow fever into Asia via busy commercial airline routes. Large parts of the region are hyperendemic for the related Flavivirus dengue and are widely infested by Aedes aegypti, the primary mosquito vector of urban yellow fever transmission. The combination of sustained introduction of viraemic travellers, an ecology conducive to local transmission, and an unimmunized population raises the possibility of a yellow fever epidemic in Asia. This represents a major global health threat, particularly in the context of a depleted emergency vaccine stockpile and untested surveillance systems in the region. In this review, the potential for a yellow fever outbreak in Asia is discussed with reference to the ecological and historical forces that have shaped global yellow fever epidemiology. The limitations of surveillance and vector control in the region are highlighted, and priorities for outbreak preparedness and response are suggested. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  10. Attitudes towards fever amongst UK paediatric intensive care staff. (United States)

    Brick, Thomas; Agbeko, Rachel S; Davies, Patrick; Davis, Peter J; Deep, Akash; Fortune, Peter-Marc; Inwald, David P; Jones, Amy; Levin, Richard; Morris, Kevin P; Pappachan, John; Ray, Samiran; Tibby, Shane M; Tume, Lyvonne N; Peters, Mark J


    The role played by fever in the outcome of critical illness in children is unclear. This survey of medical and nursing staff in 35 paediatric intensive care units and transport teams in the United Kingdom and Ireland established attitudes towards the management of children with fever. Four hundred sixty-two medical and nursing staff responded to a web-based survey request. Respondents answered eight questions regarding thresholds for temperature control in usual clinical practice, indications for paracetamol use, and readiness to participate in a clinical trial of permissive temperature control. The median reported threshold for treating fever in clinical practice was 38 °C (IQR 38-38.5 °C). Paracetamol was reported to be used as an analgesic and antipyretic but also for non-specific comfort indications. There was a widespread support for a clinical trial of a permissive versus a conservative approach to fever in paediatric intensive care units. Within a trial, 58% of the respondents considered a temperature of 39 °C acceptable without treatment. Staff on paediatric intensive care units in the United Kingdom and Ireland tends to treat temperatures within the febrile range. There was a willingness to conduct a randomized controlled trial of treatment of fever. What is known: • The effect of fever on the outcome in paediatric critical illness is unknown. • Paediatricians have traditionally been reluctant to allow fever in sick children. What is new: • Paediatric intensive care staff report a tendency towards treating fever, with a median reported treatment threshold of 38 °C. • There is widespread support amongst PICU staff in the UK for a randomized controlled trial of temperature in critically ill children. • Within a trial setting, PICU staff attitudes to fever are more permissive than in clinical practice.

  11. Antiphospholipid Antibody Syndrome With Valvular Vegetations in Acute Q Fever. (United States)

    Million, Matthieu; Thuny, Franck; Bardin, Nathalie; Angelakis, Emmanouil; Edouard, Sophie; Bessis, Simon; Guimard, Thomas; Weitten, Thierry; Martin-Barbaz, François; Texereau, Michèle; Ayouz, Khelifa; Protopopescu, Camelia; Carrieri, Patrizia; Habib, Gilbert; Raoult, Didier


    Coxiella burnetii endocarditis is considered to be a late complication of Q fever in patients with preexisting valvular heart disease (VHD). We observed a large transient aortic vegetation in a patient with acute Q fever and high levels of IgG anticardiolipin antibodies (IgG aCL). Therefore, we sought to determine how commonly acute Q fever could cause valvular vegetations associated with antiphospholipid antibody syndrome, which would be a new clinical entity. We performed a consecutive case series between January 2007 and April 2014 at the French National Referral Center for Q fever. Age, sex, history of VHD, immunosuppression, and IgG aCL assessed by enzyme-linked immunosorbent assay were tested as potential predictors. Of the 759 patients with acute Q fever and available echocardiographic results, 9 (1.2%) were considered to have acute Q fever endocarditis, none of whom had a previously known VHD. After multiple adjustment, very high IgG aCL levels (>100 immunoglobulin G-type phospholipid units; relative risk [RR], 24.9 [95% confidence interval {CI}, 4.5-140.2]; P = .002) and immunosuppression (RR, 10.1 [95% CI, 3.0-32.4]; P = .002) were independently associated with acute Q fever endocarditis. Antiphospholipid antibody syndrome with valvular vegetations in acute Q fever is a new clinical entity. This would suggest the value of systematically testing for C. burnetii in antiphospholipid-associated cardiac valve disease, and performing early echocardiography and antiphospholipid dosages in patients with acute Q fever. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail

  12. Fundus Findings in Dengue Fever: A Case Report. (United States)

    Şahan, Berna; Tatlıpınar, Sinan; Marangoz, Deniz; Çiftçi, Ferda


    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.

  13. Dengue Fever Presenting as Purtscher-like Retinopathy. (United States)

    Lima, Luiz H; Vianello, Silvana; Pimentel, Sérgio; Costa de Andrade, Gabriel; Zett, Claudio; Muller, Léo; Farah, Michel E; Belfort, Rubens


    To report the fundus manifestations and spectral-domain optical coherence tomographic (SD-OCT) features of dengue fever presenting as Purtscher-like retinopathy. Retrospective review of two cases of dengue fever. Color fundus photograph revealed the presence of cotton-wool spots in a Purtscher-like configuration in the posterior pole of all study eyes. SD-OCT demonstrated increased reflectivity signal in the inner retinal layers, and after a variable follow-up period, there was complete disappearance of cotton-wool spots and persistence of the hyperreflectivity signal. We report two unique cases of dengue fever associated with retinal lesions in a configuration of Purtscher-like retinopathy.

  14. Spotted fever rickettsiosis in Coronel Fabriciano, Minas Gerais State

    Directory of Open Access Journals (Sweden)

    Galvão Márcio Antônio Moreira


    Full Text Available We report cases of spotted fever rickettsiosis in Coronel Fabriciano Municipality of Minas Gerais State, Brazil. The cases occurred in May and June of 2000. During this period there were two deaths among children from an area named Pedreira in a periurban area of this municipality. In a boy who died with clinical manifestations of Brazilian spotted fever, a necropsy revealed the presence of a spotted fever group Rickettsia. The serological results confirm the difficulty in the differential diagnosis of patients with symptoms of rickettsial diseases.

  15. Strategies for early detection of chronic Q-fever: a systematic review

    NARCIS (Netherlands)

    Wielders, C.C.; Morroy, G.; Wever, P.C.; Coutinho, R.A.; Schneeberger, P.M.; Hoek, W. van der


    BACKGROUND: Chronic Q-fever, a condition with high morbidity and mortality, may develop after an acute infection with Coxiella burnetii (acute Q-fever). Several strategies have been suggested for early detection of chronic Q-fever, focusing on follow-up of known acute Q-fever patients and detection

  16. Differences in characteristics between first and breakthrough neutropenic fever after chemotherapy in patients with hematologic disease

    Directory of Open Access Journals (Sweden)

    Eun Young Nam


    Conclusion: It is concluded that the epidemiological profile of breakthrough neutropenic fever is different from that of first episode fever. These data reinforce the view that pooled reporting of neutropenic fever may be misleading, and that clinicians should approach breakthrough fever as a distinct entity.

  17. Nursing personnel's attitudes towards fever and antipyresis of adult patients: cross-sectional survey. (United States)

    Kiekkas, Panagiotis; Konstantinou, Evangelos; Psychogiou, Kalliopi-Styliani; Tsampoula, Iliana; Stefanopoulos, Nikolaos; Bakalis, Nick


    To investigate the attitudes of nurses caring for hospitalised adult patients towards fever and antipyresis and to identify the predictors of these attitudes. Fever is a host defence mechanism, whose harmful effects are limited to specific patients. Findings about antipyretic treatment have further challenged the need for routine or aggressive fever suppression. Unfortunately, nurses continue to be fever phobic, while their attitudes towards fever and antipyresis considerably affect antipyretic practice. Prospective, cross-sectional, multicentre survey. A convenience sample of registered and assistant nurses employed in surgical/medical wards and intensive care units of nine Greek hospitals was enrolled. The developed questionnaire included 10 multiple-choice, knowledge-evaluating items about fever and antipyresis, 10 Likert-type attitude-evaluating items towards fever and 10 towards antipyresis. Multiple linear regression analysis was used to identify the predictors of attitudes towards fever and antipyresis. The attitudes of the 458 participants were found to be relatively positive towards both fever and antipyresis. Lower fever/antipyresis knowledge score predicted both negative attitude towards fever (p = 0·001) and positive attitude towards antipyresis (p attitude towards antipyresis (p = 0·002). Advancing nurses' evidence-based knowledge about fever and antipyresis is expected to limit their tendency to overtreat fever and favour fever care based on the assessment of actual patient demands. These findings highlight the need for continuing education programmes to eliminate fever phobia and improve nurses' competency for individualised fever care. © 2014 John Wiley & Sons Ltd.

  18. 42 CFR 71.3 - Designation of yellow fever vaccination centers; Validation stamps. (United States)


    ... 42 Public Health 1 2010-10-01 2010-10-01 false Designation of yellow fever vaccination centers... Designation of yellow fever vaccination centers; Validation stamps. (a) Designation of yellow fever vaccination centers. (1) The Director is responsible for the designation of yellow fever vaccination centers...

  19. South Carolina's last yellow fever epidemic: Manning Simons at Port Royal, 1877. (United States)

    Newsom, E Y


    Throughout the 19th century, yellow fever was the scourge of southern coastal cities. Because of primitive diagnostic tools, differential diagnosis during epidemics was often difficult. Many patients were diagnosed with "malarial fever," breakbone fever, "the prevailing fever," and "mild yellow fever," to name a few. Dr. Manning Simon's opportunity to study an almost "pure" epidemic of yellow fever among an "unacclimated" population was a breakthrough in diagnostic medicine. Fortunately, his findings were not to be needed again in South Carolina, since this was the last outbreak of yellow fever in the state.

  20. Sandfly Fever with Skin Lesions: A Case Series from Turkey

    National Research Council Canada - National Science Library

    Fatih Temocin; Tugba Sari; Necla Tulek


    .... We present first cases in a different district of Turkey with the clinical findings of fever, myalgia-arthralgia, headache, gastrointestinal symptoms such as diarrhoea and nausea-vomiting and skin lesions (in two of them...

  1. A Statistical Model of Rift Valley Fever Activity in Egypt

    National Research Council Canada - National Science Library

    John M. Drake; Ali N. Hassan; John C. Beier


    Rift Valley fever (RVF) is a viral disease of animals and humans and a global public health concern due to its ecological plasticity, adaptivity, and potential for spread to countries with a temperate climate...

  2. NNDSS - Table II. Cryptosporidiosis to Dengue Hemorrhagic Fever (United States)

    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...

  3. Acute gingival bleeding as a complication of dengue hemorrhagic fever

    Directory of Open Access Journals (Sweden)

    Saif Khan


    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.

  4. NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis - 2017. In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during...

  5. A Physician’s Nightmare: Fever of Unknown Origin

    Directory of Open Access Journals (Sweden)

    Sana Din


    Full Text Available Fever of unknown origin (FUO remains to be a challenge despite advancement in diagnostic technologies and procedures. FUO is considered when fever presents intermittently without an explanation. It has been linked to various etiologies, which makes it difficult to diagnose. We present the case of 18-month-old female with recurrent fever, splenomegaly, abdominal pain, and constipation. The workup for her symptoms revealed wandering spleen. Wandering spleen is a result from excessive laxity or absence of splenic ligaments. The patient underwent splenectomy and was advised to continue on Senna, Miralax, and high fiber diet. Her mother reported that the fever is no longer present and there is marked improvement in her constipation and abdominal pain after splenectomy.

  6. Periodic Fever, Aphthous Stomatitis, Pharyngitis, Adenitis Syndrome (PFAPA) (United States)

    ... Impact Measurement Scales (AIMS) Evidence Based Practice (EBP) Fibromyalgia Impact Questionnaire (FIQ) Multidimensional Assessment of Fatigue (MAF) ... CAPS) (Juvenile) Dermatomyositis (Juvenile) Familial Mediterranean Fever (Juvenile) ... Cell Arteritis Glucocorticoid-induced Osteoperosis Gout Granulomatosis ...

  7. NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis - 2016. In this Table, provisional* cases of selected†notifiable diseases (≥1,000 cases reported during...

  8. NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis - 2015.In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during the...

  9. NNDSS - Table II. Spotted Fever Rickettsiosis to Syphilis (United States)

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

  10. Why sulfonamides are contraindicated in Rocky Mountain spotted fever. (United States)

    Ren, Vicky; Hsu, Sylvia


    Sulfonamide antibiotics are not effective for the treatment of Rocky Mountain spotted fever (RMSF). Patients suspected of having RMSF based on history and physical exam should be treated with doxycycline and not a sulfonamide to avoid increased morbidity and mortality.

  11. Ongoing Cerebral Vasculitis During Treatment of Rocky Mountain Spotted Fever. (United States)

    Sun, Lisa R; Huisman, Thierry A G M; Yeshokumar, Anusha K; Johnston, Michael V


    Rocky Mountain spotted fever is a tickborne infection that produces a systemic small-vessel vasculitis; its prognosis is excellent if appropriate treatment is initiated early. Because the advent of effective antirickettsial therapies predates the widespread use of brain magnetic resonance imaging, there are limited data on the effect of untreated Rocky Mountain spotted fever infection on neuroimaging studies. We describe a 7-year-old girl with delayed treatment of Rocky Mountain spotted fever who suffered severe neurological impairment. Serial brain magnetic resonance images revealed a progressive "starry sky appearance," which is proposed to result from the same small vessel vasculitis that causes the characteristic skin rash of this infection. Neurological injury can continue to occur despite specific antirickettsial therapy in Rocky Mountain spotted fever. This child's clinical features raise questions about the optimal management of this infection, particularly the utility of immune modulating therapies in cases of delayed treatment and neurological involvement. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Marburg haemorrhagic fever: A rare but fatal disease

    African Journals Online (AJOL)

    47(4): 21). Introduction. Marburg haemorrhagic fever was initially detected in 1967 following simultaneous outbreaks in Marburg and Frankfurt,. Germany and Belgrade (former Yugoslavia). The outbreaks occurred in laboratory workers handling ...

  13. Yellow fever vaccine-associated viscerotropic disease: current perspectives

    National Research Council Canada - National Science Library

    Thomas RE


    ...: To assess those published cases of yellow fever (YF) vaccine-associated viscerotropic disease that meet the Brighton Collaboration criteria and to assess the safety of YF vaccine with respect to viscerotropic disease. Literature search...

  14. [Cutaneous polymorph manifestations of familial Mediterranean fever in a child]. (United States)

    Gonzales, F; Begon Lours, J; Kalach, N; Gosset, P; Lasek Duriez, A


    We describe the case of a 4-year-old child with Mediterranean fever characterized by cutaneous features. Familial Mediterranean fever is an autosomal recessive disorder characterized by recurrent attacks of fever and polyserositis including peritonitis, pleuritis, and arthritis. Skin involvement is less common. In our case, the successively patient presented erysipelas-like erythema, edemas of the palmar and plantar regions, and purpuric lesions. From these clinical observations, several diagnoses were raised: infectious erysipelas, Kawasaki disease, Henoch-Schönlein purpura, and familial Mediterranean fever. Only the latter diagnosis was confirmed after exploration and then confirmed with genetic analysis, which found a M694V homozygous mutation. Erysipelas-like erythema is the most frequent cutaneous sign reported in the literature and the only one to be associated with the M694V homozygous mutation. The originality of this case is the dominancy and polymorphism of the skin lesions. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Aryu Candra


    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.

  16. [A case of Chikungunya fever in the Primorye Territory]. (United States)

    Simakova, A I; Popov, A F; Sokotun, S A; Sokotun, O A; Petukhova, S A


    The authors analyze a case of Chikungunya fever imported to Vladivostok. The disease was severe and resulted in disability in a female patient for more than 6 months. There were difficulties in its differential diagnosis with rheumatic diseases.

