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First case of yellow fever in French Guiana since 1902.  

PubMed Central

The first case of yellow fever in French Guiana since 1902 was reported in March 1998. The yellow fever virus genome was detected in postmortem liver biopsies by seminested polymerase chain reaction. Sequence analysis showed that this strain was most closely related to strains from Brazil and Ecuador.

Heraud, J. M.; Hommel, D.; Hulin, A.; Deubel, V.; Poveda, J. D.; Sarthou, J. L.; Talarmin, A.



Yellow Fever  


... tropical and subtropical areas in South America and Africa. The virus is transmitted to humans by the ... Maps Maps of yellow fever endemic areas in Africa and South America Links & References Publications and links ...


Treatment of yellow fever  

Microsoft Academic Search

Yellow fever (YF) is a life-threatening mosquito-borne flaviviral hemorrhagic fever (VHF) characterized by severe hepatitis, renal failure, hemorrhage, and rapid terminal events with shock and multi-organ failure. A live, attenuated vaccine (YF 17D), in wide use for over 60 years, causes a disease identical to wild-type virus at an incidence of 2.5×10?6. Our current understanding of the pathogenesis and treatment

Thomas P. Monath



The Original Haemorrhagic Fever: Yellow Fever.  

National Technical Information Service (NTIS)

Monkeys infected with the Asibi strain of yellow fever virus developed multiple coagulation abnormalities 3-4 days after viral inoculation. These coagulation abnormalities occurred almost simultaneously with the development of fever, clinical illness and ...

L. H. Dennis B. E. Reisberg J. Crosbie D. Crozier M. E. Conrad



Yellow fever in Swansea, 1865.  

PubMed Central

A cargo of copper ore from Cuba was discharged at Swansea in mid-September 1865, during a spell of exceptionally hot weather. A small number of mosquitoes infected with the yellow fever virus, disembarking at the same time, established an epidemic of yellow fever in the town. In the next 25 days, at least 27 inhabitants were infected and 15 of them died. The quality of contemporary observation and recording has encouraged a re-examination of the events in the light of knowledge unavailable at the time. It cannot be assumed that the episode will not be repeated.

Meers, P. D.



Yellow Fever Unwelcome Visitor Now in Residence.  

National Technical Information Service (NTIS)

The editorial reviews the history of yellow fever in Ethiopia and the progress of the current vaccination campaign around the Sidamo administrative region. The need for a vaccination team capable of responding rapidly to a Yellow Fever outbreak anywhere i...



Anaphylaxis from yellow fever vaccine  

Microsoft Academic Search

Background: There are very few reports of anaphylactic reactions to yellow fever (YF) vaccine in the literature, and these date from the 1940s. Objective: We sought to estimate the rate of YF vaccine–related anaphylaxis. Methods: All reports of adverse reactions to YF vaccine submitted to the Vaccine Adverse Event Reporting System between 1990 and 1997 were reviewed for those meeting

John M. Kelso; Gina T. Mootrey; Theodore F. Tsai



Yellow Fever Epidemic Sites Revisited: Possible Areas of Yellow Fever Endemicity in Ethiopia.  

National Technical Information Service (NTIS)

Yellow fever antibody of apparently recent origin has been found in two areas studied by the Institute Pasteur during the 1961-1962 yellow fever outbreak in Ethiopia. Yellow fever antibody in an eight year old child in Kulo Konta Awrajah would indicate th...

O. L. Wood V. H. Lee



Assessing Yellow Fever Risk in the Ecuadorian Amazon  

PubMed Central

This study reports results of a cross-sectional study based on interviews and seroepidemiological methods to identify risk factors for yellow fever infection among personnel of a military garrison in the Amazonian rainforest. Clinical symptoms and signs observed among yellow fever cases are also described. Humoral immune response to yellow fever, Mayaro, Venezuelan equine encephalitis, Oropouche, and dengue 2 infection was assessed by evaluating IgM and IgG specific antibodies. A yellow fever attack rate of 13% (44/341, with 3 fatal cases) was observed among military personnel. Signs of digestive track bleeding (14.6%) and hematuria (4.9%) were observed among the yellow fever cases. In 32.2% of the cases, we measured high levels of serum glutamic oxaloacetic transaminase and serum glutamic pyruvic transaminase with maximum levels of 6,830 and 3,500, respectively. Signs of bleeding or jaundice were observed in some cases, and high levels of transaminases were seen. The epidemiological and laboratory investigations demonstrated that the military personnel were affected by a yellow fever outbreak. The association between clearing the rainforest and also being at the detachments with yellow fever infection confirms that clearing is the main factor in the jungle model of transmission, which takes place deep in the Amazonian rainforest.

Izurieta, Ricardo O; Macaluso, Maurizio; Watts, Douglas M; Tesh, Robert B; Guerra, Bolivar; Cruz, Ligia M; Galwankar, Sagar; Vermund, Sten H



Marylanders defeat Philadelphia: yellow fever updated.  

PubMed Central

Those strategic points which influence this amateur historian to declare a victory for Baltimore and Maryland over Philadelphia are: I. Based upon clinical and epidemiological data, two Marylanders, Potter and Davidge, were among the first to contest Rush and his contagion theory; they told him so and published their views. To prove this point, Potter went to the extreme of inoculating himself with presumedly infected material. Stubbins Ffirth, a young University of Pennsylvania medical student, did the same four years later. To Rush's credit was ultimate abandonment of his originally held views. II. John Crawford, of Baltimore, although not the originator of the insect concept of transmission of infectious agents, published his concepts in 1811. III. Henry Rose Carter, a Maryland graduate, clearly delineated, in 1898, that after identification of an index case of yellow fever an extrinsic incubation period was necessary before the evolution of secondary cases. IV. James Carroll, another University of Maryland graduate, who worked as Deputy under Walter Reed with Lazear and Agramonte, helped prove Finlay's original concept that the Aedes aegypti mosquito was the natural vector of yellow fever. Carroll himself was the first experimentally induced case. V. Studies in primates provide new approaches for management of yellow fever. Nutritional support and treatment with specific anti-viral agents may be useful for therapy of human yellow fever. Maryland members of the Climatological are mindful of Philadelphia's rich medical heritage and of the many battles won in the City of Brotherly Love. Physicians in colonial and early America experienced The best and worst of times, theirs was an age of foolishness and belief, of incredulity and light, of darkness, despair and hope. This tale of two cities ends in peace. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 10 Fig. 11

Woodward, T. E.; Beisel, W. R.; Faulkner, R. D.



Clara Maass, yellow fever and human experimentation.  


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. PMID:23756016

Chaves-Carballo, Enrique



Longitudinal myelitis associated with yellow fever vaccination  

Microsoft Academic Search

Severe adverse reaction to yellow fever (YF) vaccine includes the yellow fever vaccine-associated neurotropic disease. This\\u000a terminology includes postvaccinal encephalitis, acute disseminated encephalomyelitis, and Guillain-Barré syndrome. The objective\\u000a of this communication is to report a patient who received a YF vaccine in Argentina and subsequently developed longitudinal\\u000a myelitis with a symptom that had previously gone unreported in the literature. A

M. Chaves; P. Riccio; L. Patrucco; J. I. Rojas; E. Cristiano



42 CFR 71.3 - Designation of yellow fever vaccination centers; Validation stamps.  

Code of Federal Regulations, 2010 CFR

...false Designation of yellow fever vaccination centers; Validation stamps. ...3 Designation of yellow fever vaccination centers; Validation stamps. (a) Designation of yellow fever vaccination centers. (1) The...



42 CFR 71.3 - Designation of yellow fever vaccination centers; Validation stamps.  

Code of Federal Regulations, 2010 CFR

...false Designation of yellow fever vaccination centers; Validation stamps. ...3 Designation of yellow fever vaccination centers; Validation stamps. (a) Designation of yellow fever vaccination centers. (1) The...



Structural studies of yellow fever virus helicase  

Microsoft Academic Search

Yellow fever virus (YFV) is a pathogen of the flavivirus family. NS3, one of seven viral replicase proteins, has a protease domain and a helicase domain. The helicase is thought to separate plus and minus strands following replication. Helicase from YFV and WNV (West Nile virus) have been produced in E. coli and purified. ATPase activity of these recombinant helicase

Jinhua Wu



Adverse event reports following yellow fever vaccination  

Microsoft Academic Search

Yellow fever (YF) vaccine has been used for prevention of YF since 1937 with over 500 million doses administered. However, rare reports of severe adverse events following vaccination have raised concerns about the vaccine’s safety. We reviewed reports of adverse events following YF vaccination reported to the U.S. Vaccine Adverse Event Reporting System (VAERS) from 2000 to 2006. We used

Nicole P. Lindsey; Betsy A. Schroeder; Elaine R. Miller; M. Miles Braun; Alison F. Hinckley; Nina Marano; Barbara A. Slade; Elizabeth D. Barnett; Gary W. Brunette; Katherine Horan; J. Erin Staples; Phyllis E. Kozarsky; Edward B. Hayes



Yellow Fever Outbreak, Imatong, Southern Sudan  

PubMed Central

In May 2003, the World Health Organization received reports about a possible outbreak of a hemorrhagic disease of unknown cause in the Imatong Mountains of southern Sudan. Laboratory investigations were conducted on 28 serum samples collected from patients in the Imatong region. Serum samples from 13 patients were positive for immunoglobulin M antibody to flavivirus, and serum samples from 5 patients were positive by reverse transcription–polymerase chain reaction with both the genus Flavivirus–reactive primers and yellow fever virus–specific primers. Nucleotide sequencing of the amplicons obtained with the genus Flavivirus oligonucleotide primers confirmed yellow fever virus as the etiologic agent. Isolation attempts in newborn mice and Vero cells from the samples yielded virus isolates from five patients. Rapid and accurate laboratory diagnosis enabled an interagency emergency task force to initiate a targeted vaccination campaign to control the outbreak.

Ofula, Victor O.; Sang, Rosemary C.; Konongoi, Samson L.; Sow, Abdourahmane; De Cock, Kevin M.; Tukei, Peter M.; Okoth, Fredrick A.; Swanepoel, Robert; Burt, Felicity J.; Waters, Norman C.; Coldren, Rodney L.



Yellow fever outbreak, Imatong, southern Sudan.  


In May 2003, the World Health Organization received reports about a possible outbreak of a hemorrhagic disease of unknown cause in the Imatong Mountains of southern Sudan. Laboratory investigations were conducted on 28 serum samples collected from patients in the Imatong region. Serum samples from 13 patients were positive for immunoglobulin M antibody to flavivirus, and serum samples from 5 patients were positive by reverse transcription-polymerase chain reaction with both the genus Flavivirus-reactive primers and yellow fever virus-specific primers. Nucleotide sequencing of the amplicons obtained with the genus Flavivirus oligonucleotide primers confirmed yellow fever virus as the etiologic agent. Isolation attempts in newborn mice and Vero cells from the samples yielded virus isolates from five patients. Rapid and accurate laboratory diagnosis enabled an interagency emergency task force to initiate a targeted vaccination campaign to control the outbreak. PMID:15207058

Onyango, Clayton O; Ofula, Victor O; Sang, Rosemary C; Konongoi, Sanson L; Sow, Abourahmane; De Cock, Kenin M; Tukei, Peter M; Okoth, Fredrick A; Swanepoel, Robert; Burt, Felicity J; Waters, Norman C; Coldren, Rodney L



[Should yellow fever vaccination be recommended during pregnancy or breastfeeding?].  


Yellow fever vaccine is produced from a live attenuated virus that is contraindicated in case of immunodeficiency and subject to restrictions for pregnant or breastfeeding women. The purpose of this review of available information on yellow fever vaccination during pregnancy and breastfeeding is to assist physicians in making recommendations prior to departure to yellow-fever endemic zones. Regarding pregnancy, there is no evidence to support a major risk of yellow-fever-vaccine-related complications in mothers or children. Although this finding is reassuring, it should be underlined that most reported series have been small. Regarding breastfeeding, the risk was recently confirmed by a report describing vaccine-induced encephalitis occurring in an infant 8 days after primary vaccination of the mother. The final decision to vaccinate depends on whether or not the trip can be postponed. If travel is mandatory, vaccination may be recommended in pregnant women preferably during the first trimester since the immunological response appears to be better at that time. Antibody titer should be checked following delivery. During breastfeeding, vaccination may be performed but breastfeeding must be stopped during the postvaccinal viremia phase. Breastfeeding can be resumed after a 10-day period of formula feeding. PMID:22368925

Imbert, P; Moulin, F; Mornand, P; Méchaï, F; Rapp, C



Aedes aegypti in Brazil: genetically differentiated populations with high susceptibility to dengue and yellow fever viruses  

Microsoft Academic Search

Aedes aegypti was eliminated from Brazil in 1955, but re-infested the country in the 1970s. Dengue outbreaks have occurred since 1981 and became endemic in several cities in Brazil after 1986. Urban yellow fever has not occurred since 1942, and only jungle yellow fever cases have been reported. A population genetic analysis using isoenzyme variation combined with an evaluation of

R Lourenço-de-Oliveira; M Vazeille; A. M. B de Filippis; A. B Failloux



Mosquitoes Known to Carry Dengue, Yellow Fever Seen in California  


... enable JavaScript. Mosquitoes known to carry dengue, yellow fever seen in California (*this news item will not ... October 30, 2013 Related MedlinePlus Pages Dengue Hemorrhagic Fevers Insect Bites and Stings By Steve Gorman LOS ...


The control of yellow fever: a centennial account  

Microsoft Academic Search

? The historical toll Up to 1900, yellow fever was greatly feared as a tropical disease. It decimated incomers to Central and South America, whether they were traders, soldiers or settlers, and it gave to West Africa its reputation as the white man's grave. In the Caribbean, yellow fever enfeebled British and French expeditionary armies and it claimed many lives

Philip P. Mortimer


Does yellow fever 17D vaccine protect against melanoma?  


BCG vaccine, vaccinia vaccine and certain pathogens that were shown in previous studies to protect against melanoma have antigenic determinants homologous in their amino acids sequence with the melanoma antigen HERV-K-MEL, encoded by a human endogenous retrovirus K (HERV-K), which is expressed in about 95% of malignant melanocytes. Yellow fever vaccine (YFV) likewise contains an antigenic determinant with a close homology to HERV-K-MEL and might therefore also confer protection against melanoma. To investigate this possibility we carried out a cohort study (28,306 subjects) and a nested case-control study (37 melamona cases and 151 tumors not expressing HERV-K-MEL) in Veneto region (North-Eastern Italy). The standardized incidence ratio was 1.33 (95% confidence interval, 0.84-2.11), 1.59 (0.97-2.59) and 0.59 (0.19-1.84), while the age- gender-adjusted odds ratios were 1.00, 0.96 (0.43-2.14) and 0.26 (0.07-0.96), at 0-4, 5-9, and > or =10 years elapsed from YFV administration, respectively. The risk of melanoma may therefore be lowered 10 years after vaccination with yellow fever vaccine. PMID:19010368

Mastrangelo, G; Krone, B; Fadda, E; Buja, A; Grange, J M; Rausa, G; de Vries, E; Koelmel, K F



58. Photographic copy of historic medal, The Yellow Fever Medal, ...  

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

58. Photographic copy of historic medal, The Yellow Fever Medal, presented to the Portsmouth Naval Hospital by the Town Council of Portsmouth, 1856. (Portsmouth Naval Shipyard Museum, Portsmouth, VA) - Portsmouth Naval Hospital, Hospital Building, Rixey Place, bounded by Williamson Drive, Holcomb Road, & The Circle, Portsmouth, Portsmouth, VA


Yellow Fever Virus Infectivity for Bolivian Aedes aegypti Mosquitoes  

PubMed Central

The absence of urban yellow fever virus (YFV) in Bolivian cities has been attributed to the lack of competent urban mosquito vectors. Experiments with Aedes aegypti from Santa Cruz, Bolivia, demonstrated infection (100%), dissemination (20%), and transmission of a Bolivian YFV strain (CENETROP-322).

Mutebi, John-Paul; Gianella, Alberto; Travassos da Rosa, Amelia; Tesh, Robert B.; Barrett, Alan D. T.



How Brazil joined the quest for a yellow fever vaccine.  


Brazil recently announced an agreement between its Bio-Manguinhos vaccine unit and two US companies to research and develop a new yellow fever vaccine. Claudia Jurberg and Julia D'Aloisio talk to Jaime Benchimol about the controversial history of the development of the vaccine that benefits millions of people today. PMID:23476088



Antibody-dependent Enhancement of Yellow Fever and Japanese Encephalitis Virus Neurovirulence  

Microsoft Academic Search

SUMMARY Antibody-dependent enhancement of yellow fever virus neurovirulence, as measured by a reduction in the average survival time of groups of mice, was demonstrated with wild-type or vaccine strains of yellow fever virus and with Japanese encephalitis virus using intraperitoneally administered monoclonal antibodies specific for the viral E glycoprotein of yellow fever virus. Enhancement of virulence could be induced by

E. A. Gould; A. Buckley




PubMed Central

Observations have been reported which indicate that mice inoculated intracerebrally with active yellow fever virus may develop an infection which is not only non-fatal but may also be completely inapparent. The most extensive observations were made on mice which showed signs of infection but were still alive 22 days after inoculation with virus of one or another of several 17D substrains. In such cases, the infection usually progressed no further and partial or complete recovery often ensued. Agents other than yellow fever virus were excluded as a significant cause of such nonfatal infections by the failure of repeated attempts to isolate other infective agents, by the demonstration of antibodies against yellow fever virus in the sera of the mice, and by the demonstration of a high degree of resistance on the part of such surviving mice to reinoculation with large doses of neurotropic yellow fever virus. Completely inapparent infections with 17D virus were also shown to occur. Studies of apparently normal survivors of 17D virus titrations revealed a small but significant number of animals resistant to intracerebral challenge with neurotropic yellow fever virus. Further, pooled sera from such mice were shown to contain specific protective antibodies. The occurrence of non-fatal infections with 17D virus was found related to virus dose and substrain. Small doses of virus provoked a significantly higher proportion of non-fatal infections than large doses; while different 17D substrains, tested over equivalent ranges of virus dose, varied greatly with respect to the proportion of infections which did not terminate with death. In the case of two substrains (17DD low and 17D3), non-fatal infections (as demonstrated by resistance to intracerebral challenge with neurotropic virus) were sufficiently frequent to cause an increase, when included in the computation of the infective titers, of 25 per cent above the figures based on deaths alone. The demonstration of non-fatal infections, thus, may be important to the accuracy of quantitative determinations of infectivity. Limited observations with virus of the French neurotropic and the pantropic Asibi strains revealed that non-fatal infections do occur, but only rarely. Somewhat more extensive observations with unmodified virus of strains isolated from Brazilian cases of jungle yellow fever, in contrast, revealed an occurrence of non-fatal infections much greater than that observed with the most productive 17D substrains. With these jungle strains, the demonstration of non-fatal infections proved indispensable to any measure of the level of infectivity of virus preparations. The demonstration of the proportional occurrence in mice of non-fatal infections with yellow fever virus provides an additional means by which different virus strains and substrains may be characterized.

Fox, John P.



Heparan Sulfate-Mediated Binding of Infectious Dengue Virus Type 2 and Yellow Fever Virus  

Microsoft Academic Search

Dengue virus type 2 and Yellow fever virus are arthropod-borne flaviviruses causing hemorrhagic fever in humans. Identification of virus receptors is important in understanding flavivirus pathogenesis. The aim of this work was to study the role of cellular heparan sulfate in the adsorption of infectious Yellow fever and Dengue type 2 viruses. Virus attachment was assessed by adsorbing virus to

Raphaële Germi; Jean-Marc Crance; Daniel Garin; Josette Guimet; Hugues Lortat-Jacob; Rob W. H. Ruigrok; Jean-Pierre Zarski; Emmanuel Drouet



Yellow Fever Vaccines: The Success of Empiricism, Pitfalls of Application, and Transition to Molecular Vaccinology  

Microsoft Academic Search

\\u000a In 1951, Max Theiler was awarded the Nobel Prize in Medicine and Physiology for the development of yellow fever vaccine. The\\u000a discovery phase of Theiler’s research preceded the prize by only about 20 years, during which time his vaccine against yellow\\u000a fever had been put into wide-scale use in Africa and South America, and tens of thousands of yellow fever

Thomas P. Monath


The risk of yellow fever in a dengue-infested area  

Microsoft Academic Search

Yellow fever and dengue are viral infections that in urban centres are transmitted by the same arthropod vector, a mosquito of the genus Aedes. In order to estimate the risk of an epidemic of urban yellow fever in a dengue-infested area we calculated the threshold in the basic reproduction number, R0, of dengue, above which any single sylvatic yellow fever-infected

Eduardo Massad; Francisco Antonio Bezerra Coutinho; Marcelo Nascimento Burattini; Luiz Fernandes Lopez



Yellow fever vaccination centers: concurrent vaccinations and updates on mosquito biology.  


Mandatory visits to immunization centers that offer pre-travel Yellow fever vaccine to prospective travelers would be useful for briefing the basics of the biology of the mosquito responsible for Yellow fever spread. Pre- travel knowledge on the day-time rather the nocturnal biting habit of the mosquitoes of Aedes species would prevent from bites of the mosquitoes responsible for the spread of viruses causing Yellow fever, dengue or Chikungunya infection. PMID:22613468

Arya, Subhash C; Agarwal, Nirmala



Aedes aegypti, Dengue and Re-urbanization of Yellow Fever in Brazil and other South American Countries - Past and Present Situation and Future Perspectives By  

Microsoft Academic Search

Dengue (DEN) and yellow fever (YF) viruses are two important arboviruses causing human disease. Dengue fever and dengue haemorrhagic fever (DF\\/DHF) reemerged in the Americas after Aedes aegypti had reinfested most tropical and subtropical regions in the hemisphere. The number of DF\\/DHF cases being reported are increasing each year; and in South America only Chile and Uruguay have not reported

Pedro F. C. Vasconcelos; Amélia P. A. T. Rosa; Francisco P. Pinheiro; Sueli G. Rodrigues; Ana C. R. Cruz; Jorge F. S. T. Rosa


Using next generation sequencing to identify yellow fever virus in Uganda  

Microsoft Academic Search

In October and November 2010, hospitals in northern Uganda reported patients with suspected hemorrhagic fevers. Initial tests for Ebola viruses, Marburg virus, Rift Valley fever virus, and Crimean Congo hemorrhagic fever virus were negative. Unbiased PCR amplification of total RNA extracted directly from patient sera and next generation sequencing resulted in detection of yellow fever virus and generation of 98%

Laura K. McMullan; Mike Frace; Scott A. Sammons; Trevor Shoemaker; Stephen Balinandi; Joseph F. Wamala; Julius J. Lutwama; Robert G. Downing; Ute Stroeher; Adam MacNeil; Stuart T. Nichol


Dissection of antibody specificities induced by yellow fever vaccination.  


The live attenuated yellow fever (YF) vaccine has an excellent record of efficacy and one dose provides long-lasting immunity, which in many cases may last a lifetime. Vaccination stimulates strong innate and adaptive immune responses, and neutralizing antibodies are considered to be the major effectors that correlate with protection from disease. Similar to other flaviviruses, such antibodies are primarily induced by the viral envelope protein E, which consists of three distinct domains (DI, II, and III) and is presented at the surface of mature flavivirions in an icosahedral arrangement. In general, the dominance and individual variation of antibodies to different domains of viral surface proteins and their impact on neutralizing activity are aspects of humoral immunity that are not well understood. To gain insight into these phenomena, we established a platform of immunoassays using recombinant proteins and protein domains that allowed us to dissect and quantify fine specificities of the polyclonal antibody response after YF vaccination in a panel of 51 vaccinees as well as determine their contribution to virus neutralization by serum depletion analyses. Our data revealed a high degree of individual variation in antibody specificities present in post-vaccination sera and differences in the contribution of different antibody subsets to virus neutralization. Irrespective of individual variation, a substantial proportion of neutralizing activity appeared to be due to antibodies directed to complex quaternary epitopes displayed on the virion surface only but not on monomeric E. On the other hand, DIII-specific antibodies (presumed to have the highest neutralizing activity) as well as broadly flavivirus cross-reactive antibodies were absent or present at very low titers. These data provide new information on the fine specificity as well as variability of antibody responses after YF vaccination that are consistent with a strong influence of individual-specific factors on immunodominance in humoral immune responses. PMID:23818856

Vratskikh, Oksana; Stiasny, Karin; Zlatkovic, Jürgen; Tsouchnikas, Georgios; Jarmer, Johanna; Karrer, Urs; Roggendorf, Michael; Roggendorf, Hedwig; Allwinn, Regina; Heinz, Franz X



Yellow Fever Virus in Haemagogus leucocelaenus and Aedes serratus Mosquitoes, Southern Brazil, 2008  

PubMed Central

Yellow fever virus (YFV) was isolated from Haemagogus leucocelaenus mosquitoes during an epizootic in 2001 in the Rio Grande do Sul State in southern Brazil. In October 2008, a yellow fever outbreak was reported there, with nonhuman primate deaths and human cases. This latter outbreak led to intensification of surveillance measures for early detection of YFV and support for vaccination programs. We report entomologic surveillance in 2 municipalities that recorded nonhuman primate deaths. Mosquitoes were collected at ground level, identified, and processed for virus isolation and molecular analyses. Eight YFV strains were isolated (7 from pools of Hg. leucocelaenus mosquitoes and another from Aedes serratus mosquitoes); 6 were sequenced, and they grouped in the YFV South American genotype I. The results confirmed the role of Hg. leucocelaenus mosquitoes as the main YFV vector in southern Brazil and suggest that Ae. serratus mosquitoes may have a potential role as a secondary vector.

Cardoso, Jader da C.; de Almeida, Marco A.B.; dos Santos, Edmilson; da Fonseca, Daltro F.; Sallum, Maria A.M.; Noll, Carlos A.; Monteiro, Hamilton A. de O.; Cruz, Ana C.R.; Carvalho, Valeria L.; Pinto, Eliana V.; Castro, Francisco C.; Neto, Joaquim P. Nunes; Segura, Maria N.O.



Yellow fever vaccination: Is one dose always enough?  


In March 2013, the World Health Organization (WHO) Strategic Advisory Group of Experts on Immunisation (SAGE) considered a number of issues in order to update the WHO Position Paper on Yellow Fever (2003). A key conclusion of this review was that a single dose of yellow fever (YF) vaccine appears to confer life-long protection against YF disease, and that a booster dose of YF vaccine is not needed to maintain immunity. While the efficacy of YF vaccine in the majority of vaccine recipients is not in doubt, the WHO announcement is somewhat surprising as there are some limitations in the evidence base, but more importantly, this announcement is not accompanied by any imminent change in the International Health Regulations 2005. The tension between what is considered best clinical practice and the law will be difficult to reconcile for many health professionals, travellers, and the travel industry, in an area of travel medicine that is already subject to debate and confusion. This commentary reviews the recent WHO announcement, and considers the practical implications for health professionals providing YF vaccine to international travellers. PMID:24074827

Patel, Dipti; Simons, Hilary



Entomological investigation of a sylvatic yellow fever area in São Paulo State, Brazil.  


Following reports of two autochthonous cases of sylvatic yellow fever in the State of São Paulo, Brazil, in 2000, entomological surveys were conducted with the objective of verifying the occurrence of vector species in forest environments close to or associated with riparian areas located in the western and northwestern regions of the State. Culicidae were captured in 39 sites distributed in four regions. Haemagogus leucocelaenus and Aedes albopictus were the most abundant species and were captured in all the regions studied. H. leucocelaenus was the most abundant species in the municipalities of Santa Albertina and Ouroeste, where the two cases of sylvatic yellow fever had been reported. Mosquitoes from the janthinomys/capricornii group were only found at eight sites in the São José do Rio Preto region, while Sabethes chloropterus was found at one site in Ribeirão Preto. H. leucocelaenus showed its capacity to adapt to a secondary and degraded environment. Our results indicate a wide receptive area for yellow fever transmission in the State of São Paulo, with particular emphasis on the possibility of H. leucocelaenus being involved in the maintenance of this sylvatic focus of the disease. PMID:16021266

Camargo-Neves, Vera L F de; Poletto, Daniela W; Rodas, Lílian A C; Pachioli, Márcio L; Cardoso, Rubens P; Scandar, Sirle A S; Sampaio, Susy M P; Koyanagui, Paulo H; Botti, Mauricio V; Mucci, Luis F; Gomes, Almério de C



First report of yellow fever virus in non-human primates in the State of Paraná, Brazil.  


Sylvatic yellow fever is a zoonosis associated mainly with wild animals, especially those in the genus Alouatta, that act as the source of infection. Once infected, these animals pass the disease on to humans by way of an infected mosquito belonging to the genera Aedes, Haemagogus, or Sabethes. The present study is the first report of a case of yellow fever in non-human primates (NHP) in the State of Paraná, Brazil. After the case was diagnosed, several prophylactic measures were adopted to prevent outbreaks of the disease in humans. PMID:23982102

Tranquilin, Marcos Vinícius; Lehmkuhl, Ricardo Coelho; Maron, Angela; Silva, Lineu Roberto da; Ziliotto, Liane; Seki, Meire Christina; Salomon, Gabriela Ronchi; Carrasco, Adriano de Oliveira Torres


Nucleotide Sequence Variation of the Envelope Protein Gene Identifies Two Distinct Genotypes of Yellow Fever Virus  

Microsoft Academic Search

The evolution of yellow fever virus over 67 years was investigated by comparing the nucleotide sequences of the envelope (E) protein genes of 20 viruses isolated in Africa, the Caribbean, and South America. Uniformly weighted parsimony algorithm analysis defined two major evolutionary yellow fever virus lineages designated E genotypes I and II. E genotype I contained viruses isolated from East




The Philip S. Hench Walter Reed Yellow Fever Collection Digitization Project  

Microsoft Academic Search

The Philip S. Hench Walter Reed Yellow Fever Collection is the cornerstone collection in the Claude Moore Health Sciences Library's Historical Collections at the University of Virginia and, beyond the walls of the library, is of national significance. This article provides information on the collection and describes the Philip S. Hench Walter Reed Yellow Fever Collection Digitization Project, a digital

Joan Echtenkamp Klein



Yellow fever epidemics and mortality in the United States, 1693-1905  

Microsoft Academic Search

Yellow fever epidemics struck the United States repeatedly in the 18th and 19th centuries. The disease was not indogenous; epidemics were imported by ship from the Caribbean. Prior to 1822, yellow fever attacked cities as far north as Boston, but after 1822 it was restricted to the south. Port cities were the primary targets, but the disease occasionally spread up

K. David Patterson



Possible Role of Birds in the Maintenance of Yellow Fever in West Africa  

Microsoft Academic Search

IN 1936 it was shown that the blood of monkeys from endemic yellow fever zones in Africa contained immune bodies to the yellow fever virus, as judged by the intraperitoneal mouse protection test: the sera of monkeys outside the endemic zone did not contain immune bodies1. These results have since been confirmed by other workers. At the same time, the

G. M. Findlay; T. A. Cockburn



Yellow fever control in Cameroon: Where are we now and where are we going?  

Microsoft Academic Search

BACKGROUND: Cameroon is one of 12 African countries that bear most of the global burden of yellow fever. In 2002 the country developed a five-year strategic plan for yellow fever control, which included strategies for prevention as well as rapid detection and response to outbreaks when they occur. We have used data collected by the national Expanded Programme on Immunisation

Charles Shey Wiysonge; Emmanuel Nomo; Jeanne Mawo; James Ofal; Julienne Mimbouga; Johnson Ticha; Peter M Ndumbe



Enzootic transmission of yellow fever virus in Peru.  


The prevailing paradigm of yellow fever virus (YFV) ecology in South America is that of wandering epizootics. The virus is believed to move from place to place in epizootic waves involving monkeys and mosquitoes, rather than persistently circulating within particular locales. After a large outbreak of YFV illness in Peru in 1995, we used phylogenetic analyses of virus isolates to reexamine the hypothesis of virus movement. We sequenced a 670-nucleotide fragment of the prM/E gene region from 25 Peruvian YFV samples collected from 1977 to 1999, and delineated six clades representing the states (Departments) of Puno, Pasco, Junin, Ayacucho, San Martin/Huanuco, and Cusco. The concurrent appearance of at least four variants during the 1995 epidemic and the genetic stability of separate virus lineages over time indicate that Peruvian YFV is locally maintained and circulates continuously in discrete foci of enzootic transmission. PMID:12967489

Bryant, Julie; Wang, Heiman; Cabezas, Cesar; Ramirez, Gladys; Watts, Douglas; Russell, Kevin; Barrett, Alan



Enzootic Transmission of Yellow Fever Virus in Peru  

PubMed Central

The prevailing paradigm of yellow fever virus (YFV) ecology in South America is that of wandering epizootics. The virus is believed to move from place to place in epizootic waves involving monkeys and mosquitoes, rather than persistently circulating within particular locales. After a large outbreak of YFV illness in Peru in 1995, we used phylogenetic analyses of virus isolates to reexamine the hypothesis of virus movement. We sequenced a 670-nucleotide fragment of the prM/E gene region of from 25 Peruvian YFV samples collected from 1977 to 1999, and delineated six clades representing the states (Departments) of Puno, Pasco, Junin, Ayacucho, San Martin/Huanuco, and Cusco. The concurrent appearance of at least four variants during the 1995 epidemic and the genetic stability of separate virus lineages over time, indicate that Peruvian YFV is locally maintained and circulates continuously in discrete foci of enzootic transmission.

Bryant, Juliet; Wang, Heiman; Cabezas, Cesar; Ramirez, Gladys; Watts, Douglas; Russell, Kevin



Surveillance for yellow fever virus in eastern Senegal during 1993.  


During the 1993 rainy season, 15,806 mosquitoes, including 14,304 Aedes ssp., were collected and tested for virus infection in 702 and 547 pools, respectively. Aedes furcifer (Edwards) was the most abundant species collected throughout the survey period. Yellow fever (YF) virus was detected in 187 pools: Ae. furcifer (123 isolates), Ae. taylori (Edwards) (41 isolates), and Ae. luteocephalus (Newstead) (23 isolates). A high prevalence of immunoglobulin (IgG) antibodies was found in human and simian populations. Results clearly indicated that increased sylvatic YF activity in eastern Senegal has the increased the risk of YF transmission among rural populations in West Africa. Our results showed that a minimal survey period may be effective in detecting the circulation of YF in the Kedougou area. PMID:8840681

Traoré-Lamizana, M; Fontenille, D; Zeller, H G; Mondo, M; Diallo, M; Adam, F; Eyraud, M; Maiga, A; Digoutte, J P



[Epidemiological situation of yellow fever in Burkina Faso from 2003 to 2008].  


Despite the existence of antiamaril vaccine in the routine Expanded Program of Immunization (EPI) in Burkina Faso, yellow fever cases still occur in the country. In collaboration with WHO, the national health authorities set up a surveillance system through the national reference laboratory in Centre Muraz (Bobo-Dioulasso). All samples of feverish icterus cases of the 63 health districts of the country were analysed in this lab for M Immunoglobulin using Enzyme Linked Immunosorbent Assay (Elisa). Positive Elisa samples were sent to Pasteur Institute of Dakar (Senegal) for confirmation using a Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) assay. From 2003 to 2005, the number of confirmed cases of yellow fever was respectively of 1/413 (0.24%), 14/616 (2.27%) and 19/618 (3.07%). This increasing of the proportion was statistical different. Then, from 2006 to 2008, the confirmed case proportion was respectively 0.35%, 0.27 and 0.54% without significant difference (P = 0.69). The entomological investigations conducted in 2004 in Bobo-Dioulasso showed that the water pots constitute 48.11% mosquitoes lodgings, followed by metal drums with a strong representation of Culex quinquefasciatus (48.7%), followed by Aedes aegypti (43.3%), as vectors in domestic areas with sectorial variations. These results suggest that more attention must be paid by the national health authorities and international community regarding this disease. PMID:20101488

Yaro, S; Zango, A; Rouamba, J; Diabaté, A; Dabiré, R; Kambiré, C; Tiendrebeogo, S M R; Yonli, T; Ouango, J G; Diagbouga, S P



Assessment of Aerosol Stability of Yellow Fever Virus by Fluorescent-Cell Counting  

PubMed Central

The effects of three temperatures [30, 50, and 80 F (-1.11, 10, and 26.67 C)] and three relative humidities (30, 50, and 80%) on biological and physical decay rates of aerosols of yellow fever virus were investigated. Neither temperature nor relative humidity, independently or jointly, significantly affected biological or physical decay rates. The advantages of assaying yellow fever virus by the fluorescent-cell counting technique are discussed.

Mayhew, Charles J.; Zimmerman, W. Douglas; Hahon, Nicholas



Why dengue and yellow fever coexist in some areas of the world and not in others?  


Urban yellow fever and dengue coexist in Africa but not in Asia and South America. In this paper, we examine four hypotheses (and various combinations thereof) to explain the absence of yellow fever in urban areas of Asia and South America. In addition, we examine an additional hypothesis that offers an explanation of the coexistence of the infections in Africa while at the same time explaining their lack of coexistence in Asia. The hypotheses we tested to explain the nonexistence of yellow fever in Asia are the following: (1) the Asian Aedes aegypti is relatively incompetent to transmit yellow fever; (2) there would exist a competition between dengue and yellow fever viruses within the mosquitoes, as suggested by in vitro studies in which the dengue virus always wins; (3) when an A. aegypti mosquito that is infected by or latent for yellow fever acquires dengue, it becomes latent for dengue due to internal competition within the mosquito between the two viruses; (4) there is an important cross-immunity between yellow fever and other flaviviruses, dengue in particular, such that a person recovered from a bout of dengue exhibits a diminished susceptibility to yellow fever. This latter hypothesis is referred to below as the "Asian hypothesis." Finally, we hypothesize that: (5) the coexistence of the infections in Africa is due to the low prevalence of the mosquito Aedes albopictus in Africa, as it competes with A. aegypti. We will refer to this latter hypothesis as the "African hypothesis." We construct a model of transmission that allows all of the above hypotheses to be tested. We conclude that the Asian and the African hypotheses can explain the observed phenomena, whereas other hypotheses fail to do so. PMID:21839800

Amaku, Marcos; Coutinho, Francisco Antonio Bezerra; Massad, Eduardo



Insights into human CD8+ T-cell memory using the yellow fever and smallpox vaccines  

Microsoft Academic Search

Live virus vaccines provide a unique opportunity to study human CD8+ T-cell memory in the context of a controlled, primary acute viral infection. Yellow fever virus-17D and Dryvax are two such live-virus vaccines that are highly efficacious, used worldwide and provide long-term immunity against yellow fever and smallpox respectively. In this review, we describe the properties of virus-specific memory CD8+

Rafi Ahmed; Rama S Akondy



Intriguing olfactory proteins from the yellow fever mosquito, Aedes aegypti  

NASA Astrophysics Data System (ADS)

Four antennae-specific proteins (AaegOBP1, AaegOBP2, AaegOBP3, and AaegASP1) were isolated from the yellow fever mosquito, Aedes aegypti and their full-length cDNAs were cloned. RT-PCR indicated that they are expressed in female and, to a lesser extent, in male antennae, but not in control tissues (legs). AaegOBP1 and AaegOBP3 showed significant similarity to previously identified mosquito odorant-binding proteins (OBPs) in cysteine spacing pattern and sequence. Two of the isolated proteins have a total of eight cysteine residues. The similarity of the spacing pattern of the cysteine residues and amino acid sequence to those of previously identified olfactory proteins suggests that one of the cysteine-rich proteins (AaegOBP2) is an OBP. The other (AaegASP1) did not belong to any group of known OBPs. Structural analyses indicate that six of the cysteine residues in AaegOBP2 are linked in a similar pattern to the previously known cysteine pairing in OBPs, i.e., Cys-24 Cys-55, Cys-51 Cys-104, Cys-95 Cys-113. The additional disulfide bridge, Cys-38 Cys-125, knits the extended C-terminal segment of the protein to a predicted ?2-helix. As indicated by circular dichroism (CD) spectra, the extra rigidity seems to prevent the predicted formation of a C-terminal ?-helix at low pH.