  17. Association of Familial Mediterranean Fever and Crohn’s disease

    Directory of Open Access Journals (Sweden)

    Gökhan Tümgör


    Full Text Available Familial Mediterranean fever is an autosomal recessive,short, acute, self-limiting disease characterized by attacksof fever and polyserositis, which is common in countriesaround the Mediterranean. Inflammatory bowel diseaseis a term used to describe Ulcerative colitis and Crohn’sdisease that associated with chronic idiopathic inflammatory.The patient had FMF but she had been well untilapproximately 20 days before admission, when malaise,fever, abdominal pain, right knee and ankle edema developed.She was taking colchicine. The patient diagnosedas Crohn Disease by endoscopy and histopathology. Thiscase report is presented to emphasize the association oftwo diseases.Key words: Familial Mediterranean Fever, inflammatorybowel disease, Crohn’s disease, childhood

  18. Relationship Between Fever and Malaria Parasitaemia in Adults ...

    African Journals Online (AJOL)

    Saharan Africa and both may co-exist. We conducted a survey on the relationship between fever and malaria parasitaemia in adult Nigerians and further determined if HIV infection makes any difference in this relationship. Methodology: One ...

  19. Q Fever: An Old but Still a Poorly Understood Disease


    Hamidreza Honarmand


    Q fever is a bacterial infection affecting mainly the lungs, liver, and heart. It is found around the world and is caused by the bacteria Coxiella burnetii. The bacteria affects sheep, goats, cattle, dogs, cats, birds, rodents, and ticks. Infected animals shed this bacteria in birth products, feces, milk, and urine. Humans usually get Q fever by breathing in contaminated droplets released by infected animals and drinking raw milk. People at highest risk for this infection are farmers, laborat...



    Galimberti R; Kowalczuk A; Luque K; Musso C; Enz P; Algranati L


    SUMMARYSecondary hyperparathyroidism is one of the main deragements caused by chronic renal failure, and parathyroid hormone is considered one of the toxins of the uremic syndrome. Prolonged fever due to primary hyperparathyroidism have already been described in the literature but not yet as induced by secondary hyperparathyroidism. In this case report a patient suffering from an erythema nodosum and prolonged fever associated to secondary hyperparathyroidism that disappeared through subtotal...

  1. Periodic fever associated with aphthous stomatitis, pharyngitis and cervical adenitis. (United States)

    Kyvsgaard, Nini; Mikkelsen, Torben; Korsholm, Jakob; Veirum, Jens Erik; Herlin, Troels


    The periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome is a non-hereditary idiopathic febrile syndrome belonging to the group of autoinflammatory diseases. PFAPA does not cause long-lasting sequelae. An early diagnosis provides treatment possibilities for the patient and comfort to the family. This study is a retrospective review of the medical records of patients diagnosed with PFAPA and admitted to our clinic from January 1999 to January 2010 (n = 31). The study population (n = 31) consisted of 21 males and ten females: 30 Caucasians and 1 Asian. Normal growth was seen in 30 patients. The median age at onset was 33 months. The mean duration of fever episodes was 4.45 days (95% confidence interval (CI): 3.92-4.98 days), and the mean duration of intervals between fever episodes was 29.66 days (95% CI: 25.31-34.01 days). Concomitantly with the fever, all patients had characteristic symptoms. All patients were asymptomatic in between their fever episodes. Prodromal symptoms were seen in 12 patients. Oral prednisolone was used in 24 patients and caused immediate fever reduction in 87.5%. A reduction in the duration of the asymptomatic interval after treatment was seen in 75.0%. Tonsillectomy was performed in 20 of the 31 patients causing cessation of fever episodes in 70%. Fever episodes continued in 15%, and the postoperative status remained unknown in the last 15%. Spontaneous resolution was seen in four patients. The diagnostic delay had a median duration of 28 months (range 2-160 months). The long diagnostic delay of PFAPA gives cause for concern and it indicates a need for greater awareness of the disease so that the diagnosis may be made earlier. not relevant. not relevant.

  2. Investigation of chikungunya fever outbreak in Laguna, Philippines, 2012


    Ballera, Julius Erving; Zapanta, Ma Justina; de los Reyes, Vikki Carr; Sucaldito, Ma Nemia; Tayag, Enrique


    Background: In July 2012, the Philippines National Epidemiology Center received a report of a suspected chikungunya fever outbreak in San Pablo City, Laguna Province, the first chikungunya cases reported from the city since surveillance started in 2007. We conducted an outbreak investigation to identify risk factors associated with chikungunya. Methods: A case was defined as any resident of Concepcion Village in San Pablo City who had fever of at least two days duration and either joint ...

  3. Complete Atrioventricular Block in an Adolescent With Rheumatic Fever


    Yoo, Gyeong-Hee


    Rheumatic fever is an acute inflammatory sequela following a group A, ?-hemolytic streptococcal infection. Rheumatic fever is characterized by polyarthritis, carditis, chorea, subcutaneous nodules, and erythema marginatum as the major diagnostic criteria. Rarely, advanced heart block may also occur. A 13-year-old boy was admitted to the Pediatric Department for evaluation and management of complete atrioventricular block. The patient had exertional dyspnea for 1 month. Based on the findings o...

  4. Fatigue following Acute Q-Fever: A Systematic Literature Review (United States)

    Delsing, Corine E.; Bleijenberg, Gijs; Langendam, Miranda; Timen, Aura; Bleeker-Rovers, Chantal P.


    Background Long-term fatigue with detrimental effects on daily functioning often occurs following acute Q-fever. Following the 2007–2010 Q-fever outbreak in the Netherlands with over 4000 notified cases, the emphasis on long-term consequences of Q-fever increased. The aim of this study was to provide an overview of all relevant available literature, and to identify knowledge gaps regarding the definition, diagnosis, background, description, aetiology, prevention, therapy, and prognosis, of fatigue following acute Q-fever. Design A systematic review was conducted through searching Pubmed, Embase, and PsycInfo for relevant literature up to 26th May 2015. References of included articles were hand searched for additional documents, and included articles were quality assessed. Results Fifty-seven articles were included and four documents classified as grey literature. The quality of most studies was low. The studies suggest that although most patients recover from fatigue within 6–12 months after acute Q-fever, approximately 20% remain chronically fatigued. Several names are used indicating fatigue following acute Q-fever, of which Q-fever fatigue syndrome (QFS) is most customary. Although QFS is described to occur frequently in many countries, a uniform definition is lacking. The studies report major health and work-related consequences, and is frequently accompanied by nonspecific complaints. There is no consensus with regard to aetiology, prevention, treatment, and prognosis. Conclusions Long-term fatigue following acute Q-fever, generally referred to as QFS, has major health-related consequences. However, information on aetiology, prevention, treatment, and prognosis of QFS is underrepresented in the international literature. In order to facilitate comparison of findings, and as platform for future studies, a uniform definition and diagnostic work-up and uniform measurement tools for QFS are proposed. PMID:27223465

  5. Shortage of vaccines during a yellow fever outbreak in Guinea.


    Nathan, N; Barry, M; Van Herp, M.; Zeller, H


    A yellow fever epidemic erupted in Guinea in September, 2000. From Sept 4, 2000, to Jan 7, 2001, 688 instances of the disease and 225 deaths were reported. The diagnosis was laboratory confirmed by IgM detection in more than 40 patients. A mass vaccination campaign was limited by insufficient international stocks. After the epidemic in Guinea, the International Coordinating Group on Vaccine Provision for Epidemic Meningitis Control decided that 2 million doses of 17D yellow fever vaccine, bei...

  6. Typhoid fever: aspects of environment, host and pathogen interaction


    Ali, Soegianto


    In a surveillance study in Jakarta, Indonesia, 88 typhoid and 26 paratyphoid fever patients were identified by blood culture. Risk factors for transmission of typhoid fever were mainly intra-household factors (poor hand-washing hygiene, recent household contacts), whereas paratyphoid was mainly contracted through street food. In an additional study, street vendors observed poorer hand-washing and food-handling hygiene compared to food handlers in restaurants, and had higher bacterial loads in...

  7. Proteinuria during dengue fever in children. (United States)

    Andries, Anne-Claire; Duong, Veasna; Cappelle, Julien; Ong, Sivuth; Kerleguer, Alexandra; Ly, Sowath; Tarantola, Arnaud; Horwood, Paul F; Sakuntabhai, Anavaj; Dussart, Philippe; Buchy, Philippe


    This study aimed to investigate proteinuria occurring during dengue disease in children and assess if measurement of this parameter can help physicians in the clinical management of patients. Proteinuria was assessed by dipstick and quantified by urine protein:creatinine ratio (UPCR) in samples from patients hospitalized with a confirmed dengue infection and in healthy controls. The dipstick tested positive in 42.9% of the patients presenting at hospital with dengue versus 20.0% in healthy controls. UPCR increased during the critical phase of the disease; peaking one week after fever onset then decreasing as the patients recovered. Patients with warnings signs or severe dengue were more likely to present with proteinuria detected by UPCR at the time of hospital admission compared to patients without warning signs. The sensitivity of this marker, however, was limited as only 16.1% of the patients with warning signs had proteinuria. Urine dipstick and UPCR do not seem to be very valuable for the triage of the patients at the time of the initial consultation but the observation of a decrease of the UPCR during the course of the illness appears to indicate an evolution towards recovery. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. [Heat and Fever in ancient Greek physiology]. (United States)

    Yeo, In-Sok


    This paper aims at clarifying the relationship of physiological heat and pathological heat(fever) using the theoretical scheme of Georges Canguilhem as is argued in his famous book The Normal and the Pathologic. Ancient authors had presented various views on the innate heat and pathological heat. Some argued that there is only pathological heat while others, like Galen, distinguished two different kinds of heat. Galen was the first medial author who had the clear notion of the relationship between the normal heat and the pathological heat. He conceptualized their difference as the heat conforming to nature (kata phusin) and the heat against nature (para phusin). However, the Peripatetic authors, such as ps-Alexander Aphrodisias, who laid more emphasis on physiology tended to regard pathology in continuation with physiology as Claude Bernard attempted to do it. Therefore, Canguilhem's theoretical scheme turns out to be very useful in analysing the relationship of normal heat and pathological heat as is manifested in ancient Greek physiology.

  9. Crimean-Congo hemorrhagic fever in Iran (United States)

    Keshtkar-Jahromi, Maryam; Sajadi, Mohammad M.; Ansari, Hossein; Mardani, Masoud; Naieni, Kourosh Holakouie


    The presence of Crimean-Congo hemorrhagic fever virus (CCHFV) in Iran was first identified in studies of livestock sera and ticks in the 1970s, but the first human infection was not diagnosed until 1999. Since that time, the number of cases of CCHF in Iran has markedly increased. Through January 2012, articles in the published literature have reported a total of 870 confirmed cases, with 126 deaths, for a case fatality rate (CFR) of 17.6%. The disease has been seen in 26 of the country’s 31 provinces, with the greatest number of cases in Sistan and Baluchestan, Isfahan, Fars, Tehran, Khorasan, and Khuzestan provinces. The increase in CCHF in Iran has paralleled that in neighboring Turkey, though the number of cases in Turkey has been much larger, with an overall CFR of around 5%. In this article, we review the features of CCHF in Iran, including its history, epidemiology, animal and tick reservoirs, current surveillance and control programs, diagnostic methods, clinical features and experience with ribavirin therapy, and consider possible explanations for the difference in the CFR of CCHF between Iran and Turkey. The emergence of CCHF in Iran calls for countermeasures at many levels to protect the population, but also provides opportunities for studying the epidemiology, diagnosis and management of the disease. PMID:23872313

  10. Towards a Vaccine Against Rheumatic Fever

    Directory of Open Access Journals (Sweden)

    L. Guilherme


    Full Text Available Rheumatic fever (RF is an autoimmune disease which affects more than 20 million children in developing countries. It is triggered by Streptococcus pyogenes throat infection in untreated susceptible individuals. Carditis, the most serious manifestation of the disease, leads to severe and permanent valvular lesions, causing chronic rheumatic heart disease (RHD. We have been studying the mechanisms leading to pathological autoimmunity in RF/RHD for the last 15 years. Our studies allowed us a better understanding of the cellular and molecular pathogenesis of RHD, paving the way for the development of a safe vaccine for a post-infection autoimmune disease. We have focused on the search for protective T and B cell epitopes by testing 620 human blood samples against overlapping peptides spanning 99 residues of the C-terminal portion of the M protein, differing by one amino acid residue. We identified T and B cell epitopes with 22 and 25 amino acid residues, respectively. Although these epitopes were from different regions of the C-terminal portion of the M protein, they showed an identical core of 16 amino acid residues. Antibodies against the B cell epitope inhibited bacterial invasion/adhesion in vitro. Our results strongly indicated that the selected T and B cell epitopes could potentially be protective against S. pyogenes.

  11. Hemorrhagic fever with renal syndrome in Montenegro. (United States)

    Gledovic, Z B; Jeknic, A S; Grgurevic, A D; Rakocevic, B B; Bozovic, B R; Mugosa, B V


    The objective of the study was to analyze the epidemiological features of hemorrhagic fever with renal syndrome (HFRS) in Montenegro. The study included 169 cases of HFRS diagnosed in the period between 1995 and 2005 according to the clinical symptoms and serological confirmation. For the analysis of the demographic characteristics of the cases, as well as of the chronological and topographical features of the disease, a descriptive epidemiological method was employed. The average incidence rate in the observed period was 2.6 per 100,000. In the observed period, 8 people died; the average case fatality rate was 4.8% (range: 0.1-15%). Among the diseased persons, 116 were males and 53 were females; most of the cases were adults. The greatest number of HFRS cases occurred during the summer months. The highest incidence rates were registered in the northeastern, rural part of the country. The most frequent type of hantaviruses in Montenegro were Dobrava-Belgrade and Hantaan, carried by rodent species, i.e., the yellow-neck mouse and the striped-field mouse. It is likely that HFRS in Montenegro will become more common in the near future, unless public health control measures are taken.

  12. A Patient with Microcytic Anemia and Fever

    Directory of Open Access Journals (Sweden)

    Sacha Bhatia


    Full Text Available A 62-year-old man with a history of mechanical aortic valve insertion and ascending aorta replacement in 1997 presented to his family doctor in August 2004 with a two-week history of melena after recently returning from a six-month vacation in Mexico. The patient had no other abdominal complaints. He took warfarin but did not take nonsteroidal anti-inflammatory agents, acetylsalicylic acid or alcohol. The patient had no history of liver or peptic ulcer disease. He had lost 7 kg over the past month, but did not complain of fever or night sweats. On physical examination, vital signs were normal, the second heart sound was mechanical, and there were no abnormal findings. Laboratory investigations showed a borderline microcytic anemia (hemoglobin 76 g/L; mean corpuscular volume 79 fL; mean corpuscular hemoglobin concentration 323 g/L, a therapeutic international normalized ratio (2.6 and an elevated creatinine level (112 µmol/L. His stool was positive for occult blood, although the ferritin level was high (623 µg/L. Other routine blood work was normal. The patient was admitted to hospital for investigation of the anemia.