Ishida, Yuko; Chen, Angela M.; Tsuruda, Jennifer M.; Cornel, Anthon J.; Debboun, Mustapha; Leal, Walter S.



Antibody response to 17D yellow fever vaccine in Ghanaian infants.  

PubMed Central

OBJECTIVES: To assess the seroresponses to yellow fever vaccination at 6 and 9 months of age; assess any possible adverse effects of immunization with the 17D yellow fever vaccine in infants, particularly at 6 months of age. METHODS: Four hundred and twenty infants who had completed BCG, OPV and DPT immunizations were randomized to receive yellow fever immunization at either 6 or 9 months. A single dose of 0.5 ml of the reconstituted vaccine was administered to each infant by subcutaneous injection. To determine the yellow fever antibody levels of the infants, each donated 1 ml whole blood prior to immunization and 3 months post-immunization. Each serum sample was titred on Vero cells against the vaccine virus. FINDINGS: The most common adverse reactions reported were fever, cough, diarrhoea and mild reactions at the inoculation site. The incidences of adverse reactions were not statistically different in both groups. None of the pre-immunization sera in both age groups had detectable yellow fever antibodies. Infants immunized at 6 months recorded seroconversion of 98.6% and those immunized at 9 months recorded 98% seroconversion. The GMT of their antibodies were 158.5 and 129.8, respectively. CONCLUSIONS: The results indicate that seroresponses to yellow fever immunization at 6 and 9 months as determined by seroconversion and GMTs of antibodies are similar. The findings of good seroresponses at 6 months without significant adverse effects would suggest that the 17D yellow fever vaccine could be recommended for use in children at 6 months in outbreak situations or in high risk endemic areas.

Osei-Kwasi, M.; Dunyo, S. K.; Koram, K. A.; Afari, E. A.; Odoom, J. K.; Nkrumah, F. K.



Use of the yellow fever virus vaccine strain 17D for the study of strategies for the treatment of yellow fever virus infections  

Microsoft Academic Search

We have employed the attenuated vaccine strain 17D of yellow fever virus (YFV) to evaluate the inhibitory effect of a selected series of compounds on YFV in Vero cells. Use of the vaccine strain does not require high-level microbiological containment facilities and should allow extensive screening. In addition, YFV may serve as a model for other flaviviruses including hepatitis C

J. Neyts; A. Meerbach; P. McKenna; E. De Clercq



Suspected Yellow Fever Vaccine-Associated Viscerotropic Adverse Events (1973 and 1978), United States  

PubMed Central

Two cases of yellow fever vaccine-associated viscerotropic adverse events (YEL-AVD) were identified by review of correspondence received at the Centers for Disease Control and Prevention (CDC; Ft. Collins, CO). The cases occurred in Indiana and Maryland in 1973 and 1978, respectively. One patient, a 75-year-old man with multi-organ failure died, and the other, a 31-year-old woman, was hospitalized for 14 days. Onset was 3–6 days after vaccination. The illness was characterized by fever, headache, myalgia, gastrointestinal symptoms, hepatic and renal dysfunction, and (in the fatal case), shock and coagulopathy, compatible with YEL-AVD. Liver pathology showed diffuse, spotty necrosis, acidophilic degeneration, Kupffer cell hyperplasia, and microvesicular fat. No virological confirmation was obtained, so that both cases remain classified as “suspect.” The 1973 case is the earliest record of YEL-AVD; until now, the earliest known case of YEL-AVD had been in 1975 in Brazil, and most subsequent cases have been reported after 1995.

Monath, Thomas P.



Yellow fever in Par? State, Amazon region of Brazil, 1998-1999: entomologic and epidemiologic findings.  

PubMed Central

Yellow fever (YF) is frequently associated with high severity and death rates in the Amazon region of Brazil. During the rainy seasons of 1998 and 1999, 23 (eight deaths) and 34 (eight deaths) human cases of YF were reported, respectively, in different geographic areas of Pará State; most cases were on Marajó Island. Patients were 1 to 46 years of age. Epidemiologic and ecological studies were conducted in Afuá and Breves on Marajó Island; captured insects yielded isolates of 4 and 11 YF strains, respectively, from Haemagogus janthinomys pooled mosquitoes. The cases on Marajó Island in 1999 resulted from lack of vaccination near the focus of the disease and intense migration, which brought many nonimmune people to areas where infected vectors were present. We hypothesize that YF virus remains in an area after an outbreak by vertical transmission among Haemagogus mosquitoes.

Vasconcelos, P. F.; Rosa, A. P.; Rodrigues, S. G.; Rosa, E. S.; Monteiro, H. A.; Cruz, A. C.; Barros, V. L.; Souza, M. R.; Rosa, J. F.



Yellow fever outbreak in Kaffrine, Senegal 1996: epidemiological and entomological findings.  


In November 1996 a yellow fever (YF) outbreak occurred near Kaffrine in the central part of Senegal. Thirty-six deaths were notified, all children under 15 years of age. The YF diagnosis was confirmed by MAC-ELISA or by virus isolation. The immune status against YF virus of a sample population of 449 individuals was determined, and 31 confirmed cases and 69 asymptomatic cases were reported. Distribution of YF cases and incidence rate decreased with age, while the attack rate was stable in all age groups. Larva indices were high and Aedes aegypti was common in all villages, causing man-to-man transmission. The greatest risk of YF disease was lack of immunity, especially in individuals <20 years of age. The outbreak was rapidly controlled by an emergency immunization campaign. YF epidemics occurred in Senegal over two consecutive years. The last outbreak reached the main road to Dakar and the risk of spread to urban areas has increased. PMID:9855398

Thonnon, J; Spiegel, A; Diallo, M; Sylla, R; Fall, A; Mondo, M; Fontenille, D



Persistence of yellow Fever vaccine-induced antibodies after solid organ transplantation.  


Immunization using live attenuated vaccines represents a contra-indication after solid organ transplantation (SOT): consequently, transplant candidates planning to travel in countries where yellow fever is endemic should be vaccinated prior to transplantation. The persistence of yellow fever vaccine-induced antibodies after transplantation has not been studied yet. We measured yellow-fever neutralizing antibodies in 53 SOT recipients vaccinated prior to transplantation (including 29 kidney recipients and 18 liver recipients). All but one (98%) had protective titers of antibodies after a median duration of 3 years (min.: 0.8, max.: 21) after transplantation. The median antibody level was 40?U/L (interquartile range: 40-80). For the 46 patients with a known or estimated date of vaccination, yellow-fever antibodies were still detectable after a median time of 13 years (range: 2-32 years) post-immunization. Our data suggest there is long-term persistence of antibodies to yellow fever in SOT recipients who have been vaccinated prior to transplantation. PMID:23834702

Wyplosz, B; Burdet, C; François, H; Durrbach, A; Duclos-Vallée, J C; Mamzer-Bruneel, M-F; Poujol, P; Launay, O; Samuel, D; Vittecoq, D; Consigny, P H



Yellow fever vaccine: An updated assessment of advanced age as a risk factor for serious adverse events  

Microsoft Academic Search

Since 1996, the scientific community has become aware of 14 reports of yellow fever vaccine (YEL)-associated viscerotropic disease (YEL-AVD) cases and four reports of YEL-associated neurotropic disease (YEL-AND) worldwide, changing our understanding of the risks of the vaccine. Based on 722 adverse event reports after YEL submitted to the U.S. Vaccine Adverse Event Reporting System in 1990–2002, we updated the

Alena Y. Khromava; Rachel Barwick Eidex; Leisa H. Weld; Katrin S. Kohl; Robert D. Bradshaw; Robert T. Chen; Martin S. Cetron



[Assessment of vaccination coverage among travelers to areas where yellow fever is endemic (Senegal)].  


This prospective survey, conducted at the Dakar airport from August 18, 2011, to May 8, 2012, asked a sample of travelers living in France and returning there after a stay in Senegal to complete a questionnaire. The aim of the study was to assess the determinants of vaccination coverage against yellow fever. The study included 10 298 travelers, with a median age of 48 years (interquartile range: 27-58); 52% were tourists, and 22% were traveling for business purposes. The measured level of anti-yellow fever vaccination coverage was 39.3%. Vaccination coverage was influenced by the travelers' level of knowledge and their perception of the risk. PMID:24001654

Rapp, C; Fall, K B; Tall, A; Michel, R; Royon, P; de Gentile, L; Leroy, J P; Caumes, E; Bouchaud, O



Isolations of yellow fever virus from Haemagogus leucocelaenus in Rio Grande do Sul State, Brazil.  


Following howling monkey (Alouatta caraya) deaths and yellow fever (YF) antigen detection by immunohistochemistry in the liver sample of a dead monkey in April and May 2001 in the municipalities of Garruchos and Santo Antônio das Missões, Rio Grande do Sul State, Brazil, epidemiological field investigations were initiated. Two strains of YF virus were isolated in suckling mice from 23 Haemagogus (Conopostegus) leucocelaenus Dyar & Shannon mosquitoes collected from the study sites. The YF virus was isolated from this species in the 1930s in Brazil and in the 1940s in Colombia. No human cases were reported during the current epizootic outbreak. The YF virus isolation and the absence of Hg. (Haemagogus) janthinomys Dyar from the area suggest that Hg. leucocelaenus may be a secondary YF vector and play an important role in the epidemiology of this disease in the Southern Cone. PMID:12892055

Vasconcelos, Pedro F; Sperb, Alethéa F; Monteiro, Hamilton A; Torres, Maria A; Sousa, Maria R; Vasconcelos, Helena B; Mardini, Lúcia B; Rodrigues, Sueli G


[Integrated approach to yellow fever surveillance: pilot study in Senegal in 2003-2004].  


The aim was to undertake a pilot study of integrated surveillance of yellow fever (YF) in Senegal, based on i) a human surveillance involving healthcare centers in the 11 administrative regions of the country ii) an entomological surveillance including domestic and sylvatic environment and iii) screening mosquitoes for YF virus using RT-PCR method. The integrated approach of human and entomological surveillance was conducted for 2 years (2003-2004). Surveillance in human population was based on screening samples of YF suspected cases (i.e. patients with acute (< or = 15 days) febrile illness with jaundice) for YF specific IgM antibodies. The entomological surveillance was carried out by collecting mosquitoes using human landing catch method and attempt to detect YF virus on them by RT-PCR. Forty five percent of the healthcare centres notified at least one suspected YF case during 2003-2004 periods. Among the 342 sera collected over 2 years, 2 revealed anti-YF IgM antibodies leading to investigations which allowed identification of the source and place of infection and implementation of a reactive focused YF immunization campaign. In addition, YFV was detected by RT-PCR from 49 out of 1762 mosquitoes tested and distributed as follows: in the sylvatic environment, 29 from Aedes furcifer and 1 from Aedes aegypti while in the domestic area, 15 Aedes aegypti and 4 Aedes furcifer. RT-PCR was found more sensitive and rapid than viral isolation for YF virus detection in mosquitoes. The pilot study in Senegal for YF surveillance integrating human and entomological parameters in domestic and sylvatic areas showed that this approach is very efficient in detecting yellow fever virus circulation due to the complementarity of the two systems. Therefore, in the light of the encouraging results presented herein, similar studies in different context and areas are needed to further validate and allow the extension of its application to other endemic regions of Africa. PMID:17824313

Faye, O; Diallo, M; Dia, I; Ba, Y; Faye, O; Mondo, M; Sylla, R; Faye, P C; Sall, A A



A neonatal case of Japanese spotted Fever.  


We herein present the case of a 28-day-old female with Japanese spotted fever, who is the youngest reported patient so far. Tick-borne diseases, including Japanese spotted fever, should be included in the differential diagnosis of eruptive fever even in neonates because a treatment delay can lead to a fatal outcome. PMID:23743544

Hamaguchi, Yo; Shirakawa, Toshihiko; Kuwatsuka, Yutaka; Ando, Shuji



Fever revealing Behçet's disease: Two new cases  

Microsoft Academic Search

Behçet's disease (BD) is an uncommon cause of fever of unknown origin. We report two cases, both involving 42-year-old males, who initially presented with prolonged fever and who were ultimately diagnosed as having BD after a delay of 12 and 21 months, respectively. Both patients developed pulmonary aneurysms. Although fevers resolved after therapy, both patients died within the first year after

H. Harmouche; M. Maamar; I. Sahnoune; Z. Tazi-Mezalek; M. Aouni; A. Maaouni



An outbreak of yellow fever with concurrent chikungunya virus transmission in South Kordofan, Sudan, 2005.  


From September through December 2005, an outbreak of hemorrhagic fever occurred in South Kordofan, Sudan. Initial laboratory test results identified IgM antibodies against yellow fever (YF) virus in patient samples, and a YF outbreak was declared on 14 November. To control the outbreak, a YF mass vaccination campaign was conducted and vector control implemented in parts of South Kordofan. Surveillance data were obtained from the Sudan Federal Ministry of Health. Clinical information and serum samples were obtained from a subset of patients with illness during the outbreak. Nomads, health personnel and village chiefs were interviewed about the outbreak. Mosquitoes were collected in 11 villages and towns in North and South Kordofan. From 10 September to 9 December 2005 a total of 605 cases of outbreak-related illness were reported, of which 45% were in nomads. Twenty-nine percent of 177 patients seen at clinics in Julud and Abu Jubaiyah had illness consistent with YF. Five of 18 unvaccinated persons with recent illness and 4 of 16 unvaccinated asymptomatic persons had IgM antibodies to YF virus. IgM antibodies to chikungunya virus were detected in five (27%) ill persons and three (19%) asymptomatic persons. These results indicate that both chikungunya and YF occurred during the outbreak. PMID:18502458

Gould, L Hannah; Osman, Magdi S; Farnon, Eileen C; Griffith, Kevin S; Godsey, Marvin S; Karch, Said; Mulenda, Basimike; El Kholy, Amgad; Grandesso, Francesco; de Radiguès, Xavier; Brair, Maria-Emanuela; Briand, Sylvie; El Tayeb, El Sadig Mahgoub; Hayes, Edward B; Zeller, Herve; Perea, William



Pictorial Key for the Identification of the Mosquitoes Associated with Yellow Fever in Africa.  

National Technical Information Service (NTIS)

A pictorial key was developed as a training aid for the identification of the adults of 15 species of mosquitoes involved in the transmission of yellow fever virus in Africa. Included are 14 species of Aedes (subgenera Aedimorphus, Diceromyia and Stegomyi...

R. A. Ward Y. Huang




Microsoft Academic Search

The first recorded outbreak of yellow fever in Kenya occurred from mid-1992 through March 1993 in the south Kerio Valley, Rift Valley Province. We conducted entomologic studies in February-March 1993 to identify the likely vectors and determine the potential for transmission in the surrounding rural and urban areas. Mosquitoes were collected by landing capture and processed for virus isolation. Container



Detection of yellow fever virus: a comparison of quantitative real-time PCR and plaque assay  

Microsoft Academic Search

Yellow fever virus quantitation is performed routinely by cultivation of virus containing samples using susceptible cells. Counting of the resulting plaques provides a marker for the number of infectious particles present in the sample. This assay usually takes up to 5 days before results are obtained and must be carried out under L2 or L3 laboratory conditions, depending on the

Hi-Gung Bae; Andreas Nitsche; Anette Teichmann; Stefan S. Biel; Matthias Niedrig



Complete nucleotide sequence of yellow fever virus vaccine strains 17DD and 17D-213  

Microsoft Academic Search

The complete nucleotide sequence of the genome from two yellow fever (YF) virus vaccine strains, 17DD and 17D-213, has been determined. Comparison of these sequences with those of other YF viruses including the parental virulent Asibi strain allowed the identification of 48 nucleotide sequence differences which are common to all 17D substrains. This is a significant reduction from the 67

Claudia N. Duarte dos Santos; Paulo R. Post; Ricardo Carvalho; Idevaldo I. Ferreira; Charles M. Rice; Ricardo Galler



Genetic Variation in Yellow Fever Virus: Duplication in the 3? Noncoding Region of Strains from Africa  

Microsoft Academic Search

The nucleotide sequences of three regions of the genomes of 13 yellow fever (YF) virus isolates were determined to define genetic variation and evolution of the virus. Phylogenetic trees generated from sequences of either the 5? terminal 1320 nucleotides of the genome, 754 nucleotides from the NS4A and NS4B genes, or the 3? terminal 511 nucleotides were very similar and

Eryu Wang; Scott C. Weaver; Robert E. Shope; Robert B. Tesh; Douglas M. Watts; Alan D. T. Barrett



The Aquaporin Gene Family of the Yellow Fever Mosquito, Aedes aegypti  

Microsoft Academic Search

BackgroundThe mosquito, Aedes aegypti, is the principal vector of the Dengue and yellow fever viruses. During feeding, an adult female can take up more than its own body weight in vertebrate blood. After a blood meal females excrete large amounts of urine through their excretion system, the Malpighian tubules (MT). Diuresis starts within seconds after the mosquito starts feeding. Aquaporins

Lisa L. Drake; Dmitri Y. Boudko; Osvaldo Marinotti; Victoria K. Carpenter; Angus L. Dawe; Immo A. Hansen; Pedro Lagerblad Oliveira



Stable Transformation of the Yellow Fever Mosquito, Aedes aegypti, with the Hermes Element from the Housefly  

Microsoft Academic Search

The mosquito Aedes aegypti is the world's most important vector of yellow fever and dengue viruses. Work is currently in progress to control the transmission of these viruses by genetically altering the capacity of wild Ae. aegypti populations to support virus replication. The germline transformation system reported here constitutes a major advance toward the implementation of this control strategy. A

Nijole Jasinskiene; Craig J. Coates; Mark Q. Benedict; Anthony J. Cornel; Cristina Salazar Rafferty; Anthony A. James; Frank H. Collins



The Effect of Lactic Acid on Odour-Related Host Preference of Yellow Fever Mosquitoes  

Microsoft Academic Search

In a behavioural study we have investigated the role of lactic acid for the host preferences of yellow fever mosquitoes (Aedes aegypti) by comparing the attractiveness of rubbings from the hands of different human individuals and extracts obtained from skin rubbings from different mammals (Bos primigenius f. taurus, Capra aegagrus f. hircus, Felis silvestris f. catus and Homo sapiens). Certain

Birgit M. Steib; Martin Geier; Jürgen Boeckh



Size Heterogeneity in the 3' Noncoding Region of South American Isolates of Yellow Fever Virus  

Microsoft Academic Search

The 3 noncoding region (3 NCR) of flaviviruses contains secondary and tertiary structures essential for virus replication. Previous studies of yellow fever virus (YFV) and dengue virus have found that modifications to the 3 NCR are sometimes associated with attenuation in vertebrate and\\/or mosquito hosts. The 3 NCRs of 117 isolates of South American YFV have been examined, and major

Juliet E. Bryant; Pedro F. C. Vasconcelos; Rene C. A. Rijnbrand; J. P. Mutebi; Stephen Higgs; Alan D. T. Barrett



The safety of yellow fever vaccine 17D or 17DD in children, pregnant women, HIV+ individuals, and older persons: systematic review.  


Yellow fever vaccine provides long-lasting immunity. Rare serious adverse events after vaccination include neurologic or viscerotropic syndromes or anaphylaxis. We conducted a systematic review of adverse events associated with yellow fever vaccination in vulnerable populations. Nine electronic bibliographic databases and reference lists of included articles were searched. Electronic databases identified 2,415 abstracts for review, and 32 abstracts were included in this review. We identified nine studies of adverse events in infants and children, eight studies of adverse events in pregnant women, nine studies of adverse events in human immunodeficiency virus-positive patients, five studies of adverse events in persons 60 years and older, and one study of adverse events in individuals taking immunosuppressive medications. Two case studies of maternal-neonate transmission resulted in serious adverse events, and the five passive surveillance databases identified very small numbers of cases of yellow fever vaccine-associated viscerotropic disease, yellow fever vaccine-associated neurotropic disease, and anaphylaxis in persons ? 60 years. No other serious adverse events were identified in the other studies of vulnerable groups. PMID:22302874

Thomas, Roger E; Lorenzetti, Diane L; Spragins, Wendy; Jackson, Dave; Williamson, Tyler



Evolutionary and ecological factors underlying the tempo and distribution of yellow fever virus activity.  


Yellow fever virus (YFV) is historically one of the most important viruses to affect human populations. Despite the existence of highly effective vaccines for over 70 years, yellow fever remains a significant and re-emerging cause of morbidity and mortality in endemic and high-risk regions of South America and Africa. The virus may be maintained in sylvatic enzootic/epizootic, transitional and urban epidemic transmission cycles with geographic variation in terms of levels of genetic diversity, the nature of transmission cycles and patterns of outbreak activity. In this review we consider evolutionary and ecological factors underlying YFV emergence, maintenance and spread, geographic distribution and patterns of epizootic/epidemic activity. PMID:22981999

Carrington, Christine V F; Auguste, Albert J



Neutralization of Yellow Fever Virus Studied Using Monoclonal and Polyclonal Antibodies  

Microsoft Academic Search

SUMMARY Monoclonal and polyclonal antibodies with known specificity for either the 54K envelope glycoprotein or the 48K non-structural glycoprotein of yellow fever (YF) virus-infected cells were studied in plaque reduction neutralization tests. Viruses employed in the tests comprised wild-type and vaccine strains of YF and a selection of other flaviviruses. Of 17 monoclonal antibodies examined, six of the 54K-specific antibodies

A. Buckley; E. A. Gould



The In Vivo Differentiation of Strains of Yellow Fever Virus in Mice  

Microsoft Academic Search

SUMMARY Strains of yellow fever virus isolated since I927 in Africa and the Americas, and strains derived from them, have been differentiated by the responses of mice of different ages to intraperitoneal (i.p.) or intracerebral (i.c.) infection. Infection, antibody conversion, protection and death have been presented on age-dose response phase diagrams that serve as in vivo 'fingerprints' for the differentiation

R. Fitzgeorge; C. J. Bradish



A rapid test for measuring the infectivity of Yellow Fever vaccine  

Microsoft Academic Search

An in-house reference preparation of 17D-204 Yellow Fever vaccine was tested 60 times using LD50 mouse assay and CCID50 method. The mean virus titre, standard deviation and coefficient of variation obtained were comparable. Student's t-test indicated that there was a statistically insignificant difference between the two methods (p > 0.05) used for potency test with a correlation coefficient of 0.666

D. K. Sood; R. K. Aggarwal; S. Kumar; J. Sokhey



Genome analysis and phylogenetic relationships between east, central and west African isolates of Yellow fever virus  

Microsoft Academic Search

Yellow fever virus (YFV), a reemerging disease agent in Africa and South America, is the prototype member of the genus Flavivirus. Based on examination of the prM\\/M, E and 39 non-coding regions of the YFV genome, previous studies have identified seven genotypes of YFV, including the Angolan, east\\/central African and east African genotypes, which are highly divergent from the prototype

Jana J. von Lindern; Sarah Aroner; Nicholas D. Barrett; Jason A. Wicker; C. Todd Davis; Alan D. T. Barrett



Molecular Characterization of a Hamster Viscerotropic Strain of Yellow Fever Virus  

Microsoft Academic Search

A hamster viscerotropic strain of yellow fever (YF) virus has been derived after serial passage of strain Asibi through hamsters. The parental Asibi\\/hamster p0 virus causes a mild and transient viremia in hamsters with no outward, clinical signs of illness. In contrast, the viscerotropic Asibi\\/hamster p7 virus causes a robust viremia, severe illness, and death in subadult hamsters. The genome

Monica A. McArthur; Miguel T. Suderman; John-Paul Mutebi; Shu-Yuan Xiao; Alan D. T. Barrett



Neurovirulence of yellow fever 17DD vaccine virus to rhesus monkeys  

Microsoft Academic Search

The yellow fever 17D virus is attenuated and used for human vaccination. Two of its substrains, 17D-204 and 17DD, are used for vaccine production. One of the remarkable properties of this vaccine is limited viral replication in the host but with significant dissemination of the viral mass, yielding a robust and long-lived neutralizing antibody response. The vaccine has excellent records

Renato S Marchevsky; Marcos S Freire; Evandro S. F Coutinho; Ricardo Galler



Attenuation of Recombinant Yellow Fever 17D Viruses Expressing Foreign Protein Epitopes at the Surface  

Microsoft Academic Search

The yellow fever (YF) 17D vaccine is a live attenuated virus. Three-dimensional (3D) homology modeling of the E protein structure from YF 17D virus and its comparison with that from tick-borne encephalitis virus revealed that it is possible to accommodate inserts of different sizes and amino acid compositions in the flavivirus E protein fg loop. This is consistent with the

Myrna C. Bonaldo; Richard C. Garratt; Renato S. Marchevsky; Evandro S. F. Coutinho; Alfredo V. Jabor; L. F. C. Almeida; A. M. Y. Yamamura; A. S. Duarte; P. J. Oliveira; J. O. P. Lizeu; L. A. B. Camacho; M. S. Freire; R. Galler



Fever revealing Behçet's disease: Two new cases.  


Behçet's disease (BD) is an uncommon cause of fever of unknown origin. We report two cases, both involving 42-year-old males, who initially presented with prolonged fever and who were ultimately diagnosed as having BD after a delay of 12 and 21 months, respectively. Both patients developed pulmonary aneurysms. Although fevers resolved after therapy, both patients died within the first year after diagnosis. Clinicians should be aware that long-term fever may be an inaugural sign of BD, especially in individuals living in countries along the ancient Silk Road or Mediterranean basin. PMID:17338968

Harmouche, H; Maamar, M; Sahnoune, I; Tazi-Mezalek, Z; Aouni, M; Maaouni, A



Advanced age a risk factor for illness temporally associated with yellow fever vaccination.  

PubMed Central

In 1998, the Centers for Disease Control and Prevention was notified of severe illnesses and one death, temporally associated with yellow fever (YF) vaccination, in two elderly U.S. residents. Because the cases were unusual and adverse events following YF vaccination had not been studied, we estimated age-related reporting rates for systemic illness following YF vaccination. We found that the rate of reported adverse events among elderly vaccinees was higher than among vaccinees 25 to 44 years of age. We also found two additional deaths among elderly YF vaccinees. These data signal a potential problem but are not sufficient to reliably estimate incidence rates or to understand potential underlying mechanisms; therefore, enhanced surveillance is needed. YF remains an important cause of severe illness and death, and travel to disease-endemic regions is increasing. For elderly travelers, the risk for severe illness and death due to YF infection should be balanced against the risk for systemic illness due to YF vaccine.

Martin, M.; Weld, L. H.; Tsai, T. F.; Mootrey, G. T.; Chen, R. T.; Niu, M.; Cetron, M. S.




Technology Transfer Automated Retrieval System (TEKTRAN)

Sustained, heavy East African rainfall is associated with Aedes spp. breeding in Kenyan grasslands and Rift Valley Fever (RVF) epidemics. Validated RVF forecasts use satellite measurements of vegetation greenness (which increases after heavy rains) and other eco-climate indicators. These models may ...


Immunity and immune response, pathology and pathologic changes: progress and challenges in the immunopathology of yellow fever.  


Yellow fever is a viral hemorrhagic fever, which affects people living in Africa and South America and is caused by the yellow fever virus, the prototype species in the Flavivirus genus (Flaviviridae family). Yellow fever virus infection can produce a wide spectrum of symptoms, ranging from asymptomatic infection or oligosymptomatic illness to severe disease with a high fatality rate. In this review, we focus in the mechanisms associated with the physiopathology of yellow fever in humans and animal models. It has been demonstrated that several factors play a role in the pathological outcome of the severe form of the disease including direct viral cytopathic effect, necrosis and apoptosis of hepatocyte cells in the midzone, and a minimal inflammatory response as well as low-flow hypoxia and cytokine overproduction. New information has filled several gaps in the understanding of yellow fever pathogenesis and helped comprehend the course of illness. Finally, we discuss prospects for an immune therapy in the light of new immunologic, viral, and pathologic tools. PMID:23873723

Quaresma, Juarez A S; Pagliari, Carla; Medeiros, Daniele B A; Duarte, Maria I S; Vasconcelos, Pedro F C



Isolation of yellow fever virus from mosquitoes in Misiones province, Argentina.  


Yellow fever (YF) is a viral hemorrhagic fever endemic to tropical regions of South America and Africa. From 2007 to 2009 an important epidemic/epizootic of YF was detected in different populations of howler monkeys (Alouatta species) in Misiones, a northeastern Argentinian province. Yellow fever virus (YFV) infection was researched and documented by laboratory tests in humans and in dead Alouatta carayá. The objective of that research was to investigate the circulation of YFV in mosquitoes, which could be implicated in the sylvatic transmission of YF in Argentina. The above-mentioned mosquitoes were captured in the same geographical region where the epizootic took place. A YFV strain was isolated in cell culture from pools of Sabethes albiprivus. This study is not only the first isolation of YFV from mosquitoes in Argentina, but it is also the first YFV isolation reported in the species Sabethes albiprivus, suggesting that this species might be playing a key role in sylvatic YF in Argentina. PMID:23025694

Goenaga, Silvina; Fabbri, Cintia; Dueñas, Juan Climaco Rondan; Gardenal, Cristina Noemí; Rossi, Gustavo Carlos; Calderon, Gladys; Morales, Maria Alejandra; Garcia, Jorge Braulio; Enria, Delia Alcira; Levis, Silvana



Yellow Fever: Victor, Victoria, Conqueror, Conquest, Epidemics and Research in the Last Forty Years and Prospects for the Future. (Reannouncement with New Availability Information).  

National Technical Information Service (NTIS)

Yellow fever once ranked among the greatest of human afflictions, conquered attempts at colonial settlement and economic development, and caused epidemics with much suffering in towns and cities as far north as Boston and Swansea. The conquest of yellow f...

T. P. Monath




PubMed Central

Monkeys and mice surviving cerebral infection with yellow fever virus of relatively avirulent strains have been found to resist maximal intracerebral doses of yellow fever virus of a highly neurotropic strain. Such animals, however, do not resist more than very small doses of intracerebrally inoculated virus of Eastern equine encephalomyelitis. Animals immunized by extraneural routes, on the other hand, are not uniformly resistant to neural infection with neurotropic yellow fever virus. Monkeys which have undergone systemic infection with virus of the avirulent 17D strain or of several jungle strains resist only small intracerebral doses of neurotropic virus; while mice, even when possessed of very high serum-antibody levels as the result of intraperitoneal hyperimmunization, manifest only an irregular resistance to intracerebral challenge inocula. The difference in the resistance of neurally and extraneurally immunized animals is not related to similar differences in the levels of protective antibody in the sera. Indeed, the average of the serum-antibody titers of the hyperimmune mice is several times that of the intracerebral immunes. A possibly significant relation does exist, however, between the resistance of mice to neural infection and the content of protective antibody in the brain. The protective activity of suspensions of brains from mice surviving cerebral infection was found to be several times that of brain suspensions from the hyperimmunized animals. It is concluded that the superior resistance to neural infection of animals whose immunity results from a previous non-fatal infection of the nervous system is effected by a specific local mechanism which is based at least in part upon an increased concentration of antibody in the cerebral tissue.

Fox, John P.



[Q fever. Description of a case].  


Q fever is a zoonosis of global distribution with an incidence of 3 cases per 100,000 inhabitants/year. A variety of animals can be the coxiella reservoir which always must be taken into account when faced with a fever process in a compatible context. Rapid diagnosis and treatment are essential to improve the prognosis, and prevent the development of chronic infection or other potential complications associated with the coxelliosis. PMID:23834984

Peña-Irún, A; González Santamaría, A R; Munguía Rozadilla, F; Herrero González, J L



Sowing the seeds of neo-imperialism: the Rockefeller Foundation's yellow fever campaign in Mexico.  


The Rockefeller Foundation's campaign against yellow fever in Mexico sought to advance the economic and political interests of U.S. capitalism. The campaign was implemented at a time of strong anti-American sentiments on the part of the Mexican people. With no diplomatic relationships between Mexico and the United States, the Rockefeller Foundation presented its campaign as an international commitment. Thus, Foundation doctors became the most salient U.S. diplomats. At the same time they made sure that the Mexican yellow fever would not spread to the United States through the southern border. The by-products of the campaign went beyond the political arena. Special techniques to combat the vectors allowed the Rockefeller Foundation's brigades to change the anti-American sentiments of the people. When the campaign ended, the Foundation had already set in place the foundation for the modern Mexican health care system. Benefits from the campaign also accrued to President Obregón, who used the campaign to strengthen his position of power. Mexican doctors adopting a pro-American attitude also allied with the Rockefeller Foundation to gain reputation and power within the emerging Mexican State. PMID:1644514

Solórzano, A



[A rare case of arthritis and fever].  


We present the case report ofa 28 year old male presenting with recurrent fever episodes and arthralgia. Based on the presence of an inflammatory syndrome, a hyperferritinemia, a salmon-pink rash and recurrent fever episodes, the diagnosis of an adult onset Still's disease (AOSD) was made. A treatment with corticosteroids was started. During the following years, the corticosteroids could not be tapered. Eventually, a treatment with anakinra, an interleukin 1 (IL-1) receptor antagonist was started, allowing tapering of the corticosteroids. This case report supports the possible role of IL-1 in the pathogenesis ofAOSD, possibly through the inflammasome. PMID:24053103

Rinkin, C; Van Durme, C; Fautrel, B; Malaise, M


Travel characteristics and yellow fever vaccine usage among US Global TravEpiNet travelers visiting countries with risk of yellow fever virus transmission, 2009-2011.  


Yellow fever (YF) vaccine-associated serious adverse events and changing YF epidemiology have challenged healthcare providers to vaccinate only travelers whose risk of YF during travel is greater than their risk of adverse events. We describe the travel characteristics and YF vaccine use among US travelers visiting Global TravEpiNet clinics from January of 2009 to March of 2011. Of 16,660 travelers, 5,588 (34%) had itineraries to areas with risk of YF virus transmission. Of those travelers visiting one country with YF risk (N = 4,517), 71% were vaccinated at the visit, and 20% were presumed to be immune from prior vaccination. However, travelers visiting friends and relatives (odds ratio [OR] = 2.57, 95% confidence interval [95% CI] = 1.27-5.22) or going to Nigeria (OR = 3.01, 95% CI = 1.37-6.62) were significantly more likely to decline vaccination. To optimize YF vaccine use, clinicians should discuss an individual's risk-benefit assessment of vaccination and close knowledge gaps regarding vaccine use among at-risk populations. PMID:23458961

Jentes, Emily S; Han, Pauline; Gershman, Mark D; Rao, Sowmya R; LaRocque, Regina C; Staples, J Erin; Ryan, Edward T



Geographic distribution and evolution of yellow fever viruses based on direct sequencing of genomic cDNA fragments  

Microsoft Academic Search

We have compared the nucleotide sequence of an envelope protein gene fragment encoding amino acids 291 to 406 of 22 yellow fever (YF) virus strains of diverse geographic and host origins isolated over a 63 year time span. The nucleotide fragment of viral RNA was examined by direct sequencing ofa PCR product derived from complementary DNA. Alignment with the proto-

Loic Lepiniec; Lynn Dalgarno; V. T. Q. Huong; T. P. Monath; J.-P. Digoutte; V. Deubel



Effect of a Nuclease-Resistant Derivative of Poly I.Poly C on Yellow Fever in Rhesus Monkeys.  

National Technical Information Service (NTIS)

Monkeys treated with a newly developed nuclease-resistant complex of poly I.poly C, poly-l-lysine and carboxymethylcellulose (poly ICLC) did not die following challenge with virulent Asibi strain yellow fever (YF) virus. This strain of virus is sensitive ...

E. L. Stephen M. L. Sammons W. L. Pannier S. Baron R. O. Spertzel



Yellow Fever Virus NS3 Plays an Essential Role in Virus Assembly Independent of Its Known Enzymatic Functions  

Microsoft Academic Search

In flaviviruses it has been proposed that there is a coupling between genome replication and virion assembly and that nonstructural proteins are involved in this process. It was previously reported that mutations in yellow fever virus (YFV) nonstructural protein NS2A blocked production of infectious virus and that this block could be released by a suppressor mutation in NS3. Here, based

Chinmay G. Patkar; Richard J. Kuhn



[Microeconomic evaluation of a mass preventive immunisation campaign against meningococcal meningitis and yellow fever in Senegal in 1997].  


Large epidemics of group A meningococcal meningitis occurred in 1995 and 1996 in several countries of the Sub-Saharan Africa zone known as the "meningitis belt", and more particularly in West Africa. Most of these countries affected by the epidemics met difficulties to set up the strategy recommended by the World Health Organization and which includes: Epidemiological surveillance and epidemic incidence threshold calculation to detect early meningitis epidemics and emergency vaccination campaigns with meningococcal A + C polysaccharide vaccine, if possible within the 4-to-6 weeks following the moment the threshold is reached. In this context of epidemics, notably in Mali, and in front of the risk of resurgence of yellow fever, the Ministry of Health of Senegal decided to conduct mass preventive immunization campaigns in 1997 against meningo- coccal meningitis and yellow fever in the districts located in the eastern part of the country and where emergency vaccination would have been difficult in case of epidemic because these area are difficult to reach. A short-term microeconomic evaluation of additional costs that are necessary to organize one of these mass preventive immunization campaigns was conducted in 1997 in the Matam District, in the Northeast part of Senegal. The method rested on value attribution and accounting procedure. The cost was defined as the monetary value of all mobilized resources to product the campaign corresponding to a plurality of charges and representing all of the effective expenses and donations. During this campaign, 85,925 people were vaccinated and a total number of 163,981 doses of both polysaccharide A + C meningococcal and yellow fever vaccines were administered within 3 weeks. Four intervention strategies were involved: Three for vaccination (mobile, fixed and outreach strategy) and one for coordination, information and training. The total cost of the campaign was 55,322.75 euros. Vaccines and solvents represented 60% of the total cost of the campaign, materiel for injection and safety of injection 26%, vaccination staff 7%, and logistics 7%. The mean cost was 0.34 euro per administered dose and 0.64 euro per vaccinee. The mean cost per administered dose of meningococcal vaccine was 0.44 euro. The mean cost of preventive meningococcal immunization was not higher than the mean cost of meningococcal vaccination during mass emergency immunization campaigns in other countries. The addition of yellow fever antigen brought down the campaign mean cost by 0.11 euro and it allowed economies of scales. Direct unit costs per administered dose were higher when people were vaccinated through the outreach strategy (0.35 euro) than when fixed and mobile strategies were used (0.318 and 0.323 euro, respectively). Costs related to transportation and staff were proportionally higher for the outreach strategy. Direct unit costs per administered dose were higher when vaccinations were done in rural areas (0.32 euro) than when done in urban areas (0.31 euro). Direct unit costs increased when the size of target communities decreased (in communities with less than 100 people to vaccinate versus 0.38 euro in communities with more than 2,000 people to vaccinate). This study allowed us to set up a method to measure, describe and analyze the costs of a mass preventive campaign. It demonstrated the economic impact of using multiple antigens during a single preventive campaign. PMID:15047438

da Silva, Alfred; Parent du Châtelet, Isabelle; Beckr Gaye, Abou; Dompnier, Jean-Pierre; Seck, Ibrahima


Safety profile of the yellow fever vaccine Stamaril®: a 17-year review.  