  13. Acute Macular Neuroretinopathy Associated With Chikungunya Fever. (United States)

    Pang, Claudine E; Navajas, Eduardo V; Warner, Simon J; Heisler, Morgan; Sarunic, Marinko V


    A 47-year-old man with recent travel to the Caribbean was admitted with acute febrileillness associated with arthralgia and skin rash followed by sudden onset of bilateral visual field defects. Funduscopy revealed subtle bilateral paracentral dark lesions nasal to the fovea best seen on near infrared imaging as hyporeflective, wedge-shaped, paracentral macular lesions. Spectral-domain optical coherence tomography (SD-OCT) through the lesions revealed hyperreflective bands at the level of the outer plexiform layer and outer nuclear layer (ONL), with concomitant attenuation of the underlying external limiting membrane (ELM), ellipsoid zone (EZ), and interdigitation zone (IZ). Neither fluorescein angiography nor speckle variance OCT angiography (sv-OCTA) showed any defects in retinal circulation. Work up revealed positive Immunoglobulin M for Chikungunya virus (CHIKV). Six months later, the patient had persistent scotomas, although reduced in size. SD-OCT showed subtle ONL thinning and restoration of the ELM, although EZ and IZ remained disrupted. Chikungunya fever may manifest as bilateral acute macular neuroretinopathy (AMN). Clinicians should be aware of possible systemic associations of AMN. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:596-599.]. Copyright 2016, SLACK Incorporated.

  14. Classical Swine Fever-An Updated Review. (United States)

    Blome, Sandra; Staubach, Christoph; Henke, Julia; Carlson, Jolene; Beer, Martin


    Classical swine fever (CSF) remains one of the most important transboundary viral diseases of swine worldwide. The causative agent is CSF virus, a small, enveloped RNA virus of the genus Pestivirus. Based on partial sequences, three genotypes can be distinguished that do not, however, directly correlate with virulence. Depending on both virus and host factors, a wide range of clinical syndromes can be observed and thus, laboratory confirmation is mandatory. To this means, both direct and indirect methods are utilized with an increasing degree of commercialization. Both infections in domestic pigs and wild boar are of great relevance; and wild boars are a reservoir host transmitting the virus sporadically also to pig farms. Control strategies for epidemic outbreaks in free countries are mainly based on classical intervention measures; i.e., quarantine and strict culling of affected herds. In these countries, vaccination is only an emergency option. However, live vaccines are used for controlling the disease in endemically infected regions in Asia, Eastern Europe, the Americas, and some African countries. Here, we will provide a concise, updated review on virus properties, clinical signs and pathology, epidemiology, pathogenesis and immune responses, diagnosis and vaccination possibilities.

  15. An unusual cause of acute abdominal pain in dengue fever. (United States)

    Waseem, Tariq; Latif, Hina; Shabbir, Bilquis


    Dengue fever is an acute febrile viral disease caused by the bite of Aedes aegypti mosquito. It is a major health problem especially in tropical and subtropical areas including South East Asia and Pakistan. In the past few years, dengue fever has been endemic in Northern Punjab. Physicians managing dengue fever come across varied and uncommon complications of dengue fever. We report a case of dengue fever that developed severe right upper quadrant abdominal pain and induration after extreme retching and vomiting for 2 days. A rectus sheath hematoma was confirmed on noncontrast computed tomography (CT). Rectus sheath hematoma as a complication of dengue fever has rarely been reported before and never from this part of the world. Rectus sheath hematoma is an uncommon and often clinically misdiagnosed cause of abdominal pain. It is the result of bleeding into the rectus sheath from damage to the superior or inferior epigastric artery or their branches or from a direct tear of the rectus muscle. It can mimic almost any abdominal condition (See Fig.) (See Table).

  16. Meteorological factors and dengue fever transmission in South Taiwan (United States)

    Chien, Lung-Chang; Lin, Yuan-Chien; Cheng, Ming-Hung; Yu, Hwa-Lung


    The variations in meteorological conditions induced by climate change causes the diffusion pattern of infectious disease and serious epidemic situation. The objective of this study is to investigate the impact of meteorological variables to the temporal variation of dengue fever epidemic in weekly basis in south Taiwan. Several extreme and average index of meteorological variables, i.e. temperature and humidity, were used for this analysis, including averaged, maximum and minimum temperature, and average rainfall, maximum 1-hr rainfall, and maximum 24-hr rainfall. This study applies the distributed lag nonlinear model (DLNM) to reveal the significant meteorological variables and their temporal lag effects to the dengue fever epidemic by analyzing the dengue fever records from 1998-2011. Results show that the weekly minimum temperature (minT) and 1-hr maximum rainfall (maxR) are significantly important to the dengue fever spread. Among them, once minT is higher than 20°C, the relative risk of dengue fever of nine-fourteen week later will be significantly elevated. On the other hand, the incidences of maxR higher than 80mm can also increase the relative risk of dengue fever occurrences around nine-fourteen weeks afterwards.

  17. Spontaneous splenic rupture during the recovery phase of dengue fever. (United States)

    de Silva, W T T; Gunasekera, M


    Spontaneous splenic rupture is a rare but known complication of dengue fever. Previously reported cases have occurred early during the course of the disease and most cases have led to a fatal outcome. Here we report a case of spontaneous splenic rupture in a patient with dengue fever, which occurred during the recovery phase of the illness. A 28-year-old Sinhalese, Sri Lankan man presented with a history of fever, myalgia and vomiting of 4 days duration. Investigations revealed a diagnosis of dengue fever with no signs of plasma leakage. He was managed in the ward as per local protocol. During the recovery phase the patient developed severe abdominal distention with circulatory failure. Radiology revealed splenic rupture with massive amounts of abdominal free fluid. The patient was resuscitated and Emergency laparotomy with splenectomy was performed. The outcome was excellent with the patient making a complete recovery. Although splenic rupture is a known complication of dengue fever it may be manifested late in the disease process. A high degree of suspicion should be maintained and patients must be monitored even during the recovery phase of dengue fever. Early diagnosis and intervention can prevent mortality.

  18. Systemic immune presentations of Coxiella burnetii infection (Q Fever). (United States)

    Lefebvre, Maeva; Grossi, Olivier; Agard, Christian; Perret, Christophe; Le Pape, Patrice; Raoult, Didier; Hamidou, Mohamed A


    Q fever is a worldwide zoonosis caused by Coxiella burnetii. Its presentation can be atypical, delaying and complicating the diagnosis. We report 7 cases of Q fever mimicking vasculitis, systemic inflammatory disease, or auto-immune disorder. Seven cases of Q fever diagnosed between 1995 and 2007 in Nantes University Hospital (France) are described. They occurred in a nonendemic region and were selected on the basis of initial clinical presentation suggesting systemic immune disease. C. burnetii was detected using indirect immunofluorescence serology. Q fever was acute in 4 of the 7 patients and chronic in 3. None had endocarditis. The initial presentations suggested Crohn's disease, Goodpasture's syndrome, polymyalgia rheumatica, adult-onset Still's disease, polyarteritis nodosa, giant-cell arteritis, and essential type II cryoglobulinemia. Two patients had antiphospholipid antibodies, 1 had transient IgG kappa monoclonal gammopathy, and 1 had polyclonal T CD8+ large granular lymphocyte expansion. Clinicians must be aware of the potential diagnosis of Q fever, and C. burnetii serology is a helpful diagnostic tool in the investigation of fever of unknown origin with atypical systemic symptoms suggesting vasculitis or inflammatory disease. Copyright 2010 Elsevier Inc. All rights reserved.

  19. [Trends in yellow fever mortality in Colombia, 1998-2009]. (United States)

    Segura, Ángela María; Cardona, Doris; Garzón, María Osley


    Yellow fever is a neglected tropical disease, thus, knowing the trends in mortality from this disease in Colombia is an important source of information for decision making and identifying public health interventions. To analyze trends in yellow fever mortality in Colombia during the 1998-2009 period and the differences in the morbidity and mortality information sources for the country, which affect indicators such as the lethality one. This is a descriptive study of deaths by yellow fever according to the Departamento Administrativo Nacional de Estadística and the incidence of the disease according to the Instituto Nacional de Salud . We used secondary sources of information in the calculation of proportions of socio-demographic characteristics of the deceased and epidemiological measures of lethality, incidence and mortality from yellow fever by department of residence of the deceased. Yellow fever deaths occur primarily in men of working age residing in scattered rural areas, who were members of the regimen vinculado, and who were living in the eastern, southeastern, northern and central zones in the country. We observed inconsistencies in the reports that affect the comparative analysis. The inhabitants of the departments located in national territories and Norte de Santander have an increased risk of illness and death from yellow fever, but this information could be underestimated, according to the source of information used for its calculation.

  20. Safety and Immunogenicity of Typhoid Fever and Yellow Fever Vaccines When Administered Concomitantly With Quadrivalent Meningococcal ACWY Glycoconjugate Vaccine in Healthy Adults

    National Research Council Canada - National Science Library

    Alberer, Martin; Burchard, Gerd; Jelinek, Tomas; Reisinger, Emil; Beran, Jiri; Hlavata, Lucie Cerna; Forleo‐Neto, Eduardo; Dagnew, Alemnew F; Arora, Ashwani K


    .... This article discusses the immunogenicity and safety of travel vaccines for typhoid fever (TF) and yellow fever (YF), when administered with or without a quadrivalent meningococcal glycoconjugate ACWY-CRM vaccine...

  1. The revised global yellow fever risk map and recommendations for vaccination, 2010: consensus of the Informal WHO Working Group on Geographic Risk for Yellow Fever. (United States)

    Jentes, Emily S; Poumerol, Gilles; Gershman, Mark D; Hill, David R; Lemarchand, Johan; Lewis, Rosamund F; Staples, J Erin; Tomori, Oyewale; Wilder-Smith, Annelies; Monath, Thomas P


    The changing epidemiology of yellow fever and continued reports of rare but serious adverse events associated with yellow fever vaccine have drawn attention to the need to revisit criteria for the designation of areas with risk for yellow fever virus activity, and to revise the vaccine recommendations for international travel. WHO convened a working group of international experts to review factors important for the transmission of yellow fever virus and country-specific yellow fever information, to establish criteria for additions to or removal from the list of countries with risk for yellow fever virus transmission, to update yellow fever risk maps, and to revise the recommendations for vaccination for international travel. This report details the recommendations made by the working group about criteria for the designation of risk and specific changes to the classification of areas with risk for transmission of yellow fever virus. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. Acute Q Fever Presenting as Fever of Unknown Origin with Rapidly Progressive Hepatic Failure in a Patient with Alcoholism

    Directory of Open Access Journals (Sweden)

    Po-Han Lin


    Full Text Available We report a case of fulminant acute Q fever presenting as fever of unknown origin with rapidly progressive hepatic failure in a patient with alcoholism. A 51-year-old electrician, who was a habitual drinker, presented with a 2-week history of intermittent high fever, acute hepatomegaly and rapidly progressive jaundice after being accidentally exposed to dust from bird nests when he was repairing electrical equipment and circuitry at an abandoned factory in Taipei County. Ascites and prolonged prothrombin time were noted at admission. Transjugular liver biopsy and bone marrow biopsy found multiple small fibrinoid-ring granulomas in liver parenchyma and bone marrow. Doxycycline therapy was empirically started. The fever gradually subsided over a 2-week period, along with the recovery of liver function. The diagnosis of acute Q fever was confirmed by high titers of antibodies against Coxiella burnetii (phase I IgM 1:160 and IgG 1:2560, phase II IgM > 1:320 and IgG 1:5120 and a four-fold elevation of phase II IgG titer in the paired serum. The experience of this case shows that the possibility of Q fever should not be overlooked in patients who have an unexplained febrile illness and severe liver function impairment following exposure to a contaminated environment in Taiwan.

  3. Responses to Fever Overnight: Do Residents Choose Wisely? (United States)

    Howard-Anderson, Jessica; Schwab, Kristin; Chang, Sandy; Graber, Christopher J; Quinn, Roswell


    Abstract Background Residents at our institution rely heavily on the terminology “Full Fever Work Up” (FFWU) as a cognitive tool for cross-covering patients with a fever. Prior survey data revealed that residents vary considerably in how they respond to fevers and what FFWU means. We sought to determine what tests are included in the FFWU, how often the term is adhered to, and if it significantly changes clinical outcomes. Methods For 3 months, study investigators collected FFWU instructions for patients who experienced a fever at night. For each febrile episode, investigators reviewed chart data on patient factors, circumstances surrounding the fever, tests ordered, etiologies of the fever, and outcomes (immediately and 30-days after the fever). The UCLA Institutional Review Board approved this study. Results We reviewed 253 fever episodes. For 204 episodes, written sign-out by the primary team was available. 59% of the fevers were in male patients and the mean age was 59 years. 12% had an organ transplant and 45% qualified as highly immunocompromised. 79% met SIRS criteria, whereas only 3% met qSOFA criteria and 2% required escalation of care. The cross-covering physician wrote a note in 4% of the cases and evaluated the patient in-person in 12% of the cases per chart review. Residents most often ordered bacterial blood cultures (48%), followed by urinary tests (34%) and chest X-rays (30%). These tests, as well as fungal blood cultures, lactate and CBC, were significantly more likely to be ordered by the cross-covering resident if the sign-out instructed to perform a FFWU. The mean number of diagnostic tests ordered was 2 and residents started or changed antibiotics in 14% of cases. 88% of the time patients were alive 30 days after their fever. 11% had an antibiotic-related complication and 8% of blood cultures drawn were positive. Conclusion Ordering practices overnight were significantly influenced by the FFWU sign-out instructions, yet evaluating the

  4. The 2007-2010 Q fever epidemic in The Netherlands: characteristics of notified acute Q fever patients and the association with dairy goat farming.

    NARCIS (Netherlands)

    Dijkstra, F.; Hoek, W. van der; Wijers, N.; Schimmer, B.; Rietveld, A.; Wijkmans, C.J.; Vellema, P.; Schneeberger, P.M.


    We describe the Q fever epidemic in the Netherlands with emphasis on the epidemiological characteristics of acute Q fever patients and the association with veterinary factors. Data from 3264 notifications for acute Q fever in the period from 2007 through 2009 were analysed. The patients most

  5. [Malignant catarrhal fever in zoo ruminants]. (United States)

    Hänichen, T; Reid, H W; Wiesner, H; Hermanns, W


    An outbreak of malignant catarrhal fever (MCF) in Indian gauer (Bos gaurus gaurus) and Javan banteng (Bos javanicus javanicus) occurred in the year 1964 and killed almost all animals of the groups of these species kept at the Munich zoo at that time. In the consecutive years at highly irregular intervals cases of the head-and-eye-form of MCF occurred sporadically at the zoo in European and American bison (Bison bonasus, B. bison' bison, B. bison athabascae), elk (Alces alces), red deer (Cervus elaphus), Père David's deer (Elaphurus davidianus) and again in gaur and banteng. The clinical and pathomorphological observations, including those of prophylactic and tentative treatment are reported. The subspecies of caprinae and alcelaphinae potentionally latently infected with viral agents of MCF kept at the zoo over the reported period are listed. Some details concerning housing, taking care of the animals etc. of the latently infected carriers of the family caprinae and the susceptible species of bovidae and cervidae are also given as far as they are of epidemiological interest. The results of the retrospective analysis and the results of testing paraffin-embedded tissue samples for the presence of ovine herpesvirus-2 (OHV-2)-specific DNA and alcelaphine herpesvirus-1 (AHV-1)-specific DNA from 1964 up to 1997 are discussed. The negative results for OHV-2-specific DNA suggest that MCF at Munich zoo until 1979 could have been "wildebeest-associated", also because until 1974 blue wildebeest (Connochaetes taurinus taurinus) and until 1983 white-tailed gnu (Connochaetes gnou) were kept. However, positive results for OHV-2-specific DNA in the tissues collected from 1985 onwards, strongly suggest the "sheep-associated" MCF.