Since the creation by the manufacturer in 1993, of an electronic pharmacovigilance database for all spontaneous, voluntary reports of adverse events (AEs) after vaccination, 276 million doses of Stamaril® have been distributed worldwide. We review this database for the safety of Stamaril with emphasis on yellow fever (YF) vaccine associated acute viscerotropic and neurotropic diseases, anaphylaxis and on specific at risk groups: elderly adults, pregnant and lactating women and the immunosuppressed. Findings confirm that the vaccine's safety profile in routine practice is favorable and consistent with the summary of product characteristics. Estimated reporting rates of serious adverse events associated after Stamaril vaccination are lower than the previously published and widely cited estimates of the worldwide reporting rate for YF vaccines in general. These data provide important additional information for the prescribers in assessing the risks and benefits associated with the use of Stamaril in individuals exposed to YF virus. PMID:24066727

Cottin, Pascale; Niedrig, Matthias; Domingo, Cristina



Multivariate discrimination between two cryptic Haemagogus species associated with the transmission of yellow fever virus in the Americas.  


Mosquitoes of the genus Haemagogus are important vectors of yellow fever virus and other arboviruses and are the principal reservoirs of these viruses in nature. Haemagogus capricornii and Haemagogus janthinomys are closely related species between which females are morphologically cryptic. A morphometric study of these species was performed on male and female specimens from 14 municipalities in Brazil. Morphometric analyses were able to distinguish females. Multivariate morphometrics may be a useful tool for taxonomic studies of cryptic species in this group. PMID:19432064

Alencar, Jeronimo; Rodriguez-Fernández, Jaime; Dégallier, Nicolas; Marcondes, Carlos Brisola; Costa, Janira Martins; Guimarães, Anthony Erico



Cell surface expression of yellow fever virus non-structural glycoprotein NS1: consequences of interaction with antibody  

Microsoft Academic Search

Among antibodies to flaviviral proteins only those directed at the virion envelope protein (E) or the non- structural glycoprotein NS1 are known to confer protection. To investigate the possible role of comple- ment-mediated cytolysis (CMC) in protection we measured the capacity of anti-NS 1, or E monospecific serum or monoclonal antibodies to bind to yellow fever virus (YFV)-infected cells and

Jacob J. Schlesinger; Michael W. Brandriss; J. Robert Putnak; Edward E. Walsh



Antennal expressed genes of the yellow fever mosquito ( Aedes aegypti L.); characterization of odorant-binding protein 10 and takeout  

Microsoft Academic Search

A small cDNA library was constructed from antennae of 100 adult male Aedes aegypti yellow fever mosquitoes. Sequencing of 80 clones identified 49 unique gene products, including a member of the Odorant Binding Protein family (Aaeg-OBP10), a homologue of Takeout (Aaeg-TO), and transposable elements of the LINE, SINE and MITE classes. Aaeg-OBP10 encodes a 140 amino acid protein including a

Jonathan Bohbot; Richard G. Vogt



Biological and Phylogenetic Characteristics of Yellow Fever Virus Lineages from West Africa  

PubMed Central

The yellow fever virus (YFV), the first proven human-pathogenic virus, although isolated in 1927, is still a major public health problem, especially in West Africa where it causes outbreaks every year. Nevertheless, little is known about its genetic diversity and evolutionary dynamics, mainly due to a limited number of genomic sequences from wild virus isolates. In this study, we analyzed the phylogenetic relationships of 24 full-length genomes from YFV strains isolated between 1973 and 2005 in a sylvatic context of West Africa, including 14 isolates that had previously not been sequenced. By this, we confirmed genetic variability within one genotype by the identification of various YF lineages circulating in West Africa. Further analyses of the biological properties of these lineages revealed differential growth behavior in human liver and insect cells, correlating with the source of isolation and suggesting host adaptation. For one lineage, repeatedly isolated in a context of vertical transmission, specific characteristics in the growth behavior and unique mutations of the viral genome were observed and deserve further investigation to gain insight into mechanisms involved in YFV emergence and maintenance in nature.

Laraway, Hewad; Faye, Ousmane; Diallo, Mawlouth; Niedrig, Matthias



Dynamic Viral Dissemination in Mice Infected with Yellow Fever Virus Strain 17D.  


Arboviruses such as yellow fever virus (YFV) are transmitted between arthropod vectors and vertebrate hosts. While barriers limiting arbovirus population diversity have been observed in mosquitoes, whether barriers exist in vertebrate hosts is unclear. To investigate whether arboviruses encounter bottlenecks during dissemination in the vertebrate host, we infected immunocompetent mice and immune-deficient mice lacking alpha/beta interferon (IFN-?/?) receptors (IFNAR(-/-) mice) with a pool of genetically marked viruses to evaluate dissemination and host barriers. We used the live attenuated vaccine strain YFV-17D, which contains many mutations compared with virulent YFV. We found that intramuscularly injected immunocompetent mice did not develop disease and that viral dissemination was restricted. Conversely, 32% of intramuscularly injected IFNAR(-/-) mice developed disease. By following the genetically marked viruses over time, we found broad dissemination in IFNAR(-/-) mice followed by clearance. The patterns of viral dissemination were similar in mice that developed disease and mice that did not develop disease. Unlike our previous results with poliovirus, these results suggest that YFV-17D encounters no major barriers during dissemination within a vertebrate host in the absence of the type I IFN response. PMID:24027319

Erickson, Andrea K; Pfeiffer, Julie K



Description of a Prospective 17DD Yellow Fever Vaccine Cohort in Recife, Brazil  

PubMed Central

From September 2005 to March 2007, 238 individuals being vaccinated for the first time with the yellow fever (YF) -17DD vaccine were enrolled in a cohort established in Recife, Brazil. A prospective study indicated that, after immunization, anti-YF immunoglobulin M (IgM) and anti-YF IgG were present in 70.6% (IgM) and 98.3% (IgG) of the vaccinated subjects. All vaccinees developed protective immunity, which was detected by the plaque reduction neutralization test (PRNT) with a geometric mean titer of 892. Of the 238 individuals, 86.6% had IgG antibodies to dengue virus; however, the presence of anti-dengue IgG did not interfere significantly with the development of anti-YF neutralizing antibodies. In a separate retrospective study of individuals immunized with the 17DD vaccine, the PRNT values at 5 and 10 years post-vaccination remained positive but showed a significant decrease in neutralization titer (25% with PRNT titers < 100 after 5 years and 35% after 10 years).

de Melo, Andrea Barbosa; da Silva, Maria da Paz C.; Magalhaes, Maria Cecilia F.; Gonzales Gil, Laura Helena Vega; Freese de Carvalho, Eduardo M.; Braga-Neto, Ulisses M.; Bertani, Giovani Rota; Marques, Ernesto T. A.; Cordeiro, Marli Tenorio



Regulation of the ribonucleotide reductase small subunit (R2) in the yellow fever mosquito, Aedes aegypti.  


Ribonucleotide reductase (RNR) catalyzes the formation of deoxyribonucleotides, a rate limiting step in DNA synthesis. Class I RNR is a tetramer that consists of two subunits, R1 and R2; enzymatic activity requires association of R1 with R2. The R2 subunit is of special interest because it dictates the interaction with R1 that is required for enzymatic activity expression, and it is expressed only during the S phase of the cell cycle. We previously sequenced an R2 cDNA clone from the yellow fever mosquito, Aedes aegypti. We found the message was upregulated by blood feeding. We now report the sequence of an R2 genomic clone. The gene consists of 4 introns and 5 exons. Both major and minor transcriptional start sites have been identified, and their use differs in sugar-fed versus blood-fed females. The gene contains putative cis-regulatory sites for E2F, Caudal (Cdx) and Dearolf (Dfd). The mosquito R2 gene contains iron-specific regulatory elements immediately upstream of the minimal promoter region. Binding of a factor to the distal putative Cdx site in the -400 region is altered by iron treatment of cells. Further, following blood feeding, R2 message is significantly induced in mosquito ovaries (tissues that are involved in oogenesis--a process requiring DNA synthesis). PMID:16530987

Pham, Daphne Q-D; Kos, Peter J; Mayo, Jonathan J; Winzerling, Joy J



Stable transformation of the yellow fever mosquito, Aedes aegypti, with the Hermes element from the housefly  

PubMed Central

The mosquito Aedes aegypti is the world’s most important vector of yellow fever and dengue viruses. Work is currently in progress to control the transmission of these viruses by genetically altering the capacity of wild Ae. aegypti populations to support virus replication. The germ-line transformation system reported here constitutes a major advance toward the implementation of this control strategy. A modified Hermes transposon carrying a 4.7-kb fragment of genomic DNA that includes a wild-type allele of the Drosophila melanogaster cinnabar (cn) gene was used to transform a white-eyed recipient strain of Ae. aegypti. Microinjection of preblastoderm mosquito embryos with this construct resulted in 50% of the emergent G0 adults showing some color in their eyes. Three transformed families were recovered, each resulting from an independent insertion event of the cn+-carrying transposon. The cn+ gene functioned as a semidominant transgene and segregated in Mendelian ratios. Hermes shows great promise as a vector for efficient, heritable, and stable transformation of this important mosquito vector species.

Jasinskiene, Nijole; Coates, Craig J.; Benedict, Mark Q.; Cornel, Anthony J.; Rafferty, Cristina Salazar; James, Anthony A.; Collins, Frank H.



First evidence of natural vertical transmission of yellow fever virus in Aedes aegypti, its epidemic vector.  


Entomological investigations were conducted in 1995 in Senegal, following a yellow fever (YF) outbreak. A total of 1125 mosquitoes collected in the field, including males, females and 12-48 h old newly emerged adults reared from wild-caught larvae, were tested for YF virus. Among the 22 species captured, Aedes aegypti was the most common. 'Wild' vectors of YF were also captured, including A. furcifer, A. metallicus and A. luteocephalus. In all, 28 YF virus isolations were made: 19 from A. aegypti females, including 2 from newly emerged specimens; 5 were obtained from A. aegypti males, including one from a pool of newly emerged specimens, 2 from A. furcifer females, and one each from a female A. metallicus and a female A. luteocephalus. The true infection rates (TIRs) were much higher in adult A. aegypti than in specimens reared from larvae--8.2% and 31.4% for female and male A. aegypti captured on human volunteers, respectively (P < 0.0001). The TIRs for A. aegypti reared from larvae were 1.4% and 0.5% for females and males, respectively (P > 0.05). This outbreak was an intermediate YF epidemic, involving 4 vector species. Our data provide the first evidence of vertical transmission of YF virus in nature by A. aegypti, its main vector to humans, and strongly suggest that vertical transmission played a major role in the spread of the epidemic. PMID:9463659

Fontenille, D; Diallo, M; Mondo, M; Ndiaye, M; Thonnon, J


Genetic lineages in the yellow fever mosquito Aedes (Stegomyia) aegypti (Diptera: Culicidae) from Peru.  


The yellow fever mosquito Aedes aegypti was introduced in Peru in 1852 and was considered to be eradicated in 1958. In 2001, Ae. aegypti had been recorded in 15 out of 24 Peruvian Departments. Peru has great ecological differences between the east and west sides of Andes. Because of this, we consider that Ae. aegypti populations of both east and west sides can have a genetically distinct population structure. In this study we examined genetic variability and genealogical relationships among three Ae. aegypti Peruvian populations: Lima, Piura (west Andes), and Iquitos (east Andes) using a fragment of the ND4 gene of the mitochondrial genome. Three haplotypes were detected among 55 samples. Lima and Iquitos showed the same haplotype (Haplotype I), whereas Piura has two haplotypes (Haplotype II and III). Haplotype II is four mutational steps apart from Haplotype I, while Haplotype III is 13 mutational steps apart from Haplotype I in the network. The analysis of molecular variation showed that mostly of the detected genetic variation occurs at interpopulational level. The significant value Phi(st) suggests that Piura population is structured in relation to Lima and Iquitos populations and the gene flow of the ND4 is restricted in Piura when compared to Lima and Iquitos. Genetic relationship between haplotype I and haplotype II suggests introduction of the same mtDNA lineage into those localities. However the existence of a genetically distant haplotype III also suggests introduction of at least two Ae. aegypti lineages in Peru. PMID:16302064

da Costa-da-Silva, André Luis; Capurro, Margareth Lara; Bracco, José Eduardo



Circulation of antibodies against yellow fever virus in a simian population in the area of Porto Primavera Hydroelectric Plant, São Paulo, Brazil.  


Yellow fever (YF) is an acute viral infectious disease transmitted by mosquitoes which occurs in two distinct epidemiological cycles: sylvatic and urban. In the sylvatic cycle, the virus is maintained by monkey's infection and transovarian transmission in vectors. Surveillance of non-human primates is required for the detection of viral circulation during epizootics, and for the identification of unaffected or transition areas. An ELISA (enzyme-linked immunosorbent assay) was standardized for estimation of the prevalence of IgG antibodies against yellow fever virus in monkey sera (Alouatta caraya) from the reservoir area of Porto Primavera Hydroelectric Plant, in the state of São Paulo, Brazil. A total of 570 monkey sera samples were tested and none was reactive to antibodies against yellow fever virus. The results corroborate the epidemiology of yellow fever in the area. Even though it is considered a transition area, there were no reports to date of epizootics or yellow fever outbreaks in humans. Also, entomological investigations did not detect the presence of vectors of this arbovirus infection. ELISA proved to be fast, sensitive, an adequate assay, and an instrument for active search in the epidemiological surveillance of yellow fever allowing the implementation of prevention actions, even before the occurrence of epizootics. PMID:20305949

Lima, Maura Antonia; Romano-Lieber, Nicolina Silvana; Duarte, Ana Maria Ribeiro de Castro


Viral haemorrhagic fevers of man.  


This article reviews the current state of knowledge on the viral haemorrhagic fevers that infect man, namely smallpox, chikungunya fever, dengue fever, Rift Valley fever, yellow fever, Crimean haemorrhagic fever, Kyasanur Forest disease, Omsk haemorrhagic fever, Argentinian haemorrhagic fever (Junin virus), Bolivian haemorrhagic fever (Machupo virus), Lassa fever, haemorrhagic fever with renal syndrome, and Marburg and Ebola virus diseases. PMID:310725

Simpson, D I



Viral haemorrhagic fevers of man*  

PubMed Central

This article reviews the current state of knowledge on the viral haemorrhagic fevers that infect man, namely smallpox, chikungunya fever, dengue fever, Rift Valley fever, yellow fever, Crimean haemorrhagic fever, Kyasanur Forest disease, Omsk haemorrhagic fever, Argentinian haemorrhagic fever (Junin virus), Bolivian haemorrhagic fever (Machupo virus), Lassa fever, haemorrhagic fever with renal syndrome, and Marburg and Ebola virus diseases.

Simpson, D. I. H.



Pathology Case Study: Fever, Purpura and Hypotension  

NSDL National Science Digital Library

The Department of Pathology at the University of Pittsburgh Medical Center has compiled a wide range of pathology case studies to aid students and instructors in the medical/health science field. In this case, a 20 year old male college student is admitted to the emergency room with "general malaise, low-grade fever, and purplish discoloration on his face. Using the information provided, which includes patient and social history, images and descriptions from his physical exam, the hospital course and microscopic images, students are encouraged to test their knowledge of pathology and diagnose the patient's medical condition. You can check your diagnosis against the official conclusions in the "Final Diagnosis" section. This is an excellent resource for providing students experience with patient history, lab results and diagnostics.

Richert, Charles A.; Aronica, Patricia; Pasculle, A. W.; Anhalt, John P.




Technology Transfer Automated Retrieval System (TEKTRAN)

Risk analysis has five components: Risk awareness, Risk perception, Risk assessment, Risk management, and Risk communication. Using the case with the foreign plant pathogen, Puccinia jaceae, under evaluation for biological control of yellow starthistle (Centaurea solstitialis, YST), approaches and...


[Effectiveness of the yellow fever vaccine 17D: an epidemiologic evaluation in health services].  


The purpose of this study was to evaluate the efficacy of the 17D yellow fever vaccine in the conditions under which it is used in public health services. In 1989, a nonconcurrent prospective study was carried out in Bocaiúva, Minas Gerais State, Brazil, 6 months after mass vaccination of the population. The study population was made up of first-grade students from all the schools in Bocaiúva. The exposed group consisted of a simple random sample of vaccinated students (n = 173) and the unexposed group consisted of all those who had not been vaccinated (n = 55). Serum samples were examined with the neutralization test in mice; these tests were conducted blind, that is, the examiner did not know the vaccination status of the subject. The serology results were as follows: of those vaccinated, 75% were seropositive, 17% were seronegative, and 7% showed an inconclusive result; in the unvaccinated children, these results were 9%, 87%, and 4%, respectively. The age-adjusted seropositivity ratio between vaccinated and unvaccinated children was 7.6 (95% CI: 3.4 to 16.7). The proportion of seropositivity attributable to vaccination, adjusted for age, was 86.8% (95% CI: 70.6 to 94.0). The results showed that the efficacy of the vaccine, defined by means of seropositivity for the virus, was below the levels expected for the 17D vaccine. This may have been due to operational failures in the conservation or application of the vaccine. The results point to the need for routine systematic evaluations by the health services after mass utilization of the vaccine. PMID:9312418

Guerra, H L; Sardinha, T M; da Rosa, A P; Lima e Costa, M F



Attenuation of recombinant yellow fever 17D viruses expressing foreign protein epitopes at the surface.  


The yellow fever (YF) 17D vaccine is a live attenuated virus. Three-dimensional (3D) homology modeling of the E protein structure from YF 17D virus and its comparison with that from tick-borne encephalitis virus revealed that it is possible to accommodate inserts of different sizes and amino acid compositions in the flavivirus E protein fg loop. This is consistent with the 3D structures of both the dimeric and trimeric forms in which the fg loop lies exposed to solvents. We demonstrate here that YF 17D viruses bearing foreign humoral (17D/8) and T-cell (17D/13) epitopes, which vary in sequence and length, displayed growth restriction. It is hypothesized that interference with the dimer-trimer transition and with the formation of a ring of such trimers in order to allow fusion compromises the capability of the E protein to induce fusion of viral and endosomal membranes, and a slower rate of fusion may delay the extent of virus production. This would account for the lower levels of replication in cultured cells and of viremia in monkeys, as well as for the more attenuated phenotype of the recombinant viruses in monkeys. Testing of both recombinant viruses (17D/8 and 17D/13) for monkey neurovirulence also suggests that insertion at the 17D E protein fg loop does not compromise the attenuated phenotype of YF 17D virus, further confirming the potential use of this site for the development of new live attenuated 17D virus-based vaccines. PMID:15956601

Bonaldo, Myrna C; Garratt, Richard C; Marchevsky, Renato S; Coutinho, Evandro S F; Jabor, Alfredo V; Almeida, Luís F C; Yamamura, Anna M Y; Duarte, Adriana S; Oliveira, Prisciliana J; Lizeu, Jackeline O P; Camacho, Luiz A B; Freire, Marcos S; Galler, Ricardo



The Aquaporin Gene Family of the Yellow Fever Mosquito, Aedes aegypti  

PubMed Central

Background The mosquito, Aedes aegypti, is the principal vector of the Dengue and yellow fever viruses. During feeding, an adult female can take up more than its own body weight in vertebrate blood. After a blood meal females excrete large amounts of urine through their excretion system, the Malpighian tubules (MT). Diuresis starts within seconds after the mosquito starts feeding. Aquaporins (AQPs) are a family of membrane transporters that regulate the flow of water, glycerol and other small molecules across cellular membranes in both prokaryotic and eukaryotic cells. Our aim was to identify aquaporins that function as water channels, mediating transcellular water transport in MTs of adult female Ae. aegypti. Methodology/Principal Findings Using a bioinformatics approach we screened genome databases and identified six putative AQPs in the genome of Ae. aegypti. Phylogenetic analysis showed that five of the six Ae. aegypti AQPs have high similarity to classical water-transporting AQPs of vertebrates. Using microarray, reverse transcription and real time PCR analysis we found that all six AQPs are expressed in distinct patterns in mosquito tissues/body parts. AaAQP1, 4, and 5 are strongly expressed in the adult female MT. RNAi-mediated knockdown of the MT-expressed mosquito AQPs resulted in significantly reduced diuresis. Conclusions/Significance Our results support the notion that AQP1, 4, and 5 function as water transporters in the MTs of adult female Ae. aegypti mosquitoes. Our results demonstrate the importance of these AQPs for mosquito diuresis after blood ingestion and highlight their potential as targets for the development of novel vector control strategies.

Drake, Lisa L.; Boudko, Dmitri Y.; Marinotti, Osvaldo; Carpenter, Victoria K.; Dawe, Angus L.; Hansen, Immo A.



Yellow Fever/Japanese Encephalitis Chimeric Viruses: Construction and Biological Properties  

PubMed Central

A system has been developed for generating chimeric yellow fever/Japanese encephalitis (YF/JE) viruses from cDNA templates encoding the structural proteins prM and E of JE virus within the backbone of a molecular clone of the YF17D strain. Chimeric viruses incorporating the proteins of two JE strains, SA14-14-2 (human vaccine strain) and JE Nakayama (JE-N [virulent mouse brain-passaged strain]), were studied in cell culture and laboratory mice. The JE envelope protein (E) retained antigenic and biological properties when expressed with its prM protein together with the YF capsid; however, viable chimeric viruses incorporating the entire JE structural region (C-prM-E) could not be obtained. YF/JE(prM-E) chimeric viruses grew efficiently in cells of vertebrate or mosquito origin compared to the parental viruses. The YF/JE SA14-14-2 virus was unable to kill young adult mice by intracerebral challenge, even at doses of 106 PFU. In contrast, the YF/JE-N virus was neurovirulent, but the phenotype resembled parental YF virus rather than JE-N. Ten predicted amino acid differences distinguish the JE E proteins of the two chimeric viruses, therefore implicating one or more residues as virus-specific determinants of mouse neurovirulence in this chimeric system. This study indicates the feasibility of expressing protective antigens of JE virus in the context of a live, attenuated flavivirus vaccine strain (YF17D) and also establishes a genetic system for investigating the molecular basis for neurovirulence determinants encoded within the JE E protein.

Chambers, Thomas J.; Nestorowicz, Ann; Mason, Peter W.; Rice, Charles M.



Cloning and characterization of a dopachrome conversion enzyme from the yellow fever mosquito, Aedes aegypti.  


In this study we describe the purification and molecular cloning of a dopachrome conversion enzyme (DCE) from the yellow fever mosquito, Aedes aegypti. DCE catalyzes the conversion of L-dopachrome to 5,6-dihydroxyindole in the melanization pathway. Melanin biosynthesis is involved with crucial protective phenomena in mosquitoes, including egg chorion and cuticular tanning, wound healing, and the melanotic encapsulation immune response. The enzyme was purified to homogeneity by various chromatographic techniques from A. aegypti larvae and has a relative molecular mass of 51 kDa as-revealed by SDS-PAGE analysis. Physiochemical analysis of DCE revealed a pH optimum of 7.5-8.0 and substrate activity for L-dopachrome and aminochromes generated from dopa methyl ester, alpha-methyl dopa and dopamine. Trypsin digestion of the isolated DCE and subsequent reverse-phase separation resulted in the isolation of several polypeptide fragments, from which two partial internal amino acid sequences were obtained by Edman degradation. PCR amplification, using a degenerate primer based on one internal amino acid sequence and an oligo-dT primer, produced a 650 bp DNA fragment. Subsequent screening of an A. aegypti pupal cDNA library resulted in the isolation of a 1.6 kb clone containing coding sequence for both internal DCE amino acid sequences, thereby confirming the identity of the isolated gene product (pAaDce1) as DCE. Northern analysis revealed the constitutive expression of DCE message in developmental stages and adults, with the majority of transcript localized in the fat body and ovaries of adult females. AaDce1 mRNA increased in abundance above constitutive levels in adult females when a melanotic encapsulation immune response was initiated by the intrathoracic inoculation of Dirofilaria immitis microfilariae. PMID:11520691

Johnson, J K; Li, J; Christensen, B M



Recombinant Yellow Fever Viruses Elicit CD8+ T Cell Responses and Protective Immunity against Trypanosoma cruzi  

PubMed Central

Chagas’ disease is a major public health problem affecting nearly 10 million in Latin America. Despite several experimental vaccines have shown to be immunogenic and protective in mouse models, there is not a current vaccine being licensed for humans or in clinical trial against T. cruzi infection. Towards this goal, we used the backbone of Yellow Fever (YF) 17D virus, one of the most effective and well-established human vaccines, to express an immunogenic fragment derived from T. cruzi Amastigote Surface Protein 2 (ASP-2). The cDNA sequence of an ASP-2 fragment was inserted between E and NS1 genes of YF 17D virus through the construction of a recombinant heterologous cassette. The replication ability and genetic stability of recombinant YF virus (YF17D/ENS1/Tc) was confirmed for at least six passages in Vero cells. Immunogenicity studies showed that YF17D/ENS1/Tc virus elicited neutralizing antibodies and gamma interferon (IFN-?) producing-cells against the YF virus. Also, it was able to prime a CD8+ T cell directed against the transgenic T. cruzi epitope (TEWETGQI) which expanded significantly as measured by T cell-specific production of IFN-? before and after T. cruzi challenge. However, most important for the purposes of vaccine development was the fact that a more efficient protective response could be seen in mice challenged after vaccination with the YF viral formulation consisting of YF17D/ENS1/Tc and a YF17D recombinant virus expressing the TEWETGQI epitope at the NS2B-3 junction. The superior protective immunity observed might be due to an earlier priming of epitope-specific IFN-?-producing T CD8+ cells induced by vaccination with this viral formulation. Our results suggest that the use of viral formulations consisting of a mixture of recombinant YF 17D viruses may be a promising strategy to elicit protective immune responses against pathogens, in general.

Nogueira, Raquel Tayar; Nogueira, Alanderson Rocha; Pereira, Mirian Claudia Souza; Rodrigues, Mauricio Martins; Neves, Patricia Cristina da Costa; Galler, Ricardo; Bonaldo, Myrna Cristina



Fever of Unknown Origin: An Unusual Case  

PubMed Central

Recurrent episodic fever of unknown origin (FUO) arising from tumour of the gastrointestinal tract is rare. We report an otherwise healthy 62-year-old man with recurrent circumscribed bouts of fever and raised CRP for 3 years who has remained well and fever-free 2 years after the removal of a well-differentiated adenocarcinoma of the colon. Occult colonic neoplasm should be considered and sought when routine investigations for FUO are negative.

Bansal, R. A.; Hayman, G. R.; Bansal, A. S.



Gustatory receptor neuron responds to DEET and other insect repellents in the yellow-fever mosquito, Aedes aegypti  

NASA Astrophysics Data System (ADS)

Three gustatory receptor neurons were characterized for contact chemoreceptive sensilla on the labella of female yellow-fever mosquitoes, Aedes aegypti. The neuron with the smallest amplitude spike responded to the feeding deterrent, quinine, as well as N, N-diethyl-3-methylbenzamide and other insect repellents. Two other neurons with differing spikes responded to salt (NaCl) and sucrose. This is the first report of a gustatory receptor neuron specific for insect repellents in mosquitoes and may provide a tool for screening chemicals to discover novel or improved feeding deterrents and repellents for use in the management of arthropod disease vectors.

Sanford, Jillian L.; Shields, Vonnie D. C.; Dickens, Joseph C.



Yellow fever outbreak affecting Alouatta populations in southern Brazil (Rio Grande do Sul State), 2008-2009.  


The natural transmission cycle of Yellow Fever (YF) involves tree hole breeding mosquitoes and a wide array of nonhuman primates (NHP), including monkeys and apes. Some Neotropical monkeys (howler monkeys, genus Alouatta) develop fatal YF virus (YFV) infections similar to those reported in humans, even with minimum exposure to the infection. Epizootics in wild primates may be indicating YFV circulation, and the surveillance of such outbreaks in wildlife is an important tool to help prevent human infection. In 2001, surveillance activities successfully identified YF-related death in a black-and-gold howler monkey (Alouatta caraya), Rio Grande do Sul State (RGS) in southern Brazil, and the YFV was isolated from a species of forest-dwelling mosquito (Haemagogus leucocelaenus). These findings led the State Secretariat of Health to initiate a monitoring program for YF and other 18 arboviral infections in Alouatta monkeys. The monitoring program included monkey captures, reporting of monkey casualties by municipalities, and subsequent investigations. If monkey carcasses were found in forests, samples were collected in a standardized manner and this practice resulted in increased reporting of outbreaks. In October 2008, a single howler monkey in a northwestern RGS municipality was confirmed to have died from YF. From October 2008 to June 2009, 2,013 monkey deaths were reported (830 A. caraya and 1,183 A. guariba clamitans). Viruses isolation in blood, viscera, and/or immunohistochemistry led to the detection of YF in 204 of 297 (69%) (154 A. g. clamitans and 50 A. caraya) dead Alouatta monkeys tested. The number of municipalities with confirmed YFV circulation in howlers increased from 2 to 67 and 21 confirmed human cases occurred. This surveillance system was successful in identifying the largest YF outbreak affecting wild NHP ever recorded. PMID:22020690

de Almeida, Marco Antônio Barreto; Dos Santos, Edmilson; da Cruz Cardoso, Jader; da Fonseca, Daltro Fernandes; Noll, Carlos Alberto; Silveira, Vivian Regina; Maeda, Adriana Yurika; de Souza, Renato Pereira; Kanamura, Cristina; Brasil, Roosecelis Araújo



Strong alkalinization in the anterior midgut of larval yellow fever mosquitoes (Aedes aegypti): involvement of luminal Na+/K+-ATPase.  


Recently, Na(+)/K(+)-ATPase has been detected in the luminal membrane of the anterior midgut of larval yellow fever mosquitoes (Aedes aegypti) with immunohistochemical techniques. In this study, the possible involvement of this ATPase in strong alkalinization was investigated on the level of whole larvae, isolated and perfused midgut preparations and on the molecular level of the Na(+)/K(+)-ATPase protein. Ouabain (5 mM) did not inhibit the capability of intact larval mosquitoes to alkalinize their anterior midgut. Also in isolated and perfused midgut preparations the perfusion of the lumen with ouabain (5 mM) did not result in a significant change of the transepithelial voltage or the capacity of luminal alkalinization. Na(+)/K(+)-ATPase activity was completely abolished when KCl was substituted with choline chloride, suggesting that the enzyme cannot act as an ATP-driven Na(+)/H(+)-exchanger. Altogether the results of the present investigation indicate that apical Na(+)/K(+)-ATPase is not of direct importance for strong luminal alkalinization in the anterior midgut of larval yellow fever mosquitoes. PMID:19048614

Onken, Horst; Patel, Malay; Javoroncov, Margarita; Izeirovski, Sejmir; Moffett, Stacia B; Moffett, David F



Imaginal Discs - A New Source of Chromosomes for Genome Mapping of the Yellow Fever Mosquito Aedes aegypti  

PubMed Central

Background The mosquito Aedes aegypti is the primary global vector for dengue and yellow fever viruses. Sequencing of the Ae. aegypti genome has stimulated research in vector biology and insect genomics. However, the current genome assembly is highly fragmented with only ?31% of the genome being assigned to chromosomes. A lack of a reliable source of chromosomes for physical mapping has been a major impediment to improving the genome assembly of Ae. aegypti. Methodology/Principal Findings In this study we demonstrate the utility of mitotic chromosomes from imaginal discs of 4th instar larva for cytogenetic studies of Ae. aegypti. High numbers of mitotic divisions on each slide preparation, large sizes, and reproducible banding patterns of the individual chromosomes simplify cytogenetic procedures. Based on the banding structure of the chromosomes, we have developed idiograms for each of the three Ae. aegypti chromosomes and placed 10 BAC clones and a 18S rDNA probe to precise chromosomal positions. Conclusion The study identified imaginal discs of 4th instar larva as a superior source of mitotic chromosomes for Ae. aegypti. The proposed approach allows precise mapping of DNA probes to the chromosomal positions and can be utilized for obtaining a high-quality genome assembly of the yellow fever mosquito.

Sharakhova, Maria V.; Timoshevskiy, Vladimir A.; Yang, Fan; Demin, Sergei Iu.; Severson, David W.; Sharakhov, Igor V.



Lassa fever presenting as acute abdomen: a case series  

PubMed Central

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.



Three Novel Families of Miniature Inverted-Repeat Transposable Elements are Associated with Genes of the Yellow Fever Mosquito, Aedes aegypti  

Microsoft Academic Search

Three novel families of transposable elements, Wukong, Wujin, and Wuneng, are described in the yellow fever mosquito, Aedes aegypti. Their copy numbers range from 2,100 to 3,000 per haploid genome. There are high degrees of sequence similarity within each family, and many structural but not sequence similarities between families. The common structural characteristics include small size, no coding potential, terminal

Zhijian Tu



Yellow fever virus envelope protein expressed in insect cells is capable of syncytium formation in lepidopteran cells and could be used for immunodetection of YFV in human sera  

PubMed Central

Background Yellow fever is an haemorrhagic disease caused by a virus that belongs to the genus Flavivirus (Flaviviridae family) and is transmitted by mosquitoes. Among the viral proteins, the envelope protein (E) is the most studied one, due to its high antigenic potencial. Baculovirus are one of the most popular and efficient eukaryotic expression system. In this study a recombinant baculovirus (vSynYFE) containing the envelope gene (env) of the 17D vaccine strain of yellow fever virus was constructed and the recombinant protein antigenicity was tested. Results Insect cells infected with vSynYFE showed syncytium formation, which is a cytopathic effect characteristic of flavivirus infection and expressed a polypeptide of around 54 kDa, which corresponds to the expected size of the recombinant E protein. Furthermore, the recombinant E protein expression was also confirmed by fluorescence microscopy of vSynYFE-infected insect cells. Total vSynYFE-infected insect extracts used as antigens detected the presence of antibodies for yellow fever virus in human sera derived from yellow fever-infected patients in an immunoassay and did not cross react with sera from dengue virus-infected patients. Conclusions The E protein expressed by the recombinant baculovirus in insect cells is antigenically similar to the wild protein and it may be useful for different medical applications, from improved diagnosis of the disease to source of antigens for the development of a subunit vaccine.



An indirect estimation of the developmental time of Haemagogus janthinomys (Diptera: Culicidae), the main vector of yellow fever in South America  

Microsoft Academic Search

Yellow fever is a re-emergent disease in many South American countries where its main vector is Haemagogus janthinomys. Epizootics and epidemics have long been associated with the onset of the rainy season, when mosquito densities are higher. Thus, a more precise understanding of the relationship between rainfall and mosquito densities is necessary to evaluate the risk of transmission. Mosquitoes were

Nicolas Degallier; Hamilton A. De Oliveira Monteiro; Francisco C. Castro; Orlando V. Da Silva; Gregório C. S. Á. Filho; Eric Elguero



Efficacy and duration of immunity after yellow Fever vaccination: systematic review on the need for a booster every 10 years.  


Abstract. Current regulations stipulate a yellow fever (YF) booster every 10 years. We conducted a systematic review of the protective efficacy and duration of immunity of YF vaccine in residents of disease-endemic areas and in travelers to assess the need for a booster in these two settings and in selected populations (human immunodeficiency virus-infected persons, infants, children, pregnant women, and severely malnourished persons). Thirty-six studies and 22 reports were included. We identified 12 studies of immunogenicity, 8 of duration of immunity, 8 of vaccine response in infants and children, 7 of human-immunodeficiency virus-infected persons, 2 of pregnant women, and 1 of severely malnourished children. Based on currently available data, a single dose of YF vaccine is highly immunogenic and confers sustained life-long protective immunity against YF. Therefore, a booster dose of YF vaccine is not needed. Special considerations for selected populations are detailed. PMID:24006295

Gotuzzo, Eduardo; Yactayo, Sergio; Córdova, Erika





... determine the cause of the fever. Call for emergency medical assistance if a seizure lasts longer than ... around anyone who's been ill. Write down key personal information, including any major stresses, recent life changes ...




... too much fruit or apple juice and avoid sports drinks in younger children. Although eating foods with a fever ... urination Have trouble with your immune system (chronic steroid therapy, ... were being treated for cancer) Have recently traveled ...


[Two cases of acute hepatitis associated with Q fever].  


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 doxycycline for 14 days and became afebrile within four days. These cases were presented to emphasize that C.burnetii infection should be considered in the differential diagnosis of patients with fever and elevated serum transaminase levels, irrespective of the presence of abdominal pain and exposure to potentially infected animals. PMID:22951661

Ye?ilyurt, Murat; K?l?ç, Selçuk; Gürsoy, Bensu; Celebi, Bekir; Yerer, Mehmet



[Dengue Fever cases in czech workers returning from the maldives].  


Aim: 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.Material and Methods: 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. Results: 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. Conclusion: 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 by another serotype. Furthermore, sick leaves or premature departures cause a considerable economic burden to employers. In the diagnosis of acute dengue fever, preference should be given to highly sensitive and specific tests for the direct detection of dengue virus (NS1 antigen and RT-PCR assays). Keywords: dengue - flaviviruses - imported infections - fever. PMID:24116697

Trojánek, Milan; Tomí?ková, Dora; Rohá?ová, Hana; Kosina, Pavel; Gebouský, Jan; Dvo?ák, Jan; Chmelik, Vaclav; Batistová, Kv?toslava; Husa, Petr; Maixner, Jan; Sojková, Nad?žda; Zelená, Hana; Marešová, Vilma; Stejskal, František



Efficient transformation of the yellow fever mosquito Aedes aegypti using the piggyBac transposable element vector pBac[3xP3-EGFP afm  

Microsoft Academic Search

We report efficient germ-line transformation in the yellow fever mosquito Aedes aegypti accomplished using the piggyBac transposable element vector pBac[3xP3-EGFP afm]. Two transgenic lines were established and characterized; each contained the Vg-Defensin A transgene with strong eye-specific expression of the enhanced green fluorescent protein (EGFP) marker gene regulated by the artificial 3xP3 promoter. Southern blot hybridization and inverse PCR analyses

V. Kokoza; A. Ahmed; E. A. Wimmer; A. S. Raikhel



Mutation in a 17D-204 Vaccine Substrain-Specific Envelope Protein Epitope Alters the Pathogenesis of Yellow Fever Virus in Mice  

Microsoft Academic Search

The heterogeneous nature of the yellow fever (YF) 17D-204 vaccine virus population was exploited in this study to isolate virus variants able to escape neutralization by the 17D-204 vaccine-specific MAb 864. The conformational change on the virus surface that resulted in the loss of the MAb 864-defined epitope was effected in each variant by a single amino acid mutation in

Kate D. Ryman; T. Neil Ledger; Gerald A. Campbell; Alan D. T. Barrett



Neutralizing (54K) and Non-neutralizing (54K and 48K) Monoclonai Antibodies against Structural and Non-structural Yellow Fever Virus Proteins Confer Immunity in Mice  

Microsoft Academic Search

SUMMARY The capacity of monoclonal antibodies to protect mice passively against yellow fever (YF) virus infection was investigated. Both neutralizing (54K-specific) and non- neutralizing (54K- and 48K-specific) antibodies protected mice against challenge with the RMP substrain of YF virus. Average survival times of mice inoculated intracerebrally with a standard lethal dose of YF virus differed according to the strain used:



Comparison of the genomes of the wild-type French viscerotropic strain of yellow fever virus with its vaccine derivative French neurotropic vaccine  

Microsoft Academic Search

The French neurotropic vaccine, or FNV, was used extensively in Africa to control yellow fever (YF). Although efficacious, the vaccine caused an unaccept- able rate of post-vaccinal complications in children and was subsequently replaced by the 17D vaccine. Here we report that the genomes of the wild-type YF virus French viscerotropic virus and its attenuated vaccine derivative, FNV virus from

Eryu Wang; Kate D. Ryman; Alan D. Jennings; David J. Wood; F. Taffs; Philip D. Minor; Peter G. Sanders; Alan D. T. Barrett



Mutagenesis of the N-Linked Glycosylation Sites of the Yellow Fever Virus NS1 Protein: Effects on Virus Replication and Mouse Neurovirulence  

Microsoft Academic Search

The flavivirus nonstructural glycoprotein NS1 is highly conserved and contains two N-linked glycosylation sites which are both utilized for addition of oligosaccharides during replication in cell culture. NS1 has been shown to contain epitopes for protective antibodies; however, its roles in virus replication and pathogenesis remain unknown. To study the function of NS1 during yellow fever virus replication, six mutant

Isabella R. Muylaert; Thomas J. Chambers; Ricardo Galler; Charles M. Rice



Impact of yellow fever outbreaks on two howler monkey species (Alouatta guariba clamitans and A. caraya) in Misiones, Argentina.  