  6. African swine fever virus replication and genomics. (United States)

    Dixon, Linda K; Chapman, David A G; Netherton, Christopher L; Upton, Chris


    African swine fever virus (ASFV) is a large icosahedral DNA virus which replicates predominantly in the cytoplasm of infected cells. The ASFV double-stranded DNA genome varies in length from about 170 to 193 kbp depending on the isolate and contains between 150 and 167 open reading frames. These are closely spaced and read from both DNA strands. The virus genome termini are covalently closed by imperfectly base-paired hairpin loops that are present in two forms that are complimentary and inverted with respect to each other. Adjacent to the termini are inverted arrays of different tandem repeats. Head to head concatemeric genome replication intermediates have been described. A similar mechanism of replication to Poxviruses has been proposed for ASFV. Virus genome transcription occurs independently of the host RNA polymerase II and virus particles contain all of the enzymes and factors required for early gene transcription. DNA replication begins in perinuclear factory areas about 6h post-infection although an earlier stage of nuclear DNA synthesis has been reported. The virus genome encodes enzymes required for transcription and replication of the virus genome and virion structural proteins. Enzymes that are involved in a base excision repair pathway may be an adaptation to enable virus replication in the oxidative environment of the macrophage cytoplasm. Other ASFV genes encode factors involved in evading host defence systems and modulating host cell function. Variation between the genomes of different ASFV isolates is most commonly due to gain or loss of members of multigene families, MGFs 100, 110, 300, 360, 505/530 and family p22. These are located within the left terminal 40kbp and right terminal 20kbp. ASFV is the only member of the Asfarviridae, which is one of the families within the nucleocytoplasmic large DNA virus superfamily. Copyright © 2012 Elsevier B.V. All rights reserved.

  7. Vaccine platforms to control Lassa fever. (United States)

    Lukashevich, Igor S; Pushko, Peter


    Lassa virus (LASV), the most prominent human pathogen of the Arenaviridae, is transmitted to humans from infected rodents and can cause Lassa Fever (LF). The sizeable disease burden in West Africa, numerous imported LF cases worldwide, and the possibility that LASV can be used as an agent of biological warfare make a strong case for vaccine development. There are no licensed LASV vaccines and the antiviral treatment is limited to an off-label use of ribavirin that is only partially effective. LASV vaccine development is hampered by high cost of biocontainment requirement, the absence of appropriate small animal models, genetic diversity of LASV species, and by high HIV-1 prevalence in LASV endemic areas. Over the past 15 years several vaccine platforms have been developed. Natural history of LASV and pathogenesis of the disease provide strong justification for replication-competent (RC) vaccine as one of the most feasible approaches to control LF. Development of LASV vaccine candidates based on reassortant, recombinant, and alphavirus replicon technologies is covered in this review. Expert commentary: Two lead RC vaccine candidates, reassortant ML29 and recombinant VSV/LASV, have been successfully tested in non-human primates and have been recommended by international vaccine experts for rapid clinical development. Both platforms have powerful molecular tools to further secure safety, improve immunogenicity, and cross-protection. These platforms are well positioned to design multivalent vaccines to protect against all LASV strains citculatrd in West Africa. The regulatory pathway of Candid #1, the first live-attenuated arenaviral vaccine against Argentine hemorrhagic, will be a reasonable guideline for LASV vaccine efficacy trials.

  8. Beyond malaria--causes of fever in outpatient Tanzanian children. (United States)

    D'Acremont, Valérie; Kilowoko, Mary; Kyungu, Esther; Philipina, Sister; Sangu, Willy; Kahama-Maro, Judith; Lengeler, Christian; Cherpillod, Pascal; Kaiser, Laurent; Genton, Blaise


    As the incidence of malaria diminishes, a better understanding of nonmalarial fever is important for effective management of illness in children. In this study, we explored the spectrum of causes of fever in African children. We recruited children younger than 10 years of age with a temperature of 38°C or higher at two outpatient clinics--one rural and one urban--in Tanzania. Medical histories were obtained and clinical examinations conducted by means of systematic procedures. Blood and nasopharyngeal specimens were collected to perform rapid diagnostic tests, serologic tests, culture, and molecular tests for potential pathogens causing acute fever. Final diagnoses were determined with the use of algorithms and a set of prespecified criteria. Analyses of data derived from clinical presentation and from 25,743 laboratory investigations yielded 1232 diagnoses. Of 1005 children (22.6% of whom had multiple diagnoses), 62.2% had an acute respiratory infection; 5.0% of these infections were radiologically confirmed pneumonia. A systemic bacterial, viral, or parasitic infection other than malaria or typhoid fever was found in 13.3% of children, nasopharyngeal viral infection (without respiratory symptoms or signs) in 11.9%, malaria in 10.5%, gastroenteritis in 10.3%, urinary tract infection in 5.9%, typhoid fever in 3.7%, skin or mucosal infection in 1.5%, and meningitis in 0.2%. The cause of fever was undetermined in 3.2% of the children. A total of 70.5% of the children had viral disease, 22.0% had bacterial disease, and 10.9% had parasitic disease. These results provide a description of the numerous causes of fever in African children in two representative settings. Evidence of a viral process was found more commonly than evidence of a bacterial or parasitic process. (Funded by the Swiss National Science Foundation and others.).

  9. [Marburg and Ebola hemorrhagic fevers--pathogens, epidemiology and therapy]. (United States)

    Stock, Ingo


    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.

  10. A study of the outbreak of Chikungunya fever. (United States)

    Patil, Supriya Satish; Patil, Satish R; Durgawale, P M; Patil, A G


    Chikungunya fever occurred in an epidemic form in the state of Maharashtra after a gap of about 32 years. Many cases with symptoms which were suggestive of Chikungunya fever were reported from the village Kasegaon, Dist Sangli, Maharashtra, India. Hence, this study was done to assess the magnitude of the outbreak and to identify the possible socio-environmental factors which are responsible for Chikungunya fever. This cross sectional study was carried out at Kasegaon by a team from the Krishna Institute of Medical Sciences, Karad, Maharashtra, in collaboration with the Primary Health Centre, Kasegaon, Distt. Sangli. The Chikungunya prevalence was 9.6%. There were 154 clinically suspected Chikungunya fever cases. Of these, 54.5% were males and 45.5% were females. About 72.7% of the cases were in the age range of 11-50 years, which is the active age group. The main symptoms were an acute onset of fever with joint pain (100%). Multiple joints were involved in (89.6%) cases. The mean duration of the fever was 3 days (range 1-10 days). About 40.3% people preferred to consult a government health facility. In the affected area, 83.1% people were aware of Chikungunya fever. Only few (1.1%) knew the vectors which were responsible for the Chikungunya transmission. Among the people in the affected area, 33.1% had knowledge on insecticide spraying, 23.2% had knowledge on the use of mosquito nets and repellents, 12.5% had knowledge on source reduction and 0.8% had knowledge on larvicides.

  11. Identification of factors for physicians to facilitate early differential diagnosis of scrub typhus, murine typhus, and Q fever from dengue fever in Taiwan. (United States)

    Chang, Ko; Lee, Nan-Yao; Ko, Wen-Chien; Tsai, Jih-Jin; Lin, Wei-Ru; Chen, Tun-Chieh; Lu, Po-Liang; Chen, Yen-Hsu


    Dengue fever, rickettsial diseases, and Q fever are acute febrile illnesses with similar manifestations in tropical areas. Early differential diagnosis of scrub typhus, murine typhus, and Q fever from dengue fever may be made by understanding the distinguishing clinical characteristics and the significance of demographic and weather factors. We conducted a retrospective study to identify clinical, demographic, and meteorological characteristics of 454 dengue fever, 178 scrub typhus, 143 Q fever, and 81 murine typhus cases in three Taiwan hospitals. Case numbers of murine typhus and Q fever correlated significantly with temperature and rainfall; the scrub typhus case number was only significantly related with temperature. Neither temperature nor rainfall correlated with the case number of dengue fever. The rarity of dengue fever cases from January to June in Taiwan may be a helpful clue for diagnosis in the area. A male predominance was observed, as the male-to-female rate was 2.1 for murine typhus and 7.4 for Q fever. Multivariate analysis revealed the following six important factors for differentiating the rickettsial diseases and Q fever group from the dengue fever group: fever ≥8 days, alanine aminotransferase > aspartate aminotransferase, platelets >63,000/mL, C-reactive protein >31.9 mg/L, absence of bone pain, and absence of a bleeding syndrome. Understanding the rarity of dengue in the first half of a year in Taiwan and the six differentiating factors may help facilitate the early differential diagnosis of rickettsial diseases and Q fever from dengue fever, permitting early antibiotic treatment. Copyright © 2015. Published by Elsevier B.V.

  12. [Two cases of acute hepatitis associated with Q fever]. (United States)

    Yeşilyurt, Murat; Kılıç, Selçuk; Gürsoy, Bensu; Celebi, Bekir; Yerer, Mehmet


    Q fever which is caused by Coxiella burnetii, is a worldwide zoonosis. Many species of wild and domestic mammals, birds, and arthropods, are reservoirs of C.burnetii in nature, however farm animals are the most frequent sources of human infection. The most frequent way of transmission is by inhalation of contaminated aerosols. The clinical presentation of Q fever is polymorphic and nonspecific. Q fever may present as acute or chronic disease. In acute cases, the most common clinical syndromes are selflimited febrile illness, granulomatous hepatitis, and pneumonia, but it can also be asymptomatic. Fever with hepatitis associated with Q fever has rarely been described in the literature. Herein we report two cases of C.burnetii hepatitis presented with jaundice. In May 2011, two male cases, who inhabited in Malkara village of Tekirdag province (located at Trace region of Turkey), were admitted to the hospital with the complaints of persistent high grade fever, chills and sweats, icterus, disseminated myalgia and headache. Physical examination revealed fever, icterus and the patient appeared to be mildly ill but had no localizing signs of infection. Radiological findings of the patients were in normal limits. Laboratory findings revealed leukocytosis, increased hepatic and cholestatic enzyme levels, and moderate hyperbilirubinemia- mainly direct bilirubin, whereas serum C-reactive protein and erythrocyte sedimentation rate were found normal. Blood and urine cultures of the patients yielded no bacterial growth. Serological markers for acute viral hepatitis, citomegalovirus and Epstein-Barr virus infections, brucellosis, salmonellosis, toxoplasmosis and leptospirosis were found negative. Acute Q fever diagnosis of the cases were based on the positive results obtained by C.burnetii Phase II IgM and IgG ELISA (Vircell SL, Spain) test, and the serological diagnosis were confirmed by Phase I and II immunofluorescence (Vircell SL, Spain) method. Both cases were treated with


    Arshad, Kashan; Sheikh, Saifuliah; Naqvi, Syeda Umm-ul-Baneen; Sarwar, Imran; Javaid, Sulman; Asghar, Madiha; Butt, Muhammad Asghar


    Dengue Fever is caused by arthropod born viruses. According to World Health Organization approximately 50-100 million infections of dengue fever occur yearly. Objective of this study was to determine the frequency of splenomegaly in dengue fever in children. This cross sectional study was conducted at the Department of Paediatrics, Allied Hospital, Faisalabad, during a period from June 2012 to May 2013 by including 93 Children, aged 4-14 years presenting with fever of less than 14 days with thrombocytopenia and positive IM or IgM and IgG dengue antibodies by ELISA. Patients were thoroughly evaluated by detailed history and clinical examination. Ultrasonography of the patients was performed to confirm the splenomegaly. The data was analysed to determine the frequency and percentage of disease. Out of 93 children, 51 (54.8%) were male and 42 (45.2%) were female. The most common clinical presentation was noted is chills and rigors in 80 (86.02%). Unusual clinical features were encephalopathy in 3T (39.78%) followed by bleeding manifestations and upper respiratory tract infection (upper RTI). Splenomegaly was seen in 45 (48.4%) children. Dengue fever is increasingly presenting with atypical presentation like splenomegaly, encephalopathy, bleeding manifestations and upper RTI.

  14. [Dengue fever--not just a tropical infectious disease]. (United States)

    Stock, Ingo


    Dengue fever is a viral disease that is transmitted primarily by Aedes mosquitoes, i. e., A. aegypti and A. albopictus. Other species are rarely involved. The disease is caused by dengue virus, an enveloped RNA virus which belongs to the family of flaviviridae. Although most infections are asymptomatic, in 20 to 30 percentages all cases infections are accompanied with high fever and other influenza-like signs of illness. Serious medical conditions with lethal complications also occur. During the last decades, the incidence of dengue fever rose sharply in many tropical and subtropical countries. In some of these regions, dengue is one of the leading causes of death in children. In Europe, since a few years a strong clustering of dengue fever cases has been registered in travelers returning from certain tropical or subtropical regions. Recently, autochthonous outbreaks have been observed on the Atlantic island of Madeira and in a few other regions of South Europe. Treatment of dengue fever is supportive and symptomatic, a specific therapy does not exist. For prevention of disease, vector control is of crucial importance.

  15. What do we know about Q fever in Mexico? (United States)

    Araujo-Meléndez, Javier; Sifuentes-Osornio, José; Bobadilla-Del-valle, J Miriam; Aguilar-Cruz, Antonio; Torres-Angeles, Orestes; Ramírez-González, José L; Ponce-de-León, Alfredo; Ruiz-Palacios, Guillermo M; Guerrero-Almeida, M Lourdes


    In Mexico, Q fever is considered a rare disease among humans and animals. From March to May of 2008, three patients were referred, from the state of Hidalgo to a tertiary-care center in Mexico City, with an acute febrile illness that was diagnosed as Q fever. We decided to undertake a cross sectional pilot study to identify cases of acute disease in this particular region and to determine the seroprevalence of Coxiella burnetii among healthy individuals with known risk factors for infection with this bacteria. Q fever was defined according to the Centers for Disease Control and Prevention criteria. All subjects were interviewed for signs and symptoms of the disease, demographic and household characteristics and occupational exposure to cattle. Blood samples were taken from hospitalized and outpatients with symptoms suggestive of Q fever, as well as from asymptomatic individuals with direct and daily exposure to cattle (slaughterers, butchers, farmers, shepherds and veterinarians) in the five municipalities. We report the occurrence of 17 cases with positive antibodies against C. burnetii in a rural area of central Mexico; eight cases had clinical criteria of acute Q fever disease. Results from this pilot study underscore the need for active surveillance programs and comprehensive studies to further define the prevalence and risk factors associated with the disease in Mexico, to know more about its clinical presentation and to characterize bacterial factors involved in its pathogenesis.

  16. Complete atrioventricular block in an adolescent with rheumatic Fever. (United States)

    Yoo, Gyeong-Hee


    Rheumatic fever is an acute inflammatory sequela following a group A, beta-hemolytic streptococcal infection. Rheumatic fever is characterized by polyarthritis, carditis, chorea, subcutaneous nodules, and erythema marginatum as the major diagnostic criteria. Rarely, advanced heart block may also occur. A 13-year-old boy was admitted to the Pediatric Department for evaluation and management of complete atrioventricular block. The patient had exertional dyspnea for 1 month. Based on the findings of mitral regurgitation, fever, elevated acute phase reactants, and a high antistreptolysin O titer, the patient was diagnosed with rheumatic fever. A benzathine penicillin injection was administered, as well as salicylate therapy. On the 5(th) day of hospitalization, the electrocardiogram revealed a normal sinus rhythm with a 1(st) degree atrioventricular block. After discharge, the electrocardiogram normalized with the monthly penicillin injections. Herein we report a case of complete atrioventricular block associated with rheumatic fever. The heart block resolved without specific cardiac treatment, other than a non-steroidal anti-inflammatory medication.

  17. Yellow Fever outbreaks in unvaccinated populations, Brazil, 2008-2009.

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    Alessandro Pecego Martins Romano


    Full Text Available Due to the risk of severe vaccine-associated adverse events, yellow fever vaccination in Brazil is only recommended in areas considered at risk for disease. From September 2008 through June 2009, two outbreaks of yellow fever in previously unvaccinated populations resulted in 21 confirmed cases with 9 deaths (case-fatality, 43% in the southern state of Rio Grande do Sul and 28 cases with 11 deaths (39% in Sao Paulo state. Epizootic deaths of non-human primates were reported before and during the outbreak. Over 5.5 million doses of yellow fever vaccine were administered in the two most affected states. Vaccine-associated adverse events were associated with six deaths due to acute viscerotropic disease (0.8 deaths per million doses administered and 45 cases of acute neurotropic disease (5.6 per million doses administered. Yellow fever vaccine recommendations were revised to include areas in Brazil previously not considered at risk for yellow fever.


    Davis, Nelson C.


    1. It has been possible to introduce yellow fever virus into the small Brazilian monkeys, Callithrix albicollis and Leontocebus ursulus, by the bites of infected mosquitoes and to carry the virus through a series of four passages in each species and back to rhesus monkeys by the bites of Stegomyia mosquitoes fed on the last marmoset of each series. 2. Five specimens of L. ursulus were used. Four developed fever, and all died during the experiments. At least two showed liver necroses comparable to those found in human beings and rhesus monkeys that died of yellow fever. 3. Twenty specimens of C. albicollis were used. Very few showed a temperature reaction following the introduction of virus. Of those that died, none had lesions typical of yellow fever as seen in certain other species of monkeys and in humans. 4. The convalescent serum from each of five C. albicollis protected a rhesus monkey against yellow fever virus, but the serum from a normal marmoset of the same species was found to be non-protective. PMID:19869773

  19. Yellow fever, Asia and the East African slave trade. (United States)

    Cathey, John T; Marr, John S


    Yellow fever is endemic in parts of sub-Saharan Africa and South America, yet its principal vectors--species of mosquito of the genus Aedes--are found throughout tropical and subtropical latitudes. Phylogenetic analyses indicate that yellow fever originated in Africa and that its spread to the New World coincided with the slave trade, but why yellow fever has never appeared in Asia remains a mystery. None of several previously proposed explanations for its absence there is considered satisfactory. We contrast the trans-Atlantic slave trade, and trade across the Sahara and to the Arabian Peninsula and Mesopotamia, with that to Far East and Southeast Asian ports before abolition of the African slave trade, and before the scientific community understood the transmission vector of yellow fever and the viral life cycle, and the need for shipboard mosquito control. We propose that these differences in slave trading had a primary role in the avoidance of yellow fever transmission into Asia in the centuries before the 20(th) century. The relatively small volume of the Black African slave trade between Africa and East and Southeast Asia has heretofore been largely ignored. Although focal epidemics may have occurred, the volume was insufficient to reach the threshold for endemicity.

  20. Preventing dengue and chikungunya fever among international travelers. (United States)

    Tither, Pauline Herold


    To describe the vulnerability of U.S. travelers in tropical and subtropical regions of the world to dengue and chikungunya fever, to provide practical recommendations to avoid these mosquito-borne diseases, and to offer a communication tool as an aid for pretravel health consultations. Medical, epidemiological, and entomological research articles and reviews, and reports from government agencies. Dengue and chikungunya fever have growing public health impact around the world. International travelers return to the United States infected with these diseases. Mosquito bite avoidance is the only way to prevent dengue and chikungunya fever. Informed travelers have many options for simple and practical measures to lessen the risk of mosquito bites. A message map can be used as a communication tool for pretravel counseling on the prevention of dengue and chikungunya fever within the time frame of an office visit. In a pretravel health consultation, a nurse practitioner can promote travelers' health and prevent dengue, chikungunya fever, and other mosquito-borne diseases by counseling on the risk of these diseases and giving practical recommendations for prevention using a message map. ©2014 American Association of Nurse Practitioners.

  1. [Rheumatic fever--a review of cases]. (United States)

    Rocha, P; Freitas, S; Alvares, S


    To analyse clinical presentation of rheumatic fever (RF), with special emphasis on cardiac involvement, electrocardiographic and echocardiographic findings and the outcome of the cases referred to Maria Pia Children's Hospital from January 1990 to September 1999. We retrospectively analyzed the clinical files of all cases referred to pediatric cardiology clinics with the suspicion of acute RF (Group 1) or with rheumatic valvular disease and heart failure (Group 2). In group 1 we studied the following: age and sex distribution, year of diagnosis, presence of Jones criteria treatment and outcome. In group 2 we analysed provenance, age of initial onset of RF, age of cardiology referral, treatment and outcome. Thirteen cases were identified, 8 in groups 1 and 5 in group 2. Group 1 included 3 girls and 2 boys, mean age of 10 years. The diagnosis of RF was based in the presence of 2 major and 1 minor manifestation (4/8), 1 major and 2 minor manifestations (1/8) and chorea in 3 cases associated with clinical carditis in one and subclinical carditis in another. Colour Doppler echocardiography showed pathological mitral regurgitation jet in 6 cases, associated with aortic regurgitation in 2 and dilatation of left ventricle in 3. All were treated with penicillin associated with anti-inflammatory drugs in 5 and haloperidol in 3. Group 2 included 3 girls and 2 boys, mean age 9.56 years. Four were from African countries (Angola and Guinea), and one came from the north of Portugal. The elapsed time between the initial acute attack and cardiology referral varied from 5 months to 3 years. All presented severe mitral insufficiency associated with aortic and/or tricuspid valve lesions, and heart failure. All five underwent valve surgery. The secondary prophylaxis was recommended in every patient. There was a recurrence in a child who had interrupted chemoprophylaxis. The patients from African countries were lost for follow-up. RF still remains a problem in present times, with

  2. A Case of Pediatric Q Fever Osteomyelitis Managed Without Antibiotics. (United States)

    Khatami, Ameneh; Sparks, Rebecca T; Marais, Ben J


    Q fever osteomyelitis, caused by infection with Coxiella burnetti, is rare but should be included in the differential diagnosis of children with culture-negative osteomyelitis, particularly if there is a history of contact with farm animals, and/or granulomatous change on histologic examination of a bone biopsy specimen. We describe a case of Q fever osteomyelitis in a 6-year-old boy in which a decision was made not to treat the patient with combination antimicrobial agents, balancing possible risks of recurrence against potential side effects of prolonged antibiotic treatment. The patient had undergone surgical debridement of a single lesion and was completely asymptomatic after recovery from surgery. This case suggests that a conservative approach of watchful waiting in an asymptomatic patient with chronic Q fever osteomyelitis may be warranted in select cases when close follow-up is possible. Copyright © 2015 by the American Academy of Pediatrics.

  3. Magnesium oxide as cause of metal fume fever

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    Hartmann, A.L.; Hartmann, W.; Buehlmann, A.A.


    Seven foundry workers are described who all developed pulmonary symptoms and in the majority of cases recurrent occupational fever; the onset of these episodes coincided with the introduction of a new founding technique resulting in exposure to magnesium oxide fumes. The foreman - most exposed because responsible for vaccination of the melted iron with metallic magnesium - developed disabling pneumopathy. The feverish episodes are interpreted as metal fume fever and in 6 patients the pneumopathy is considered to be due to alkalitoxic damage to the small airways and alveoli caused by the magnesium oxide fumes. The seventh patient suffered from allergic asthma bronchiale. Differentiation from hypersensitivity pneumonitis and from humidifier fever of nonallergic etiology is discussed.

  4. A Rare Case of Mediterranean Spotted Fever and Encephalitis

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    Raquel Sousa Almeida


    Full Text Available Mediterranean spotted fever is a tick-borne zoonotic disease caused by Rickettsia conorii. It is transmitted by the dog tick Rhipicephalus sanguineus. It usually presents as a benign self-limited disease characterized by a skin rash, high fever, and, sometimes, a characteristic ulcer at the tick bite site called tache noir. The course of this disease is usually benign, although severe manifestations have been previously described, mainly in adults. Neurological manifestations are very unusual. We present a case of Mediterranean spotted fever with encephalitis to highlight the importance of clinical suspicion, mainly in endemic areas, the potential severity of this disease, and the need of early initiation of therapy in order to prevent severe complications.

  5. Fever of Unknown Origin Caused by Giant Hepatic Hemangioma. (United States)

    Liu, Xiaolei; Yang, Zhiying; Tan, Haidong; Zhou, Wenying; Su, Yunchao


    A 33-year-old man had fever for 2 months. He was admitted by the physician with the suspicion of pneumonia. However, both chest X-ray and computed tomography (CT) showed no abnormality. Tuberculosis and hematological and autoimmune diseases were all excluded. A giant hepatic lesion (20 cm) was detected by ultrasonography with the diagnosis of hemangioma. Contrast enhanced CT scan was conducted and hepatic hemangioma was confirmed. Some areas of the hepatic lesion had lower density compared to surrounding tissues and necrosis of the tumor was suspected. Right trisectionectomy was then performed and the symptom of fever disappeared after the operation. No bacteria grew in the culture of the necrosis tissue. Pathological examination confirmed the diagnosis of hemangioma and the necrosis. He was followed up for 5 months and no fever occurred.

  6. [Epidural obstetric analgesia, maternal fever and neonatal wellness parameters]. (United States)

    Fernández-Guisasola, J; Delgado Arnáiz, C; Rodríguez Caravaca, G; Serrano Rodríguez, M L; García del Valle, S; Gómez-Arnau, J I


    To study the relation between epidural analgesia and the development of maternal fever during labor and childbirth, and to determine the possible relation between that association and neonatal welfare and in the performance of tests to rule out sepsis in newborns. Prospective study of all women who gave birth at Fundación Hospital Alcorcón over a period of 3 years. All the women were offered epidural analgesia based on infusion of 0.0625% bupivacaine and 2 microg x mL(-1). Data collected were age, nulliparity, epidural analgesia infusion, induction of labor, uterine stimulation with oxytocin, type of birth, fetal weight, duration of dilation and expulsion, Apgar score (at 1 and 5 minutes), umbilical artery pH, and maternal temperature. Data for 4364 women were analyzed. Fever developed during labor in 5.7%; 93.7% of the fevers occurred in women receiving epidural analgesia (Pneonatal wellness parameters studied.

  7. Rocky Mountain spotted fever in Panama: a cluster description. (United States)

    Tribaldos, Maribel; Zaldivar, Yamitzel; Bermudez, Sergio; Samudio, Franklyn; Mendoza, Yaxelis; Martinez, Alexander A; Villalobos, Rodrigo; Eremeeva, Marina E; Paddock, Christopher D; Page, Kathleen; Smith, Rebecca E; Pascale, Juan Miguel


    Rocky Mountain spotted fever (RMSF) is a tick-borne infection caused by Rickettsia rickettsii. We report a cluster of fatal cases of RMSF in 2007 in Panama, involving a pregnant woman and two children from the same family.  The woman presented with a fever followed by respiratory distress, maculopapular rash, and an eschar at the site from which a tick had been removed.  She died four days after disease onset.  This is the second published report of an eschar in a patient confirmed by PCR to be infected with R. rickettsii.  One month later, the children presented within days of one another with fever and rash and died three and four days after disease onset. The diagnosis was confirmed by immunohistochemistry, PCR and sequencing of the genes of R. rickettsii in tissues obtained at autopsy. 

  8. Climate variability and dengue fever in warm and humid Mexico. (United States)

    Colón-González, Felipe J; Lake, Iain R; Bentham, Graham


    Multiple linear regression models were fitted to look for associations between changes in the incidence rate of dengue fever and climate variability in the warm and humid region of Mexico. Data were collected for 12 Mexican provinces over a 23-year period (January 1985 to December 2007). Our results show that the incidence rate or risk of infection is higher during El Niño events and in the warm and wet season. We provide evidence to show that dengue fever incidence was positively associated with the strength of El Niño and the minimum temperature, especially during the cool and dry season. Our study complements the understanding of dengue fever dynamics in the region and may be useful for the development of early warning systems.

  9. Molecular confirmation of Lassa fever imported into Ghana

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    Joseph H.K. Bonney


    Objective: We report the results of these investigations to highlight the importance of molecular diagnostic applications and the need for heightened awareness about Lassa fever in West Africa. Methods: We used molecular assays on sera from the two patients to identify the causativeorganism. Upon detection of positive signals for Lassa virus ribonucleic material by two differentpolymerase chain reaction assays, sequencing and phylogenetic analyses were performed. Results: The presence of Lassa virus in the soldiers’ blood samples was shown by L-gene segment homology to be the Macenta and las803792 strains previously isolated in Liberia, with close relationships then confirmed by phylogenetic tree construction. The five asymptomatic close contacts were negative for Lassa virus. Conclusions: The Lassa virus strains identified in the two Ghanaian soldiers had molecular epidemiological links to strains from Liberia. Lassa virus was probably responsible for the outbreak of viral haemorrhagic fever in the military camp. These data confirm Lassa fever endemicity in West Africa.

  10. [Analysis of dengue fever deaths in Mexico: 2009]. (United States)

    Fajardo-Dolci, Germán; Meljem-Moctezuma, José; Vicente-González, Esther; Venegas-Páez, Francisco Vicente; Villalba-Espinoza, Ignacio; Pérez-Cardoso, Ana Luisa; Barrón-Saldaña, Dante Adrián; Barragán-Ramírez, Claudia; Novoa-Boldo, Alejandro; Aguirre-Güemez, Ana Valeria; Mendoza-Larios, Laura Alejandra; Mazón-González, Betania; Montesinos-Gómez, Gabriela; López-González, Rosa; Aguirre-Gas, Héctor Gerardo


    to describe the dengue fever mortality. a descriptive and retrospective study including 104 files reported deaths caused by dengue fever during 2009 to march 2010, was done. sixty (58 %) were women and 44 (42 %) men. An increased mortality between the ages of 11 and 40 years old (47 %) was observed. Colima was a state with high incidence of cases and Jalisco had the highest mortality. Thrombocytopenia was the rule (90.4 %) and in one third of the cases platelets were below 50,000/mm(3). A quarter of cases were associated with comorbility. The initial clinical manifestations included: bleeding, hypovolemia by depletion or hemorrhage, tachycardia, paleness, depressed level of consciousness and circulatory failure. The main cause of death was hypovolemic shock or sepsis. In 42 cases, severe dengue was considered. an association between the severity of dengue fever and mortality was observed. The main cause of mortality was a shock state.

  11. Q Fever in Dogs: An Emerging Infectious Disease in Iran

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    Mahdieh Rezaei


    Full Text Available Background: Q fever is an important widespread reemerging zoonosis. The presence of Coxiellaburnetii in 100 tick-infested dogs was assessed in this study.Methods: The blood samples from 100 referred dogs were acquired and evaluated by nested-PCR.Results: C. burnetii was detected in 11 out of 100 (11% blood samples. Most of the positive dogswere kept outdoor and fed on raw diet. Based on our findings, Q fever should be considered as anemerging disease in dogs in Iran; so, zoonotic importance of this population must be notified. To betterunderstanding the role and pathogenic importance of dogs in Q fever outbreak and to determine whetherthis organism can be transmitted directly from dogs to human further in-depth studies are necessary.Conclusion: It is determined that C. burnetii is present in dogs in southeast of Iran and people who arein contact with this population, especially asymptomatic ones are at increased risk of infection.