Two yellow fever outbreaks (YFOs) occurred in northeastern Argentina between November 2007 and October 2008, seriously affecting populations of two howler monkey species: the brown howler Alouatta guariba clamitans and the black howler Alouatta caraya. Both howlers live syntopically in El Piñalito Provincial Park, Misiones, where four groups (36 individuals) were studied since January 2005. The first dead howlers were found on January 20, 2008, in El Piñalito. Systematic searches found 14 dead howlers within the area (12 from the study groups and two from neighboring groups), with only two young seen on January 25, 2008, and none found since up to December 2008. In October 2008, another YFO hit howler monkey populations from El Soberbio, Misiones. Overall, 59 howlers were found dead in Misiones from November 2007 to December 2008. Thanks to the alert of the howler's death in El Piñalito, a prompt human vaccination campaign started in the area. Wild howler monkey populations from both species are in a delicate situation in Misiones, especially the brown howler, an already endangered species in Argentina and endemic to the Atlantic Forest. If we add the recurrence of YFOs to the reduction of suitable habitat to small fragments, it could be only a matter of time until howler populations disappear from the Upper Paraná Atlantic Forest in Misiones. PMID:20095025

Holzmann, Ingrid; Agostini, Ilaria; Areta, Juan Ignacio; Ferreyra, Hebe; Beldomenico, Pablo; Di Bitetti, Mario S



Impact of Wolbachia on Infection with Chikungunya and Yellow Fever Viruses in the Mosquito Vector Aedes aegypti  

PubMed Central

Incidence of disease due to dengue (DENV), chikungunya (CHIKV) and yellow fever (YFV) viruses is increasing in many parts of the world. The viruses are primarily transmitted by Aedes aegypti, a highly domesticated mosquito species that is notoriously difficult to control. When transinfected into Ae. aegypti, the intracellular bacterium Wolbachia has recently been shown to inhibit replication of DENVs, CHIKV, malaria parasites and filarial nematodes, providing a potentially powerful biocontrol strategy for human pathogens. Because the extent of pathogen reduction can be influenced by the strain of bacterium, we examined whether the wMel strain of Wolbachia influenced CHIKV and YFV infection in Ae. aegypti. Following exposure to viremic blood meals, CHIKV infection and dissemination rates were significantly reduced in mosquitoes with the wMel strain of Wolbachia compared to Wolbachia-uninfected controls. However, similar rates of infection and dissemination were observed in wMel infected and non-infected Ae. aegypti when intrathoracic inoculation was used to deliver virus. YFV infection, dissemination and replication were similar in wMel-infected and control mosquitoes following intrathoracic inoculations. In contrast, mosquitoes with the wMelPop strain of Wolbachia showed at least a 104 times reduction in YFV RNA copies compared to controls. The extent of reduction in virus infection depended on Wolbachia strain, titer and strain of the virus, and mode of exposure. Although originally proposed for dengue biocontrol, our results indicate a Wolbachia-based strategy also holds considerable promise for YFV and CHIKV suppression.

van den Hurk, Andrew F.; Hall-Mendelin, Sonja; Pyke, Alyssa T.; Frentiu, Francesca D.; McElroy, Kate; Day, Andrew; Higgs, Stephen; O'Neill, Scott L.



Impact of Wolbachia on infection with chikungunya and yellow fever viruses in the mosquito vector Aedes aegypti.  


Incidence of disease due to dengue (DENV), chikungunya (CHIKV) and yellow fever (YFV) viruses is increasing in many parts of the world. The viruses are primarily transmitted by Aedes aegypti, a highly domesticated mosquito species that is notoriously difficult to control. When transinfected into Ae. aegypti, the intracellular bacterium Wolbachia has recently been shown to inhibit replication of DENVs, CHIKV, malaria parasites and filarial nematodes, providing a potentially powerful biocontrol strategy for human pathogens. Because the extent of pathogen reduction can be influenced by the strain of bacterium, we examined whether the wMel strain of Wolbachia influenced CHIKV and YFV infection in Ae. aegypti. Following exposure to viremic blood meals, CHIKV infection and dissemination rates were significantly reduced in mosquitoes with the wMel strain of Wolbachia compared to Wolbachia-uninfected controls. However, similar rates of infection and dissemination were observed in wMel infected and non-infected Ae. aegypti when intrathoracic inoculation was used to deliver virus. YFV infection, dissemination and replication were similar in wMel-infected and control mosquitoes following intrathoracic inoculations. In contrast, mosquitoes with the wMelPop strain of Wolbachia showed at least a 10(4) times reduction in YFV RNA copies compared to controls. The extent of reduction in virus infection depended on Wolbachia strain, titer and strain of the virus, and mode of exposure. Although originally proposed for dengue biocontrol, our results indicate a Wolbachia-based strategy also holds considerable promise for YFV and CHIKV suppression. PMID:23133693

van den Hurk, Andrew F; Hall-Mendelin, Sonja; Pyke, Alyssa T; Frentiu, Francesca D; McElroy, Kate; Day, Andrew; Higgs, Stephen; O'Neill, Scott L



A Possible Connection between the 1878 Yellow Fever Epidemic in the Southern United States and the 1877-78 El Nin??o Episode  

USGS Publications Warehouse

One of the most severe outbreaks of yellow fever, a viral disease transmitted by the Aedes aegypti mosquito, affected the southern United States in the summer of 1878. The economic and human toll was enormous, and the city of Memphis, Tennessee, was one of the most affected. The authors suggest that as a consequence of one of the strongest El Nin??o episodes on record - that which occurred in 1877-78 - exceptional climate anomalies occurred in the United States (as well as in many other parts of the world), which may have been partly responsible for the widespread nature and severity of the 1878 yellow fever outbreak. This study documents some of the extreme climate anomalies that were recorded in 1877 and 1878 in parts of the eastern United States, with particular emphasis on highlighting the evolution of these anomalies, as they might have contributed to the epidemic. Other years with major outbreaks of yellow fever in the eighteenth and nineteenth centuries also occurred during the course of El Nin??o episodes, a fact that appears not to have been noted before in the literature.

Diaz, H. F.; McCabe, G. J.



A Possible Connection between the 1878 Yellow Fever Epidemic in the Southern United States and the 1877-78 El Niño Episode.  

NASA Astrophysics Data System (ADS)

One of the most severe outbreaks of yellow fever, a viral disease transmitted by the Aedes aegypti mosquito, affected the southern United States in the summer of 1878. The economic and human toll was enormous, and the city of Memphis, Tennessee, was one of the most affected. The authors suggest that as a consequence of one of the strongest El Niño episodes on record-that which occurred in 1877-78-exceptional climate anomalies occurred in the United States (as well as in many other parts of the world), which may have been partly responsible for the widespread nature and severity of the 1878 yellow fever outbreak.This study documents some of the extreme climate anomalies that were recorded in 1877 and 1878 in parts of the eastern United States, with particular emphasis on highlighting the evolution of these anomalies, as they might have contributed to the epidemic. Other years with major outbreaks of yellow fever in the eighteenth and nineteenth centuries also occurred during the course of El Niño episodes, a fact that appears not to have been noted before in the literature.

Diaz, Henry F.; McCabe, Gregory J.



Familial Mediterranean Fever: The First Adult Case in Korea  

PubMed Central

Familial Mediterranean fever (FMF) is known to be a genetic disorder that prevalent among populations surrounding the Mediterranean Sea. Since Mediterranean fever gene (MEFV) was discovered at 1997, some cases have been reported in countries not related or close to this area like Japan. In addition it has been generally accepted that the clinical onset of FMF begins before 20 yr of age in most patients. Onset of the disease at an older age may occur but is rare. Adult-onset FMF may be a form of disease with distinct clinical, demographic and molecular characteristics. We describe a case of adult-onset FMF confirmed by DNA analysis of the MEFV gene in a Korean patient. A 32-yr-old man, who has no family history of FMF, presented with periodic fever, abdominal pain and vomiting. Though several various tests were thoroughly performed to evaluate the cause of his symptoms, there was no evidence of infectious, autoimmune or neoplastic diseases. Several gene analysis of periodic fever syndrome was finally performed and two point mutations (p.Leu110Pro, p.Glu148Gln) were identified. We confirmed the first adult case of FMF through detection of MEFV gene mutations in Korea and describe his clinical characteristics.

Lim, Ah Leum; Han, Jung Wan; Song, Yong Keun; Song, Won Jun; Woo, Heung Jung; Jung, Young Ok; Kae, Sea Hyub; Lee, Jin



Rhabdomyolysis and Dengue Fever: A Case Report and Literature Review  

PubMed Central

The medical literature contains only a few reports of rhabdomyolysis occurring in patients with dengue fever. We report the case of a 25-year-old Jamaican man who was admitted to a private hospital four days after the onset of an acute febrile illness with fever, myalgia, and generalized weakness. Dengue fever was confirmed with a positive test for the dengue antigen, nonstructural protein 1. He remained well and was discharged on day 6 of his illness. On day 8, he started to pass red urine and was subsequently admitted to the University Hospital of the West Indies. On admission he was found to have myoglobinuria and an elevated creatine phosphokinase (CPK) of 325,600?U/L, leading to a diagnosis of rhabdomyolysis. Dengue IgM was positive. He was treated with aggressive hydration and had close monitoring of his urine output, creatinine, and CPK levels. His hospital course was uneventful without the development of acute renal failure and he was discharged after 14 days in hospital, with a CPK level of 2463?U/L. This case highlights that severe rhabdomyolysis may occur in patients with dengue fever and that early and aggressive treatment may prevent severe complications such as acute renal failure and death.

Sargeant, Tanya; Harris, Tricia; Wilks, Rohan; Barned, Sydney; Galloway-Blake, Karen; Ferguson, Trevor



Nonclassical yellow nail syndrome in six-year-old girl: a case report  

PubMed Central

Introduction The yellow nail syndrome is usually described as the combination of yellow nails with lymphoedema and often with respiratory manifestations such as pleural effusions, chronic sinusitis and bronchiectasis. The syndrome is most often seen in the middle-aged individuals. Case presentation We present a 6-year-old girl with yellow nail syndrome having pansinusitis and bronchiectasis. Conclusion The components comprising the classical triad of yellow nail syndrome in children may not necessarily be present altogether. Therefore, yellow nail syndrome should be suspected in children having only typical nail changes.



Coagulation factors, fibrinogen and plasminogen activator inhibitor-1, are differentially regulated by yellow fever virus infection of hepatocytes.  


Yellow fever virus (YFV) infection poses a great risk to un-vaccinated individuals living or traveling in the endemic regions of Africa and South America. It is estimated that approximately 30,000 people die each year of this disease. The liver is the main target of YFV, where as many as 80% of the hepatocytes may become involved in the infection. The overwhelming infection of the liver is associated with the observed hemorrhagic disease manifestations such as petechiae, ecchymoses, and hematemesis which are all thought to be linked with the observed coagulation abnormalities that include prolonged clotting times, reduction in clotting factors, fibrin-split products (D-dimers) and elevated prothrombin times. Many factors involved in the coagulation pathway are produced by hepatocytes, such as fibrinogen (FBG) and plasminogen activator inhibitor-1 (PAI-1). Both of these proteins have been indicated in another flavivirus related disease, dengue, as having roles related to the bleeding abnormalities observed and overall outcome of infection. In this study we wanted to determine if FBG and PAI-1 expression levels by human hepatocytes was disrupted or altered by infection with either wild-type Asibi or vaccine strain17-D YFVs. Our findings indicate that YFV infection does affect the transcriptional and translational expression of FBG and PAI-1 in human hepatocytes and that these results are further affected by IL-6 during early stages of infection. These results may lead to further understanding of the molecular mechanism associated with bleeding abnormalities observed during late stage YFV infection. PMID:23639427

Woodson, Sara E; Freiberg, Alexander N; Holbrook, Michael R



Transcellular and paracellular pathways of transepithelial fluid secretion in Malpighian (renal) tubules of the yellow fever mosquito Aedes aegypti.  


Isolated Malpighian tubules of the yellow fever mosquito secrete NaCl and KCl from the peritubular bath to the tubule lumen via active transport of Na(+) and K(+) by principal cells. Lumen-positive transepithelial voltages are the result. The counter-ion Cl(-) follows passively by electrodiffusion through the paracellular pathway. Water follows by osmosis, but specific routes for water across the epithelium are unknown. Remarkably, the transepithelial secretion of NaCl, KCl and water is driven by a H(+) V-ATPase located in the apical brush border membrane of principal cells and not the canonical Na(+), K(+) -ATPase. A hypothetical cation/H(+) exchanger moves Na(+) and K(+) from the cytoplasm to the tubule lumen. Also remarkable is the dynamic regulation of the paracellular permeability with switch-like speed which mediates in part the post-blood-meal diuresis in mosquitoes. For example, the blood meal the female mosquito takes to nourish her eggs triggers the release of kinin diuretic peptides that (i) increases the Cl(-) conductance of the paracellular pathway and (ii) assembles V(1) and V(0) complexes to activate the H(+) V-ATPase and cation/H(+) exchange close by. Thus, transcellular and paracellular pathways are both stimulated to quickly rid the mosquito of the unwanted salts and water of the blood meal. Stellate cells of the tubule appear to serve a metabolic support role, exporting the HCO(3)(-) generated during stimulated transport activity. Septate junctions define the properties of the paracellular pathway in Malpighian tubules, but the proteins responsible for the permselectivity and barrier functions of the septate junction are unknown. PMID:20946239

Beyenbach, K W; Piermarini, P M



Characterization of the yellow fever mosquito sterol carrier protein-2 like 3 gene and ligand-bound protein structure  

SciTech Connect

The sterol carrier protein-2 like 3 gene (AeSCP-2L3), a new member of the SCP-2 protein family, is identified from the yellow fever mosquito, Aedes aegypti. The predicted molecular weight of AeSCP-2L3 is 13.4 kDa with a calculated pI of 4.98. AeSCP-2L3 transcription occurs in the larval feeding stages and the mRNA levels decrease in pupae and adults. The highest levels of AeSCP-2L3 gene expression are found in the body wall, and possibly originated in the fat body. This is the first report of a mosquito SCP-2-like protein with prominent expression in tissue other than the midgut. The X-ray protein crystal structure of AeSCP-2L3 reveals a bound C16 fatty acid whose acyl tail penetrates deeply into a hydrophobic cavity. Interestingly, the ligand-binding cavity is slightly larger than previously described for AeSCP-2 (Dyer et al. J Biol Chem 278:39085-39091, 2003) and AeSCP-2L2 (Dyer et al. J Lipid Res M700460-JLR200, 2007). There are also an additional 10 amino acids in SCP-2L3 that are not present in other characterized mosquito SCP-2s forming an extended loop between {beta}3 and {beta}4. Otherwise, the protein backbone is exceedingly similar to other SCP-2 and SCP-2-like proteins. In contrast to this observed high structural homology of members in the mosquito SCP2 family, the amino acid sequence identity between the members is less than 30%. The results from structural analysis imply that there have been evolutionary constraints that favor the SCP-2 C{alpha} backbone fold while the specificity of ligand binding can be altered.

Dyer, David H.; Vyazunova, Irina; Lorch, Jeffery M.; Forest, Katrina T.; Lan, Que; (UW)



NHE8 is an intracellular cation/H+ exchanger in renal tubules of the yellow fever mosquito Aedes aegypti.  


The goal of this study was to identify and characterize the hypothesized apical cation/H(+) exchanger responsible for K(+) and/or Na(+) secretion in the renal (Malpighian) tubules of the yellow fever mosquito Aedes aegypti. From Aedes Malpighian tubules, we cloned "AeNHE8," a full-length cDNA encoding an ortholog of mammalian Na(+)/H(+) exchanger 8 (NHE8). The expression of AeNHE8 transcripts is ubiquitous among mosquito tissues and is not enriched in Malpighian tubules. Western blots of Malpighian tubules suggest that AeNHE8 is expressed primarily as an intracellular protein, which was confirmed by immunohistochemical localizations in Malpighian tubules. AeNHE8 immunoreactivity is expressed in principal cells of the secretory, distal segments, where it localizes to a subapical compartment (e.g., vesicles or endosomes), but not in the apical brush border. Furthermore, feeding mosquitoes a blood meal or treating isolated tubules with dibutyryl-cAMP, both of which stimulate a natriuresis by Malpighian tubules, do not influence the intracellular localization of AeNHE8 in principal cells. When expressed heterologously in Xenopus laevis oocytes, AeNHE8 mediates EIPA-sensitive Na/H exchange, in which Li(+) partially and K(+) poorly replace Na(+). The expression of AeNHE8 in Xenopus oocytes is associated with the development of a conductive pathway that closely resembles the known endogenous nonselective cation conductances of Xenopus oocytes. In conclusion, AeNHE8 does not mediate cation/H(+) exchange in the apical membrane of Aedes Malpighian tubules; it is more likely involved with an intracellular function. PMID:19193723

Piermarini, Peter M; Weihrauch, Dirk; Meyer, Heiko; Huss, Markus; Beyenbach, Klaus W



Phylogeographic reconstruction of African yellow fever virus isolates indicates recent simultaneous dispersal into east and west Africa.  


Yellow fever virus (YFV) is a mosquito-borne flavivirus that is a major public health problem in tropical areas of Africa and South America. There have been detailed studies on YFV ecology in West Africa and South America, but current understanding of YFV circulation on the African continent is incomplete. This inadequacy is especially notable for East and Central Africa, for which the unpredictability of human outbreaks is compounded by limitations in both historical and present surveillance efforts. Sparse availability of nucleotide sequence data makes it difficult to investigate the dispersal of YFV in these regions of the continent. To remedy this, we constructed Bayesian phylogenetic and geographic analyses utilizing 49 partial genomic sequences to infer the structure of YFV divergence across the known range of the virus on the African continent. Relaxed clock analysis demonstrated evidence for simultaneous divergence of YFV into east and west lineages, a finding that differs from previous hypotheses of YFV dispersal from reservoirs located on edges of the endemic range. Using discrete and continuous geographic diffusion models, we provide detailed structure of YFV lineage diversity. Significant transition links between extant East and West African lineages are presented, implying connection between areas of known sylvatic cycling. The results of demographic modeling reinforce the existence of a stably maintained population of YFV with spillover events into human populations occurring periodically. Geographically distinct foci of circulation are reconstructed, which have significant implications for studies of YFV ecology and emergence of human disease. We propose further incorporation of Bayesian phylogeography into formal GIS analyses to augment studies of arboviral disease. PMID:23516640

Beck, Andrew; Guzman, Hilda; Li, Li; Ellis, Brett; Tesh, Robert B; Barrett, Alan D T



NHE8 is an intracellular cation/H+ exchanger in renal tubules of the yellow fever mosquito Aedes aegypti  

PubMed Central

The goal of this study was to identify and characterize the hypothesized apical cation/H+ exchanger responsible for K+ and/or Na+ secretion in the renal (Malpighian) tubules of the yellow fever mosquito Aedes aegypti. From Aedes Malpighian tubules, we cloned “AeNHE8,” a full-length cDNA encoding an ortholog of mammalian Na+/H+ exchanger 8 (NHE8). The expression of AeNHE8 transcripts is ubiquitous among mosquito tissues and is not enriched in Malpighian tubules. Western blots of Malpighian tubules suggest that AeNHE8 is expressed primarily as an intracellular protein, which was confirmed by immunohistochemical localizations in Malpighian tubules. AeNHE8 immunoreactivity is expressed in principal cells of the secretory, distal segments, where it localizes to a subapical compartment (e.g., vesicles or endosomes), but not in the apical brush border. Furthermore, feeding mosquitoes a blood meal or treating isolated tubules with dibutyryl-cAMP, both of which stimulate a natriuresis by Malpighian tubules, do not influence the intracellular localization of AeNHE8 in principal cells. When expressed heterologously in Xenopus laevis oocytes, AeNHE8 mediates EIPA-sensitive Na/H exchange, in which Li+ partially and K+ poorly replace Na+. The expression of AeNHE8 in Xenopus oocytes is associated with the development of a conductive pathway that closely resembles the known endogenous nonselective cation conductances of Xenopus oocytes. In conclusion, AeNHE8 does not mediate cation/H+ exchange in the apical membrane of Aedes Malpighian tubules; it is more likely involved with an intracellular function.