  12. Rapid diagnostic tests for typhoid and paratyphoid (enteric) fever (United States)

    Wijedoru, Lalith; Mallett, Sue; Parry, Christopher M


    Background Differentiating both typhoid (Salmonella Typhi) and paratyphoid (Salmonella Paratyphi A) infection from other causes of fever in endemic areas is a diagnostic challenge. Although commercial point-of-care rapid diagnostic tests (RDTs) for enteric fever are available as alternatives to the current reference standard test of blood or bone marrow culture, or to the widely used Widal Test, their diagnostic accuracy is unclear. If accurate, they could potentially replace blood culture as the World Health Organization (WHO)-recommended main diagnostic test for enteric fever. Objectives To assess the diagnostic accuracy of commercially available rapid diagnostic tests (RDTs) and prototypes for detecting Salmonella Typhi or Paratyphi A infection in symptomatic persons living in endemic areas. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register, MEDLINE, Embase, Science Citation Index, IndMED, African Index Medicus, LILACS,, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) up to 4 March 2016. We manually searched WHO reports, and papers from international conferences on Salmonella infections. We also contacted test manufacturers to identify studies. Selection criteria We included diagnostic accuracy studies of enteric fever RDTs in patients with fever or with symptoms suggestive of enteric fever living in endemic areas. We classified the reference standard used as either Grade 1 (result from a blood culture and a bone marrow culture) or Grade 2 (result from blood culture and blood polymerase chain reaction, or from blood culture alone). Data collection and analysis Two review authors independently extracted the test result data. We used a modified QUADAS-2 extraction form to assess methodological quality. We performed a meta-analysis when there were sufficient studies for the test and heterogeneity was reasonable. Main results Thirty-seven studies met the inclusion

  13. Geriatric Fever Score: a new decision rule for geriatric care.

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    Min-Hsien Chung

    Full Text Available Evaluating geriatric patients with fever is time-consuming and challenging. We investigated independent mortality predictors of geriatric patients with fever and developed a prediction rule for emergency care, critical care, and geriatric care physicians to classify patients into mortality risk and disposition groups.Consecutive geriatric patients (≥65 years old visiting the emergency department (ED of a university-affiliated medical center between June 1 and July 21, 2010, were enrolled when they met the criteria of fever: a tympanic temperature ≥37.2°C or a baseline temperature elevated ≥1.3°C. Thirty-day mortality was the primary endpoint. Internal validation with bootstrap re-sampling was done.Three hundred thirty geriatric patients were enrolled. We found three independent mortality predictors: Leukocytosis (WBC >12,000 cells/mm3, Severe coma (GCS ≤ 8, and Thrombocytopenia (platelets <150 10(3/mm3 (LST. After assigning weights to each predictor, we developed a Geriatric Fever Score that stratifies patients into two mortality-risk and disposition groups: low (4.0% (95% CI: 2.3-6.9%: a general ward or treatment in the ED then discharge and high (30.3% (95% CI: 17.4-47.3%: consider the intensive care unit. The area under the curve for the rule was 0.73.We found that the Geriatric Fever Score is a simple and rapid rule for predicting 30-day mortality and classifying mortality risk and disposition in geriatric patients with fever, although external validation should be performed to confirm its usefulness in other clinical settings. It might help preserve medical resources for patients in greater need.

  14. Dengue hemorrhagic fever--U.S.-Mexico border, 2005. (United States)


    Dengue fever is a mosquito-transmitted disease caused by any of four closely related virus serotypes (DEN-1, DEN-2, DEN-3, and DEN-4) of the genus Flavivirus. Infection with one of these serotypes provides lifelong immunity to the infecting serotype only. Therefore, persons can acquire a second dengue infection from a different serotype, and second infections place them at greater risk for dengue hemorrhagic fever (DHF), the more severe form of the disease. DHF is characterized by bleeding manifestations, thrombocytopenia, and increased vascular permeability that can lead to life-threatening shock. In south Texas, near the border with Mexico, sporadic, locally acquired outbreaks of dengue fever have been reported previously; however, on the Texas side of the border, these outbreaks have not included recognized cases of locally acquired DHF in persons native to the area. In July 2005, a case of DHF was reported in a resident of Brownsville, Texas. In August 2005, health authorities in the neighboring state of Tamaulipas, Mexico, reported an ongoing dengue outbreak with 1,251 cases of dengue fever, including 223 cases (17.8%) of DHF. To characterize this dengue outbreak, the Texas Department of State Health Services (TDSHS), Mexican health authorities, and CDC conducted a clinical and epidemiologic investigation. This report summarizes the results of that investigation, which determined that the percentage of DHF cases associated with dengue fever outbreaks at the Texas-Tamaulipas border has increased. Health-care providers along the U.S. border with Mexico should be vigilant for DHF and familiar with its diagnosis and management to reduce the number of severe illnesses and deaths associated with outbreaks of dengue fever.

  15. Clinical Profile of Atypical Manifestations of Dengue Fever. (United States)

    Pothapregada, Sriram; Kamalakannan, Banupriya; Thulasingam, Mahalakshmy


    To study the clinical profile and outcome of the atypical manifestations of dengue fever in children. All children (0-12 y of age) diagnosed and confirmed as dengue fever at a tertiary care hospital at Puducherry, between the 1st of August 2012 and January 31st 2015 were reviewed retrospectively from hospital case records as per the revised World Health Organization (WHO) guidelines 2011 for dengue fever. The diagnosis was confirmed by NS1 antigen-based ELISA test or dengue serology for IgM and IgG antibodies and the data was analyzed using SPSS 16.0 statistical software. Out of 254 children admitted with dengue fever, non-severe dengue and severe dengue were seen in 62.6 % and 37.4 % respectively. Atypical manifestations were seen in 106 cases (41.7 %). Mean age of presentation was 6.9(3.3) y. M: F ratio was 1.2:1. The common manifestations of severe dengue infection were shock (37.4 %), bleeding (20.1 %) and multi-organ dysfunction (2.4 %). The most common atypical manifestations of dengue fever were lymphadenopathy (41.7 %), splenomegaly (21.2 %), biphasic fever (18.1 %), hepatitis (11.4 %), febrile diarrhea (6.3 %), refractory shock (2.4 %) and impaired consciousness (1.9 %). The other atypical manifestations present were portal hypertension, acalculous cholecystitis, appendicitis, acute respiratory distress syndrome (ARDS), myocarditis, pericardial effusion, paroxysmal supraventricular tachycardia (PSVT), myositis, acute kidney injury (AKI), hemophagocytic syndrome and disseminated intravascular coagulopathy (DIC). Platelet count did not always correlate well with the severity of bleeding. There were six deaths (2.4 %) and out of them four presented with impaired consciousness (66.6 %). The common causes for poor outcome were multiorgan failure, encephalopathy and refractory shock. The atypical manifestations of dengue fever are no more a rare entity. Clinicians should have a high index of suspicion and vigilance for atypical manifestations of

  16. [Dengue fever cases in Czech workers returning from the Maldives]. (United States)

    Trojánek, Milan; Tomíčková, Dora; Roháčová, Hana; Kosina, Pavel; Gebouský, Jan; Dvořák, Jan; Chmelik, Vaclav; Batistová, Květoslava; Husa, Petr; Maixner, Jan; Sojková, Naděžda; Zelená, Hana; Marešová, Vilma; Stejskal, František


    The objective of this study is to present epidemiological characteristics and clinical symptoms of dengue fever cases in Czech workers who acquired the infection while working on the island of Fushivelavaru, Maldives. Furthermore, the study compares the sensitivity of novel direct detection assays, i.e. Real-Time Polymerase Chain Reaction (RT-PCR) and detection of Dengue NS1 antigen. The retrospective study evaluated the clinical course of dengue fever cases in Czech workers returning from a job in the Maldives who were diagnosed with dengue virus infection from September 1 to October 31, 2012. The laboratory diagnosis of dengue fever was based on the serological detection of IgM and IgG antibodies, detection of dengue NS1 antigen by enzyme-linked immunosobent assay (ELISA), and detection of dengue virus DNA by RT-PCR. The infection with dengue virus was confirmed in 18 males with a median age of 40 years (IQR 36-47) who returned from a job in the Maldives. Only one patient required admission to the hospital while the others were treated on an outpatient basis. The most frequently observed symptoms were fever (18), headache (9), muscle and joint pain (8 and 7, respectively), and rash (9). Typical laboratory findings were leukocytopenia and thrombocytopenia, a low CRP level, and elevated aminotransferase activity. The clinical course was uncomplicated in all patients. The dengue NS1 antigen detection (positive in all 10 patients with acute dengue fever) showed significantly higher sensitivity than the detection of viral RNA using RT-PCR (positive in 4 patients), p = 0.011. Although the vast majority of dengue fever cases are diagnosed among travellers returning from the tropics, the presented study points out the risks posed by dengue fever to long-term workers in endemic areas. The infection in the serologically naïve hosts is usually uncomplicated; however, infected persons are at significant risk of developing a severe complicated clinical course if challenged

  17. A Case Report of Recurrent Rheumatic Fever: Considerations and Comments

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    Ramin Khamene Bagheri


    Full Text Available Rheumatic fever (RF is a prevalent healthcare problem in the developing countries. Recurrence of this disorder is often observed in childhood and adolescence. RF can mimic the presentations of infective endocarditis, and clinicians are not really familiar with this issue. Herein, we present a case of recurrent acute rheumatic fever in a patient suspicious of acute bacterial endocarditis due to her previous RF. Finally, she was definitively diagnosed and underwent valvular replacement surgery and received prophylaxis antibiotics besides regular follow-up

  18. Approach to postoperative fever in pediatric cardiac patients

    Directory of Open Access Journals (Sweden)

    Ajay K Gupta


    Full Text Available Fever in the postoperative period in children undergoing surgery for congenital heart disease is fairly common and tends to cause anxiety to both the surgeon and the patient. Such fever is associated with the metabolic response to trauma, systemic response to the cardiopulmonary bypass, hypothermia, presence of drainage tubes, drugs, blood transfusion as well as infections. Establishing the diagnosis requires proper assessment of the patient with focused history, targeted physical examination and judicious use of investigations with the knowledge of the common causes.


    Directory of Open Access Journals (Sweden)

    А.А. Alexeeva


    Full Text Available Pain and fever are one of the most frequent conditions in pediatric practice. Frequent occurrence of fever accompanied by a pain syndrome stipulates combined antipyretic and analgesic medications. This article contains information upon ibuprofen use («Nurofen for children» in pediatric patients as an antipyretic and analgesic medication to be used as part of complex treatment of acute respiratory infections.Key words: fewer, children, ibuprofen. (Voprosy sovremennoi pediatrii — Current Pediatrics. — 2011; 10 (6: 137–140

  20. Enteric fever in India: current scenario and future directions. (United States)

    Divyashree, S; Nabarro, L E B; Veeraraghavan, B; Rupali, P


    Enteric fever is a major cause of morbidity and mortality in tropical areas worldwide. The Indian subcontinent bears the brunt of the disease, both in terms of absolute case numbers and drug-resistant strains. Recent phylogenetic studies suggest that the multidrug-resistant clade H58 originated in India and subsequently expanded through Asia and Africa. In Africa, it caused unrecognised outbreaks in areas previously considered free of the disease. In this study, we discuss the current status of enteric fever in India, the factors preventing its control and its future directions in this rapidly developing nation. © 2016 John Wiley & Sons Ltd.

  1. Tick-Borne Relapsing Fever Spirochetes in the Americas

    Directory of Open Access Journals (Sweden)

    Job E. Lopez


    Full Text Available Relapsing fever spirochetes are tick- and louse-borne pathogens that primarily afflict those in impoverished countries. Historically the pathogens have had a significant impact on public health, yet currently they are often overlooked because of the nonspecific display of disease. In this review, we discuss aspects of relapsing fever (RF spirochete pathogenesis including the: (1 clinical manifestation of disease; (2 ability to diagnose pathogen exposure; (3 the pathogen’s life cycle in the tick and mammal; and (4 ecological factors contributing to the maintenance of RF spirochetes in nature.

  2. Bilateral breast abscess: A rare complication of enteric fever

    Directory of Open Access Journals (Sweden)

    Singh S


    Full Text Available Breast abscess is usually caused by Staphylococcus aureus in pregnant or lactating females. Salmonella spp. is occasionally associated with abscess formation in various organs, but breast abscess is a very rare complication. In enteric fever dissemination to multiple organ systems following bacteraemia can lead to localized abscess. We report a case of bilateral breast abscess due to Salmonella Typhi in an unmarried 35-year-old female without any predisposing conditions. She presented with fever and painful swelling of both the breasts. S. typhi was isolated from both breasts. Such rare cause must be suspected in females without any evident predisposing factors for effective management.

  3. Familial Mediterranean Fever with Rheumatoid Arthritis Complicated by Pulmonary Paragonimiasis. (United States)

    Nureki, Shin-Ichi; Ishii, Koji; Fujisaki, Hideaki; Torigoe, Masataka; Maeshima, Keisuke; Shibata, Hirotaka; Miyazaki, Eishi; Kadota, Jun-Ichi

    A 42-year-old woman presented with an intermittent fever and chest and back pain, and an abnormal chest shadow was detected. She was diagnosed with paragonimiasis caused by Paragonimus westermani. Praziquantel therapy improved the abnormal chest shadow, but did not relieve her symptoms. She was also diagnosed with familial Mediterranean fever (FMF), and colchicine therapy resolved her symptoms. She subsequently developed arthralgia and morning stiffness in her hands. We also diagnosed the patient with rheumatoid arthritis (RA), and corticosteroid and salazosulfapyridine therapy improved her symptoms. The existence of paragonimiasis complicated the diagnosis of FMF. The coexistence of FMF and RA is very rare, but does exist.

  4. [Pathomorphology and morphogenesis of myocarditis in typhoid fever]. (United States)

    Bobin, A N; Parkhommenko, Iu G


    Archives specimens of the heart, autopsy protocols and disease histories of 16 soldiers and officers of Soviet army who died in Afghanistan of typhoid fever were studied. It is concluded on the basis of morphology and statistics that interstitial myocarditis and sometimes pancarditis develop on the 2nd week of the basic disease. Characteristic features of typhoid fever myocarditis are inflammation of the heart intramural vessels, microcirculatory disturbances, edema and lymphocytic-macrophogeal infiltration of the stroma, sometimes with formation of granulomas, dystrophic and necrotic changes of cardiomyocytes.

  5. Yellow fever vaccine: worthy friend or stealthy foe? (United States)

    Seligman, Stephen J; Casanova, Jean-Laurent


    Recognition that the live yellow fever vaccine may rarely be associated with viscerotropic disease (YEL-AVD) has diminished its safety status. However, the vaccine remains the principal tool for limiting the occurrence of yellow fever, making large portions of Africa and South America more habitable. The subject has previously been exhaustively reviewed. Novel concepts in the current report include the description of a systematic method for deciding whom to vaccinate, recommendations for obtaining data helpful in making that decision, and suggestions for additional study. The vaccine is indeed a worthy friend, but its adverse reactions need to be recognized.

  6. Clinical features and patient management of Lujo hemorrhagic fever.

    Directory of Open Access Journals (Sweden)

    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

  7. Acute Disseminated Encephalomyelitis Following Typhoid Fever: A Case Report

    Directory of Open Access Journals (Sweden)

    R Adhikari


    Full Text Available The involvement of central nervous system in children with typhoid fever is common. Acute disseminated encephalomyelitis is a rare immune mediated and demyelinating disease of the central nervous system that usually affects children. We report a 7-year-old child with typhoid fever who developed acute cerebellar syndrome due to acute disseminated encephalomyelitis.Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-4, 55-58 DOI:

  8. Fever of unknown origin, giant cell arteritis, and aortic dissection. (United States)

    Hofheinz, K; Bertz, S; Wacker, J; Schett, G; Manger, B


    Giant cell arteritis is one of the most frequent causes of pyrexia of unknown origin after infectious or malignant causes have been ruled out. In this case report we describe a 66-year old female patient, who after five weeks of remitting fever developed a life-threatening, painless severe aortic dissection. The timely use of modern imaging technologies such as magnetic resonance angiography or positron emission computed tomography could in the future be of help to recognize aortic involvement early and to avoid this devastating complication in patients with fever of unknown origin.

  9. Recurrent Fever Syndromes in Patients After Recovery From Kawasaki Syndrome (United States)

    Tremoulet, Adriana H.; Burns, Jane C.; Bastian, John F.; Hoffman, Hal M.


    The recurrence of fever in a child with a history of Kawasaki syndrome (KS) poses a dilemma for clinicians who must consider the possibility of recurrent KS. In this report we present the cases of 4 patients who presented with classical symptoms of KS, were successfully treated with intravenous immunoglobulin, and later experienced a reappearance of inflammatory symptoms in a pattern consistent with a recurrent fever syndrome. The association of these syndromes within the same patient suggests that some patients may have a genetic propensity toward altered immune responses and autoinflammatory syndromes. We propose that these 2 syndromes exist within a family of febrile disorders related to innate immune dysregulation. PMID:21220401

  10. Fever during pregnancy and motor development in children

    DEFF Research Database (Denmark)

    Holst, Charlotte; Jørgensen, Sanne Ellegaard; Wohlfahrt, Jan


    . Information regarding fever (number of episodes, temperature, duration, and pregnancy week) was obtained around gestation week 12 and at the end of pregnancy. Assessments of motor development in early childhood were based on the ages at which the motor milestones 'sitting unsupported' (n=44,256) and 'walking...... unassisted' (n=53,959) were attained. The Developmental Coordination Disorder Questionnaire 2007 (DCDQ'07) was used to identify children with indication of developmental coordination disorder (DCD) at age 7 years (n=29,401). Any associations between the exposure to fever during pregnancy and motor...

  11. [Periodic fever: a description of twelve patients with periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA)]. (United States)

    De Cunto, Carmen; Britos, María; Eymann, Alfredo; Deltetto, Noelia; Liberatore, Diana


    PFAPA is a periodic fever syndrome characterized by: fever, aphthous stomatitis, pharyngitis and cervical adenitis. It is one of the autoinflammatory syndromes, but yet of unknown etiology. Our aim is to report our experience, describe clinical manifestations, laboratory findings, relapses occurrence and response to treatment. We present 12 PFAPA patients. Median age at onset: 1.15 years, mean duration of febrile episodes: 4 days, and relapses at regular intervals. All children received prednisone (1-2 mg/kg/dose) one to two doses, 9 patients responded immediately after the first dose and all experienced a lower periodicity of attacks. PFAPA is the most frequent periodic fever syndrome. To our knowledge, there are no other local series of PFAPA patients published. Recognizing this syndrome will prevent from ordering unnecessary studies and will favor family coping.

  12. Dengue fever with diffuse cerebral hemorrhages, subdural hematoma and cranial diabetes insipidus. (United States)

    Jayasinghe, Nayomi Shermila; Thalagala, Eranga; Wattegama, Milanka; Thirumavalavan, Kanapathipillai


    Neurological manifestations in dengue fever occur in dengue fever. We postulate that immunological mechanisms may play a role in pathogenesis. However further comprehensive research and studies are needed to understand the pathophysiological mechanisms leading to this complication.

  13. Arbovirus infections and viral haemorrhagic fevers in Uganda: a serological survey in Karamoja district, 1984. (United States)

    Rodhain, F; Gonzalez, J P; Mercier, E; Helynck, B; Larouze, B; Hannoun, C


    Sera collected in May 1984 from 132 adult residents of Karamoja district, Uganda, were examined by haemagglutination inhibition tests for antibodies against selected arboviruses, namely Chikungunya and Semliki Forest alphaviruses (Togaviridae); dengue type 2, Wesselsbron, West Nile, yellow fever and Zika flaviviruses (Flaviviridae); Bunyamwera, Ilesha and Tahyna bunyaviruses (Bunyaviridae); and Sicilian sandfly fever phlebovirus (Bunyaviridae); and by immunofluorescence tests against certain haemorrhagic fever viruses, Lassa fever arenavirus (Arenaviridae), Ebola-Sudan, Ebola-Zaïre and Marburg filoviruses (Filoviridae), Crimean-Congo haemorrhagic fever nairovirus and Rift Valley fever phlebovirus (Bunyaviridae). Antibodies against Chikungunya virus were the most prevalent (47%), followed by flavivirus antibodies (16%), which were probably due mainly to West Nile virus. No evidence of yellow fever or dengue virus circulation was observed. A few individuals had antibodies against Crimean-Congo haemorrhagic fever, Lassa, Ebola and Marburg viruses, suggesting that these viruses all circulate in the area.

  14. Periodic fever accompanied by aphthous stomatitis, pharyngitis and cervical adenitis syndrome (PFAPA syndrome) in adults

    National Research Council Canada - National Science Library

    Padeh, Shai; Stoffman, Nava; Berkun, Yackov


    The new syndrome, known as PFAPA, of periodic fever characterized by abrupt onset of fever, malaise, aphthous stomatitis, tonsillitis, pharyngitis and cervical adenopathy has been described only in pediatric patients...

  15. The Sensitivity Of Diazo Test In The Diagnosis Of Enteric Fevers ...

    African Journals Online (AJOL)

    serological) test in the diagnosis of enteric fevers, blood specimens from101 patients suspected of having enteric fevers were collected. 54.5% (55) of the patients were significantly seropositive. Fifteen urine specimens from these 55 seropositive ...

  16. DMPD: Cytokines, PGE2 and endotoxic fever: a re-assessment. [Dynamic Macrophage Pathway CSML Database

    Lifescience Database Archive (English)

    Full Text Available 15967158 Cytokines, PGE2 and endotoxic fever: a re-assessment. Blatteis CM, Li S, L... (.svg) (.html) (.csml) Show Cytokines, PGE2 and endotoxic fever: a re-assessment. PubmedID 15967158 Title Cytokines

  17. [From hereditary recurrent fevers to autoinflammatory syndromes: the contribution of genetics


    Delpech, Marc


    National audience; Hereditary recurrent fevers are rare genetic diseases characterized by febrile periods of variable duration. Classically, four such diseases were recognized, namely familial Mediterranean fever (previously called periodic disease in France), the Muckle-Wells syndrome, Hibernian fever, and hyper IgD with recurrent fever. The discovery of culprit genes has led to an overhaul of this classification. Molecular diagnosis of these diseases, that are difficult to identify on clini...

  18. Analysis of dengue fever risk using geostatistics model in bone regency (United States)

    Amran, Stang, Mallongi, Anwar


    This research aim is to analysis of dengue fever risk based on Geostatistics model in Bone Regency. Risk levels of dengue fever are denoted by parameter of Binomial distribution. Effect of temperature, rainfalls, elevation, and larvae abundance are investigated through Geostatistics model. Bayesian hierarchical method is used in estimation process. Using dengue fever data in eleven locations this research shows that temperature and rainfall have significant effect of dengue fever risk in Bone regency.

  19. Genetic and environmental contributions to hay fever among young adult twins

    DEFF Research Database (Denmark)

    Thomsen, Simon Francis; Suppli Ulrik, Charlotte; Kyvik, Kirsten Ohm


    BACKGROUND: The susceptibility to develop hay fever is putatively the result both of genetic and environmental causes. We estimated the significance and magnitude of genetic and environmental contributions to hay fever among young adult twins. METHODS: From the birth cohorts 1953-82 of The Danish...... to the observed data using maximum likelihood methods. RESULTS: The overall cumulative prevalence of hay fever was 12.6%. Identical twins were significantly more likely to be concordant for hay fever than were fraternal twins (P

  20. A Case of Yellow Fever Vaccine–Associated Viscerotropic Disease in Ecuador


    Douce, Richard W.; Freire, Diana; Tello, Betzabe; Vásquez, Gavino A.


    We report the first case of viscerotropic syndrome in Ecuador. Because of similarities between yellow fever and viscerotropic syndrome, the incidence of this recently described complication of vaccination with the 17D yellow fever vaccine is not known. There is a large population in South America that is considered at risk for possible reemergence of urban yellow fever. Knowledge of potentially fatal complications of yellow fever vaccine should temper decisions to vaccinate populations where ...

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

    Directory of Open Access Journals (Sweden)

    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

  2. Badge of Honor or Scarlet Letter?

    DEFF Research Database (Denmark)

    Zunino, Diego; Dushnitsky, Gary; Van Praag, Mirjam

    skill. We predict that investors will discount entrepreneurs that experienced past failure. However, in the presence of a signal of skill, the magnitude of the failure discount is reduced. We test our predictions using an online experiment where respondents are potential investors in seed stage ventures...... via equity crowdfunding. Respondents evaluate a realistic investment opportunity in a between-subjects design, where we decompose the effect of failure into luck and skill. Our results indicate that investors discount entrepreneurs who have experienced failure. Past failure in the presence of a signal...... of skill, however, is not discounted. The findings indicate no discount of failure based on the “failed” label only. Overall, our analysis sheds light on the rationality of investors. In a world where entrepreneurial failure is prevalent, we find that investors are sensitive to its core drivers: luck...

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

    African Journals Online (AJOL)

    Background: Lassa fever is a rodent-borne zoonosis that clinically manifests as an acute hemorrhagic fever. It is treated using ribavarin. Surviving Lassa fever without receiving the antiviral drug ribavarin is rare. Only few cases have been documented to date. Case Presentation: We report a case of a 59-year old female with ...

  4. Should acute Q-fever patients be screened for valvulopathy to prevent endocarditis?

    NARCIS (Netherlands)

    de Lange, Marit M A; Gijsen, Laura E V; Wielders, Cornelia C H; van der Hoek, Wim; Scheepmaker, Arko; Schneeberger, Peter M


    Echocardiographic screening of acute Q-fever patients and antibiotic prophylaxis for patients with cardiac valvulopathy are considered an important approach to prevent chronic Q-fever-related endocarditis. During a large Q-fever epidemic in the Netherlands, routine screening echocardiography was

  5. School Nurses on the Front Lines of Medicine: A Student With Fever and Sore Throat. (United States)

    Olympia, Robert P


    Fever and sore throat are common chief complaints encountered by school nurses. This article explains the etiology of both fever and sore throat in children, describes the office assessment, and delineates life-threatening complications associated with fever and sore throat that may prompt the school nurse to transfer the child to a local emergency department. © 2016 The Author(s).

  6. Differentiation of Acute Q Fever from Other Infections in Patients Presenting to Hospitals, the Netherlands(1)

    NARCIS (Netherlands)

    Keijmel, S.P.; Krijger, E.; Delsing, C.E.; Sprong, T.; Nabuurs-Franssen, M.H.; Bleeker-Rovers, C.P.


    Differentiating acute Q fever from infections caused by other pathogens is essential. We conducted a retrospective case-control study to evaluate differences in clinical signs, symptoms, and outcomes for 82 patients with acute Q fever and 52 control patients who had pneumonia, fever and lower

  7. Long-term follow-up of acute Q fever patients after a large epidemic

    NARCIS (Netherlands)

    Wielders, CCH


    Between 2007 and 2009, one of the largest Q fever epidemics documented worldwide occurred in the Netherlands. This epidemic originated from dairy goat farms and resulted in over 3,500 notified human acute Q fever cases. After an episode of acute Q fever, the causative bacterium Coxiella burnetii may

  8. Increased urinary leukotriene E-4 during febrile attacks in the hyperimmunoglobulinaemia D and periodic fever syndrome

    NARCIS (Netherlands)

    Frenkel, J; Willemsen, MAAP; Weemaes, CMR; Dorland, L; Mayatepek, E

    Background-The hyperimmunoglobulinaemia D and periodic fever syndrome is a hereditary periodic fever, caused by deficiency of the enzyme mevalonate kinase. It is unclear how this defect leads to recurrent fever episodes. Aim-To assess the involvement of cysteinyl leukotrienes in the pathogenesis of

  9. 78 FR 8960 - Texas (Splenetic) Fever in Cattle (United States)


    ... Animal and Plant Health Inspection Service 9 CFR Part 72 Texas (Splenetic) Fever in Cattle AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION: Final rule. SUMMARY: We are amending the Texas... capable of transmitting microscopic parasites (Babesia) that cause bovine babesiosis. We are amending the...

  10. Burden of typhoid fever in Sulaimania, Iraqi Kurdistan

    Directory of Open Access Journals (Sweden)

    Jonathan Dworkin


    Discussion: Cost-effective surveillance projects to calculate disease burden of typhoid fever are practical and replicable. Typhoid has successfully adapted to the healthcare environment in Sulaimania. Additional work in the region should focus on antibiotic resistance and other enteric pathogens such as Brucella spp.

  11. Serological evidence of dengue fever among refugees, Hargeysa, Somalia. (United States)

    Botros, B A; Watts, D M; Soliman, A K; Salib, A W; Moussa, M I; Mursal, H; Douglas, C; Farah, M


    Epidemics of a malaria-like illness affected several thousand residents of the Dam Camp, a refugee camp near Hargeysa in Somalia, during 1985, 1986, and 1987. The disease was characterized by fever, chills, sweats, headache, back and joint pains for as long as 10 days in some patients. Blood smears from acutely ill patients were negative for malaria. Of 28 acute and 10 convalescent sera tested by the indirect fluorescent antibody (IFA) and by the hemagglutination inhibition (HI) tests, all were negative for antibody to Rift Valley fever, Crimean-Congo hemorrhagic fever, Sindbis, Chikungunya, yellow fever, and Zika viruses. However, antibody reactive to dengue 2 virus was detected by the IFA test in 39% (15/38), and 11 of 29 (38%) of the same sera were antibody positive by the HI test. Also, IgG antibody reactive to dengue 2 was demonstrated in 60% (17/28) of the same sera by the enzyme immunoassay (EIA), and 14% (4/28) were positive for IgM antibody. Of ten patients for which acute and convalescent sera were available, two developed four fold or greater rises in antibody titer evidencing infection. These data suggested that dengue virus may have been the cause of the epidemic among the Dam Camp refugees.

  12. Evaluation of patients with Crimean-Congo hemorrhagic fever in ...

    African Journals Online (AJOL)

    Background: Crimean-Congo hemorrhagic fever (CCHF), which is associated with a high mortality rate in the Black Sea region of Turkey, has received increasing attention. Objective: In this study, the epidemiological features, clinical and laboratory findings, treatments, and outcomes of patients diagnosed with CCHF ...

  13. Epidemic dengue hemorrhagic fever in rural Indonesia. II. Clinical studies. (United States)

    Eram, S; Setyabudi, Y; Sadono, T I; Sutrisno, D S; Gubler, D J; Sulianti Saroso, J


    Clinical observations were made on 95 serologically or virologically confirmed dengue fever cases during an epidemic in a rural area of Indonesia in December 1976. The age distribution was similar to that observed in patients with dengue hemorrhagic fever in Jakarta, a highly endemic urban area. The observed disease ranged in severity from undifferentiated fever to shock and death. The majority of patients had acute onset of fever with nausea, vomiting, headache, and abdominal pain. Hepatomegaly was observed in only 19% of the patients. A positive tourniquet test was the most frequently observed hemorrhagic manifestation, but epistaxis was observed in 20% and hematemesis in 6% of the patients. Dengue shock syndrome was observed in 37% of the patients. There were four deaths, three of which were confirmed as due to dengue infection by virus isolation. The data suggest that one, and possibly two, of the fatal cases with virus isolation were primary infections, based on the results of hemagglutination-inhibition test using all four dengue antigens.


    Directory of Open Access Journals (Sweden)

    Assya Krasteva


    Full Text Available Persistent undiagnosed fever remains a common problem in clinical practice. It is a fact that dental sepsis is one potential cause of persistent fever that can escape detection (Siminoski, K., 1993. We present a 50 years old woman with chronic hepatitis B, febrile for the past two months (max. 38.60C with characteristic of septic fever. She underwent consultations with endocrinologist, rheumatologist, neurologist, gynecologist, pulmonologist and infectionst. All negative for any disease, also negative serology for Lyme disease. She had no data for urine infection. She had negative cultures. The patient was treated with corticosteroids for 30 days with no effect; she had no response to treatment with Gentamycin, Amoxicillin, Azithromycin, Ciprofloxacin, Methronidazole, Meronem, Clindamicin and Nystatin. Only reduction but not normalization, of CRP was observed, the fever remained. The patient underwent focal dental diagnostic protocol. We remarked potential dental foci - 17, 16, 27, 43, 47 and active temperature zone – submandibular lymph nodes. The dental focuses were extracted consequently and the patient became afebrile 5 days afterwards. Her liver enzymes, CRP and albumin returned to normal after performance of dental recommendations.

  15. Helicobacter pylori infection and typhoid fever in Jakarta, Indonesia.

    NARCIS (Netherlands)

    Vollaard, A.M.; Verspaget, H.W.; Ali, S.; Visser, L.G.; Veenendaal, R.A.; Asten, H.A.G.H. van; Widjaja, S.; Surjadi, C.; Dissel, J.T. van


    We evaluated the association between typhoid fever and Helicobacter pylori infection, as the latter microorganism may influence gastric acid secretion and consequently increase susceptibility to Salmonella typhi infection. Anti-H. pylori IgG and IgA antibody titres (ELISA) and gastrin concentration

  16. Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome. (United States)

    Ali, Nora S; Sartori-Valinotti, Julio C; Bruce, Alison J


    Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome, the most common periodic disorder of childhood, presents with the cardinal symptoms of periodic fever, aphthous stomatitis, pharyngitis, and adenitis typically before age 5. This review presents the recent literature on PFAPA and summarizes key findings in the pathogenesis, evaluation, and treatment of the disease. Theories surrounding the pathogenesis of PFAPA include a faulty innate immunologic response in conjunction with dysregulated T-cell activation. A potential genetic link is also under consideration. Mediterranean fever (MEFV) gene variants have been implicated and appear to modify disease severity. In individuals with the heterozygous variant, PFAPA episodes are milder and shorter in duration. Diagnostic criteria include the traditional clinical signs, in addition to the following biomarkers: elevated C-reactive protein in the absence of elevated procalcitonin, vitamin D, CD64, mean corpuscular volume, and other nonspecific inflammatory mediators in the absence of an infectious explanation for fever. Treatment of PFAPA includes tonsillectomy, a single dose of corticosteroids, and, most recently, interleukin 1 blockers such as anakinra, rilonacept, and canakinumab. Tonsillectomy remains the only permanent treatment modality. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Clinical sentinel surveillance of equine West Nile fever, Spain

    DEFF Research Database (Denmark)

    Saegerman, C.; Alba-Casals, A.; García-Bocanegra, I.


    West Nile fever (WNF) is a viral zoonotic infection caused by a mosquito-borne flavivirus of the Flaviviridae family. According to a comparative study, the passive surveillance of horses by equine veterinarians appeared to be the most cost-effective system in the European context of WNF. Clinical...

  18. Diagnosis of malaria and typhoid fevers using basic tools: a ...

    African Journals Online (AJOL)

    The use of RDT is simple and easy, but has less sensitivity, thus may leave some patients with malaria un-detected. Based on the results of these findings, vis a vis the proportion of individuals negative for both malaria and typhoid fevers, clinicians should revisit causes of febrile illnesses other than malaria or typhoid and ...

  19. 144 review article lassa fever: another infectious menace

    African Journals Online (AJOL)

    Dr Oboro VO

    final gene products- the nucleo protein (NP or. N) and the envelope glycol ... The virus is excreted in urine for three to nine weeks from .... 150. When Lassa fever infects pregnant women late in their third trimester, it is necessary to abort the pregnancy for the mother to have a good change of survival (20). This is because the ...

  20. Caregivers' perceptions of childhood fever in Ilorin, North-Central ...

    African Journals Online (AJOL)



    Jan 22, 2013 ... ture.1 In clinical practice, the relevance of fever is that it is a sign of a current illness. It remains one of the most frequently encountered paediatric problems, accounting for 25% of visits to paediatric emergency rooms.2-4 In- deed, it is often the first symptom noted by parents, and frequently, the initial “signal” ...

  1. Prenatal Exposure to Fever and Infections and Academic Performance

    DEFF Research Database (Denmark)

    Dreier, Julie Werenberg; Berg-Beckhoff, Gabriele; Kragh Andersen, Per


    performance in childhood and early adolescence. Children and mothers who were enrolled in the Danish National Birth Cohort during 1996–2002 were included in this study. Information on fever and infections common in pregnancy was prospectively collected in 2 pregnancy interviews and linked with assessments...

  2. Dengue fever treatment with Carica papaya leaves extracts. (United States)

    Ahmad, Nisar; Fazal, Hina; Ayaz, Muhammad; Abbasi, Bilal Haider; Mohammad, Ijaz; Fazal, Lubna


    The main objective of the current study is to investigate the potential of Carica papaya leaves extracts against Dengue fever in 45 year old patient bitten by carrier mosquitoes. For the treatment of Dengue fever the extract was prepared in water. 25 mL of aqueous extract of C. papaya leaves was administered to patient infected with Dengue fever twice daily i.e. morning and evening for five consecutive days. Before the extract administration the blood samples from patient were analyzed. Platelets count (PLT), White Blood Cells (WBC) and Neutrophils (NEUT) decreased from 176×10(3)/µL, 8.10×10(3)/µL, 84.0% to 55×10(3)/µL, 3.7×10(3)/µL and 46.0%. Subsequently, the blood samples were rechecked after the administration of leaves extract. It was observed that the PLT count increased from 55×10(3)/µL to 168×10(3)/µL, WBC from 3.7×10(3)/µL to 7.7×10(3)/µL and NEUT from 46.0% to 78.3%. From the patient feelings and blood reports it showed that Carica papaya leaves aqueous extract exhibited potential activity against Dengue fever. Furthermore, the different parts of this valuable specie can be further used as a strong natural candidate against viral diseases.

  3. Acute rheumatic fever in a child with Ebstein anomaly | Otaigbe ...

    African Journals Online (AJOL)

    Background: Ebstein anomaly (atrialisation of the right ventricle ) alone constitutes 0.5 -1% of congenital heart disease and usually presents as an isolated lesion. Association with mitral valve stenosis has been reported previously. We however present a case of Ebstein's anomaly with recurrent acute rheumatic fever (ARF) ...

  4. Adult Onset Still's Disease and Rocky Mountain Spotted Fever

    Directory of Open Access Journals (Sweden)

    Paul Persad


    Full Text Available Adult Still's Disease was first described in 1971 by Bywaters in fourteen adult female patients who presented with symptoms indistinguishable from that of classic childhood Still's Disease (Bywaters, 1971. George Still in 1896 first recognized this triad of quotidian (daily fevers, evanescent rash, and arthritis in children with what later became known as juvenile inflammatory arthritis (Still, 1990. Adult Onset Still's Disease (AOSD is an inflammatory condition of unknown etiology characterized by an evanescent rash, quotidian fevers, and arthralgias. Numerous infectious agents have been associated with its presentation. This case is to our knowledge the first presentation of AOSD in the setting of Rocky Mountain Spotted Fever. Although numerous infectious agents have been suggested, the etiology of this disorder remains elusive. Nevertheless, infection may in fact play a role in triggering the onset of symptoms in those with this disorder. Our case presentation is, to our knowledge, the first case of Adult Onset Still's Disease associated with Rocky Mountain spotted fever (RMSF.

  5. Adult Onset Still's Disease and Rocky Mountain Spotted Fever (United States)

    Persad, Paul; Patel, Rajendrakumar; Patel, Niki


    Adult Still's Disease was first described in 1971 by Bywaters in fourteen adult female patients who presented with symptoms indistinguishable from that of classic childhood Still's Disease (Bywaters, 1971). George Still in 1896 first recognized this triad of quotidian (daily) fevers, evanescent rash, and arthritis in children with what later became known as juvenile inflammatory arthritis (Still, 1990). Adult Onset Still's Disease (AOSD) is an inflammatory condition of unknown etiology characterized by an evanescent rash, quotidian fevers, and arthralgias. Numerous infectious agents have been associated with its presentation. This case is to our knowledge the first presentation of AOSD in the setting of Rocky Mountain Spotted Fever. Although numerous infectious agents have been suggested, the etiology of this disorder remains elusive. Nevertheless, infection may in fact play a role in triggering the onset of symptoms in those with this disorder. Our case presentation is, to our knowledge, the first case of Adult Onset Still's Disease associated with Rocky Mountain spotted fever (RMSF). PMID:20811570

  6. Involving urban communities in controlling dengue fever in Latin ...

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


    May 4, 2016 ... ... its range is spreading, with recent outbreaks in France, Croatia, and Florida. According to the World Health Organization (WHO), nearly half of the world's population is now at risk. In severe cases, this flu-like illness can take a lethal form—Dengue Hemorrhagic Fever. In Latin America and the Caribbean, ...

  7. Rheumatic fever and rheumatic heart disease in Gauteng on the ...

    African Journals Online (AJOL)

    Objective. To review the observed decline in numbers of children seen at the. Paediatric Cardiology Unit at CHBAH with a diagnosis of ARF and. RHD and those undergoing corrective valve surgery over the past two decades. Rheumatic fever and rheumatic heart disease in Gauteng on the decline: Experience at Chris Hani ...

  8. Vaccinology of classical swine fever: from lab to field

    NARCIS (Netherlands)

    Oirschot, van J.T.


    There are two types of classical swine fever vaccines available: the classical live and the recently developed E2 subunit vaccines. The live Chinese strain vaccine is the most widely used. After a single vaccination, it confers solid immunity within a few days that appears to persist lifelong. The

  9. medical cost of lassa fever treatment in irrua specialist teaching

    African Journals Online (AJOL)


    Sep 30, 2016 ... generated by the resources used in treating or coping with a disease, including expenditures for medical care and the treatment of the illness (hospital care .... attention on health and Lassa fever treatment leading to intervention from concerned authorities to ameliorate the medical cost to patients, economic ...

  10. Parental beliefs and practices regarding childhood fever in Turkish ...

    African Journals Online (AJOL)


    Mar 12, 2016 ... of fever were febrile status epilepticus and heat stroke, two rare entities.[4] Several studies published in the ... damage, stroke, coma, serious vague, illness, blindness, and even death.[13‑16] These studies also showed ..... Int J Nurs Stud 2008;45:829‑36. 14. Tessler H, Gorodischer R, Press J, Bilenko N.

  11. Molecular characterization of African swine fever virus in apparently ...

    African Journals Online (AJOL)

    Molecular characterization of African swine fever virus in apparently healthy domestic pigs in Uganda. ... If you would like more information about how to print, save, and work with PDFs, Highwire Press provides a helpful Frequently Asked Questions about PDFs. Alternatively, you can download the PDF file directly to your ...

  12. Randomised controlled trial of combined paracetamol and ibuprofen for fever


    Erlewyn-Lajeunesse, M; Coppens, K; Hunt, L.; Chinnick, P.; DAVIES, P; Higginson, I.; Benger, J.


    A randomised open label study of the combined use of paracetamol and ibuprofen to rapidly reduce fever is reported. The advantage of using both medications is less than half a degree centigrade in the first hour, and insufficient to warrant routine use.

  13. Archive Fever: 'order is no longer assured' | Boshoff | South African ...

    African Journals Online (AJOL)

    This article uses a close reading of Jacques Derrida's short work Archive fever: A Freudian impression (1996), in order to show the structural impossibility for law and the wider legal system to protect itself from the destabilising effects of deconstruction. It shows law's inability to stabilise/close the system and hence its inability ...

  14. Hyper-IgD syndrome and hereditary periodic fever syndromes

    Directory of Open Access Journals (Sweden)

    L. Vicentini


    Full Text Available Hereditary periodic fever syndromes are a group of systemic disorders characterized by recurrent attacks of systemic inflammation (autoinflammation without infectious or autoimmune cause. The hyper-IgD syndrome (HIDS is a rare autosomal recessive inflammatory disorder characterized by recurrent fever, increased serum IgD (normal value < 100 U/ml and generalized inflammation (lymphadenopathy, arthralgias/arthritis, abdominal complaints, skin rash, and headache. The attacks persist during the entire life although frequency and severity tend to diminish with age. HIDS is caused by specific mutations in the gene encoding mevalonate kinase, resulting in depressed enzymatic activity. At present the therapy for the syndrome is only supportive. Other than HIDS, other hereditary systemic inflammatory disorders have been described: the Familial Mediterranean Fever, the tumour necrosis factor receptor associated periodic syndrome (TRAPS, a disease related to the mutations of one of the TNF receptors, the Familial Cold Urticaria and the Muckle-Wells syndrome. The differential diagnosis with other causes of periodic fever is crucial for assessing appropriate management and treatment.

  15. Mathematical epidemiology and the control of classical swine fever virus

    NARCIS (Netherlands)

    Klinkenberg, Dieudonné


    The thesis describes epidemiological research carried out to improve the control of classical swine fever virus (CSFV) epidemics. First, control measures and strategies are investigated in order to enable quick and adequate action upon CSFV detection. CSFV transmission experiments are described, as

  16. Transmission rate of African swine fever virus under experimental conditions

    NARCIS (Netherlands)

    Carvalho Ferreira, de H.C.; Backer, J.A.; Weesendorp, E.; Klinkenberg, D.; Stegeman, J.A.; Loeffen, W.L.A.


    African swine fever (ASF) is a highly lethal, viral disease of swine. No vaccine is available, so controlling an ASF outbreak is highly dependent on zoosanitary measures, such as stamping out infected herds and quarantining of affected areas. Information on ASF transmission parameters could allow

  17. Immunization against east coast fever by infection and treatment ...

    African Journals Online (AJOL)

    East Coast Fever (ECF) caused by Theileria parva is known in Uganda as the must important tick-horne disease of cattle for a long time. The 1}apcr describes ... ECf' is probably the most important tick-borne disease of cattle due to the high ... This paper reviews research efforts towards development and introduction of the ...

  18. Economic aspects of Q fever control in dairy goats. (United States)

    van Asseldonk, M A P M; Bontje, D M; Backer, J A; Roermund, H J W van; Bergevoet, R H M


    This paper presents an economic analysis of Q fever control strategies in dairy goat herds in The Netherlands. Evaluated control strategies involved vaccination strategies (being either preventive or reactive) and reactive non-vaccination strategies (i.e., culling or breeding prohibition). Reactive strategies were initiated after PCR positive bulk tank milk or after an abortion storm (abortion percentage in the herd of 5% or more). Preventive vaccination eradicates Q fever in a herd on average within 2 and 7 years (depending on breeding style and vaccination strategy). Economic outcomes reveal that preventive vaccination is always the preferred Q fever control strategy on infected farms and this even holds for a partial analysis if only on-farm costs and benefits are accounted for and human health costs are ignored. Averted human health costs depend to a large extend on the number of infected human cases per infected farm or animal. Much is yet unknown with respect to goat-human transmission rates. When the pathogen is absent in both livestock and farm environment then the "freedom of Q fever disease" is achieved. This would enable a return to non-vaccinated herds but more insight is required with respect to the mechanisms and probability of re-infection. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Response to Imported Case of Marburg Hemorrhagic Fever, the Netherlands

    NARCIS (Netherlands)

    Timen, Aura; Koopmans, Marion P. G.; Vossen, Ann C. T. M.; van Doornum, Gerard J. J.; Guenther, Stephan; van den Berkmortel, Franchette; Verduin, Kees M.; Dittrich, Sabine; Emmerich, Petra; Osterhaus, Albert D. M. E.; van Dissel, Jaap T.; Coutinho, Roel A.

    On July 10, 2008, Marburg hemorrhagic fever was confirmed in a Dutch patient who had vacationed recently in Uganda. Exposure most likely occurred in the Python Cave (Maramagambo Forest), which harbors bat species that elsewhere in Africa have been found positive for Marburg virus. A

  20. Clinical complications of Chikungunya fever in Mauritius | Goorah ...

    African Journals Online (AJOL)

    Chikungunya fever, an emerging mosquito-borne viral disease, has affected Mauritius with two recent outbreaks in 2005 and 2006 respectively. A study was carried out in 2007 to describe the clinical complications post-Chikungunya infection. Ethical clearance was obtained for this study. Data collection was carried out in ...