Piermarini, Peter M.; Weihrauch, Dirk; Meyer, Heiko; Huss, Markus; Beyenbach, Klaus W.



Identification of typhoid fever and paratyphoid fever cases at presentation in outpatient clinics in Jakarta, Indonesia  

Microsoft Academic Search

Summary In Jakarta, Indonesia, over 80% of patients with typhoid fever or paraty- phoid fever are treated in outpatient settings. In a community-based prospec- tive passive surveillance study, we identified 59 typhoid, 23 paratyphoid fever and 259 non-enteric fever outpatients, all blood culture-confirmed. We compared their symptoms with the aim of developing a clinical prediction rule that may help direct

Albert M. Vollaard; Soegianto Ali; Suwandhi Widjaja; Henri A. G. H. van Asten; Leo G. Visser; Charles Surjadi; Jaap T. van Dissel



Fever versus fever: The role of host and vector susceptibility and interspecific competition in shaping the current and future distributions of the sylvatic cycles of dengue virus and yellow fever virus.  


Two different species of flaviviruses, dengue virus (DENV) and yellow fever virus (YFV), that originated in sylvatic cycles maintained in non-human primates and forest-dwelling mosquitoes have emerged repeatedly into sustained human-to-human transmission by Aedes aegypti mosquitoes. Sylvatic cycles of both viruses remain active, and where the two viruses overlap in West Africa they utilize similar suites of monkeys and Aedes mosquitoes. These extensive similarities render the differences in the biogeography and epidemiology of the two viruses all the more striking. First, the sylvatic cycle of YFV originated in Africa and was introduced into the New World, probably as a result of the slave trade, but is absent in Asia; in contrast, sylvatic DENV likely originated in Asia and has spread to Africa but not to the New World. Second, while sylvatic YFV can emerge into extensive urban outbreaks in humans, these invariably die out, whereas four different types of DENV have established human transmission cycles that are ecologically and evolutionarily distinct from their sylvatic ancestors. Finally, transmission of YFV among humans has been documented only in Africa and the Americas, whereas DENV is transmitted among humans across most of the range of competent Aedes vectors, which in the last decade has included every continent save Antarctica. This review summarizes current understanding of sylvatic transmission cycles of YFV and DENV, considers possible explanations for their disjunct distributions, and speculates on the potential consequences of future establishment of a sylvatic cycle of DENV in the Americas. PMID:23523817

Hanley, Kathryn A; Monath, Thomas P; Weaver, Scott C; Rossi, Shannan L; Richman, Rebecca L; Vasilakis, Nikos



Postextraction bleeding following a fever: a case report.  


Postoperative hemorrhage is one of the few serious complications that can occur as a result of dental procedures. We report a case of an elderly patient with postextraction bleeding caused by dengue hemorrhagic fever (DHF). Although a major sequel of DHF is bleeding secondary to thrombocytopenia, prolonged hemorrhage as a result of extraction of tooth has not been reported. In the current scenario of emerging and reemerging infections worldwide, dengue is gaining global prominence. This case documents the course and progression of this disease from a dental perspective and highlights the as yet unreported capacity of causing oral complications after dental treatment. PMID:22999964

Dubey, Prajesh; Kumar, Sanjeev; Bansal, Vishal; Kumar, K V Arun; Mowar, Apoorva; Khare, Gagan



A case of recurrent pancreatitis due to hyperlipidemia misdiagnosed as familial Mediterranean fever  

Microsoft Academic Search

Familial Mediterranean fever (FMF) is prevalent among Arabic, Turkish, Armenian, and Jewish people and it must always be considered in the differential diagnosis of patients from these ethnic groups presenting with recurrent abdominal pain with fever. In cases of fever and recurrent abdominal pain, acute pancreatitis is an important clinical condition, which should be considered in the differential diagnosis. Serum

M. Birlik; T. Demir; M. Zeybel; S. Akar; F. Onen; A. Comlekci; M. Tunca; N. Akkoc



Yellow Fever Virus NS2B–NS3 Protease: Charged-to-Alanine Mutagenesis and Deletion Analysis Define Regions Important for Protease Complex Formation and Function  

Microsoft Academic Search

Charged-to-alanine substitutions and deletions within the yellow fever virus NS2B–NS3181 protease were analyzed for effects on protease function. During cell-free translation of NS2B–3181 polyproteins, mutations at three charge clusters markedly impaired cis cleavage activity: a single N-terminal cluster in the conserved domain of NS2B (residues ELKK52–55) and two in NS3 (ED21–22, and residue H47). These mutations inhibited other protease-dependent cleavages

Deborah A. Droll; H. M. Krishna Murthy; Thomas J. Chambers



17DD and 17D-213/77 Yellow Fever Substrains Trigger a Balanced Cytokine Profile in Primary Vaccinated Children  

PubMed Central

Background This study aimed to compare the cytokine-mediated immune response in children submitted to primary vaccination with the YF-17D-213/77 or YF-17DD yellow fever (YF) substrains. Methods A non-probabilistic sample of eighty healthy primary vaccinated (PV) children was selected on the basis of their previously known humoral immune response to the YF vaccines. The selected children were categorized according to their YF-neutralizing antibody titers (PRNT) and referred to as seroconverters (PV-PRNT+) or nonseroconverters (PV-PRNT?). Following revaccination with the YF-17DD, the PV-PRNT? children (YF-17D-213/77 and YF-17DD groups) seroconverted and were referred as RV-PRNT+. The cytokine-mediated immune response was investigated after short-term in vitro cultures of whole blood samples. The results are expressed as frequency of high cytokine producers, taking the global median of the cytokine index (YF-Ag/control) as the cut-off. Results The YF-17D-213/77 and the YF-17DD substrains triggered a balanced overall inflammatory/regulatory cytokine pattern in PV-PRNT+, with a slight predominance of IL-12 in YF-17DD vaccinees and a modest prevalence of IL-10 in YF-17D-213/77. Prominent frequency of neutrophil-derived TNF-? and neutrophils and monocyte-producing IL-12 were the major features of PV-PRNT+ in the YF-17DD, whereas relevant inflammatory response, mediated by IL-12+CD8+ T cells, was the hallmark of the YF-17D-213/77 vaccinees. Both substrains were able to elicit particular but relevant inflammatory events, regardless of the anti-YF PRNT antibody levels. PV-PRNT? children belonging to the YF-17DD arm presented gaps in the inflammatory cytokine signature, especially in terms of the innate immunity, whereas in the YF-17D-213/77 arm the most relevant gap was the deficiency of IL-12-producing CD8+T cells. Revaccination with YF-17DD prompted a balanced cytokine profile in YF-17DD nonresponders and a robust inflammatory profile in YF-17D-213/77 nonresponders. Conclusion Our findings demonstrated that, just like the YF-17DD reference vaccine, the YF-17D-213/77 seed lot induced a mixed pattern of inflammatory and regulatory cytokines, supporting its universal use for immunization.

Luiza-Silva, Maria; Batista, Mauricio Azevedo; Martins, Marina Angela; Sathler-Avelar, Renato; da Silveira-Lemos, Denise; Camacho, Luiz Antonio Bastos; de Menezes Martins, Reinaldo; de Lourdes de Sousa Maia, Maria; Farias, Roberto Henrique Guedes; da Silva Freire, Marcos; Galler, Ricardo; Homma, Akira; Ribeiro, Jose Geraldo Leite; Lemos, Jandira Aparecida Campos; Auxiliadora-Martins, Maria; Caldas, Iramaya Rodrigues; Eloi-Santos, Silvana Maria; Teixeira-Carvalho, Andrea; Martins-Filho, Olindo Assis



Molecular characterization of sodium/proton exchanger 3 (NHE3) from the yellow fever vector, Aedes aegypti.  


Transport across insect epithelia is thought to depend on the activity of a vacuolar-type proton ATPase (V-ATPase) that energizes ion transport through a secondary proton/cation exchanger. Although several of the subunits of the V-ATPase have been cloned, the molecular identity of the exchanger has not been elucidated. Here, we present the identification of sodium/proton exchanger isoform 3 (NHE3) from yellow fever mosquito, Aedes aegypti (AeNHE3). AeNHE3 localizes to the basal plasma membrane of Malpighian tubule, midgut and the ion-transporting sector of gastric caeca. Midgut expression of NHE3 shows a different pattern of enrichment between larval and adult stages, implicating it in the maintenance of regional pH in the midgut during the life cycle. In all tissues examined, NHE3 predominantly localizes to the basal membrane. In addition the limited expression in intracellular vesicles in the median Malpighian tubules may reflect a potential functional versatility of NHE3 in a tissue-specific manner. The localization of V-ATPase and NHE3, and exclusion of Na+/K+-ATPase from the distal ion-transporting sector of caeca, indicate that the role of NHE3 in ion and pH regulation is intricately associated with functions of V-ATPase. The AeNHE3 complements yeast mutants deficient in yeast NHEs, NHA1 and NHX1. To further examine the functional property of AeNHE3, we expressed it in NHE-deficient fibroblast cells. AeNHE3 expressing cells were capable of recovering intracellular pH following an acid load. The recovery was independent of the large cytoplasmic region of AeNHE3, implying this domain to be dispensable for NHE3 ion transport function. 22Na+ uptake studies indicated that AeNHE3 is relatively insensitive to amiloride and EIPA and is capable of Na+ transport in the absence of the cytoplasmic tail. Thus, the core domain containing the transmembrane regions of NHE3 is sufficient for pH recovery and ion transport. The present data facilitate refinement of the prevailing models of insect epithelial transport by incorporating basal amiloride-insensitive NHE3 as a critical mediator of transepithelial ion and fluid transport and likely in the maintenance of intracellular pH. PMID:16943493

Pullikuth, Ashok K; Aimanova, Karlygash; Kang'ethe, Wanyoike; Sanders, Heather R; Gill, Sarjeet S



Construction, Safety, and Immunogenicity in Nonhuman Primates of a Chimeric Yellow Fever-Dengue Virus Tetravalent Vaccine  

PubMed Central

We previously reported construction of a chimeric yellow fever-dengue type 2 virus (YF/DEN2) and determined its safety and protective efficacy in rhesus monkeys (F. Guirakhoo et al., J. Virol. 74:5477–5485, 2000). In this paper, we describe construction of three additional YF/DEN chimeras using premembrane (prM) and envelope (E) genes of wild-type (WT) clinical isolates: DEN1 (strain PUO359, isolated in 1980 in Thailand), DEN3 (strain PaH881/88, isolated in 1988 in Thailand), and DEN4 (strain 1228, isolated in 1978 in Indonesia). These chimeric viruses (YF/DEN1, YF/DEN3, and YF/DEN4) replicated to ?7.5 log10 PFU/ml in Vero cells, were not neurovirulent in 3- to 4-week-old ICR mice inoculated by the intracerebral route, and were immunogenic in monkeys. All rhesus monkeys inoculated subcutaneously with one dose of these chimeric viruses (as monovalent or tetravalent formulation) developed viremia with magnitudes similar to that of the YF 17D vaccine strain (YF-VAX) but significantly lower than those of their parent WT viruses. Eight of nine monkeys inoculated with monovalent YF/DEN1 -3, or -4 vaccine and six of six monkeys inoculated with tetravalent YF/DEN1-4 vaccine seroconverted after a single dose. When monkeys were boosted with a tetravalent YF/DEN1-4 dose 6 months later, four of nine monkeys in the monovalent YF/DEN groups developed low levels of viremia, whereas no viremia was detected in any animals previously inoculated with either YF/DEN1-4 vaccine or WT DEN virus. An anamnestic response was observed in all monkeys after the second dose. No statistically significant difference in levels of neutralizing antibodies was observed between YF virus-immune and nonimmune monkeys which received the tetravalent YF/DEN1-4 vaccine or between tetravalent YF/DEN1-4-immune and nonimmune monkeys which received the YF-VAX. However, preimmune monkeys developed either no detectable viremia or a level of viremia lower than that in nonimmune controls. This is the first recombinant tetravalent dengue vaccine successfully evaluated in nonhuman primates.

Guirakhoo, F.; Arroyo, J.; Pugachev, K. V.; Miller, C.; Zhang, Z.-X.; Weltzin, R.; Georgakopoulos, K.; Catalan, J.; Ocran, S.; Soike, K.; Ratterree, M.; Monath, T. P.



A small animal peripheral challenge model of yellow fever using interferon-receptor deficient mice and the 17D-204 vaccine strain  

PubMed Central

Yellow fever virus (YFV), a member of the genus Flavivirus, is a mosquito-borne pathogen that requires wild-type (wt), virulent strains be handled at biosafety level (BSL) 3, with HEPA-filtration of room air exhaust (BSL3+). YFV is found in tropical regions of Africa and South America and causes severe hepatic disease and death in humans. Despite the availability of effective vaccines (17D-204 or 17DD), YFV is still responsible for an estimated 200,000 cases of illness and 30,000 deaths annually. Besides vaccination, there are no other prophylactic or therapeutic strategies approved for use in human YF. Current small animal models of YF require either intra-cranial inoculation of YF vaccine to establish infection, or use of wt strains (e.g., Asibi) in order to achieve pathology. We have developed and characterized a BSL2, adult mouse peripheral challenge model for YFV infection in mice lacking receptors for interferons ?, ?, and ? (strain AG129). Intraperitoneal challenge of AG129 mice with 17D-204 is a uniformly lethal in a dose-dependent manner, and 17D-204-infected AG129 mice exhibit high viral titers in both brain and liver suggesting this infection is both neurotropic and viscerotropic. Furthermore the use of a mouse model permitted the construction of a 59-biomarker Multi-Analyte Profile (MAP) using samples of brain, liver, and serum taken at multiple time points over the course of infection. This MAP serves as a baseline for evaluating novel therapeutics and their effect on disease progression. Changes (4-fold or greater) in serum and tissue levels of pro- and anti-inflammatory mediators as well as other factors associated with tissue damage were noted in AG129 mice infected with 17D-204 as compared to mock-infected control animals.

Thibodeaux, Brett A.; Garbino, Nina C.; Liss, Nathan M.; Piper, Joseph; Blair, Carol D.; Roehrig, John T.



A small animal peripheral challenge model of yellow fever using interferon-receptor deficient mice and the 17D-204 vaccine strain.  


Yellow fever virus (YFV), a member of the genus Flavivirus, is a mosquito-borne pathogen that requires wild-type (wt), virulent strains to be handled at biosafety level (BSL) 3, with HEPA-filtration of room air exhaust (BSL3+). YFV is found in tropical regions of Africa and South America and causes severe hepatic disease and death in humans. Despite the availability of effective vaccines (17D-204 or 17DD), YFV is still responsible for an estimated 200,000 cases of illness and 30,000 deaths annually. Besides vaccination, there are no other prophylactic or therapeutic strategies approved for use in human YF. Current small animal models of YF require either intra-cranial inoculation of YF vaccine to establish infection, or use of wt strains (e.g., Asibi) in order to achieve pathology. We have developed and characterized a BSL2, adult mouse peripheral challenge model for YFV infection in mice lacking receptors for interferons ?, ?, and ? (strain AG129). Intraperitoneal challenge of AG129 mice with 17D-204 is a uniformly lethal in a dose-dependent manner, and 17D-204-infected AG129 mice exhibit high viral titers in both brain and liver suggesting this infection is both neurotropic and viscerotropic. Furthermore the use of a mouse model permitted the construction of a 59-biomarker multi-analyte profile (MAP) using samples of brain, liver, and serum taken at multiple time points over the course of infection. This MAP serves as a baseline for evaluating novel therapeutics and their effect on disease progression. Changes (4-fold or greater) in serum and tissue levels of pro- and anti-inflammatory mediators as well as other factors associated with tissue damage were noted in AG129 mice infected with 17D-204 as compared to mock-infected control animals. PMID:22425792

Thibodeaux, Brett A; Garbino, Nina C; Liss, Nathan M; Piper, Joseph; Blair, Carol D; Roehrig, John T



Pathology Case Study: Fever and a Hilar Pulmonary Mass  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which a 37-year-old man has a recurring fever and swelling in his legs. Visitors are given the gross and microscopic descriptions, radiological results, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in pathology and clinical microbiology.

Horn, Kevin D.; Pasculle, A. W.



The Synergistic Effect of Combined Immunization with a DNA Vaccine and Chimeric Yellow Fever/Dengue Virus Leads to Strong Protection against Dengue  

PubMed Central

The dengue envelope glycoprotein (E) is the major component of virion surface and its ectodomain is composed of domains I, II and III. This protein is the main target for the development of a dengue vaccine with induction of neutralizing antibodies. In the present work, we tested two different vaccination strategies, with combined immunizations in a prime/booster regimen or simultaneous inoculation with a DNA vaccine (pE1D2) and a chimeric yellow fever/dengue 2 virus (YF17D-D2). The pE1D2 DNA vaccine encodes the ectodomain of the envelope DENV2 protein fused to t-PA signal peptide, while the YF17D-D2 was constructed by replacing the prM and E genes from the 17D yellow fever vaccine virus by those from DENV2. Balb/c mice were inoculated with these two vaccines by different prime/booster or simultaneous immunization protocols and most of them induced a synergistic effect on the elicited immune response, mainly in neutralizing antibody production. Furthermore, combined immunization remarkably increased protection against a lethal dose of DENV2, when compared to each vaccine administered alone. Results also revealed that immunization with the DNA vaccine, regardless of the combination with the chimeric virus, induced a robust cell immune response, with production of IFN-? by CD8+ T lymphocytes.

Azevedo, Adriana S.; Goncalves, Antonio J. S.; Archer, Marcia; Freire, Marcos S.; Galler, Ricardo; Alves, Ada M. B.



Epidemiological Characteristics of Serologically Confirmed Q Fever Cases in South Korea, 2006-2011  

PubMed Central

Objectives: Q fever has been reported worldwide; however, there was almost no official report of Q fever in Korea. In this study, we describe the current status of human Q fever occurrence in Korea. Methods: Demographic data of Q fever patients were collected from the National Notifiable Diseases Surveillance System from 2006 to 2011. Case investigation reports from regional public health departments were used for additional information, like risk factors and clinical manifestation, of the patients since 2008. Results: There were 65 serologically confirmed cases during the study period. The annual notification rate of Q fever was 0.22 cases per million persons. The majority of cases were men (87.7%), adults (98.5%), and urban inhabitants (67.7%). Relevant exposures to risk factors were identified in 45.7% of patients. The most common symptoms of acute Q fever were fever (89.3%), myalgia (67.9%) and asthenia (53.6%). Two cases with endocarditis were identified in chronic Q fever. Conclusion: This study suggests that Q fever has a low endemicity in Korea. However, management and research at national level is required for prevention of a future epidemic.

Kwak, Wooseok; Chu, Hyuk; Hwang, Seondo; Park, Ji-Hyuk; Hwang, Kyu Jam; Gwack, Jin; Choi, Young-Sil; Youn, Seung-Ki; Park, Mi-Yeoun



[Abnormality in the behaviour of mice after an experimental encephalitis by yellow fever virus 17 D. Experiment model(author's transl)].  


Viral encephalitides in infants are very often followed by serious mental manifestations. To be able experimentally to investigate this pathological phenomenon, we established the following model. Mice having recovered from an intracerebral infection with yellow fever virus 17 D (routine test for the potency of yellow fever vaccine) and giving the impression of normal and healthy animals were examined for their psychical behaviour. As unit of measurement we took the time for running through a labyrith (fig. 1). At the entrance of the labyrith in a box there was placed the population of animals of one cage (6 animals in maximum) and at the opposite side there was deposited the food. The animals going to be examined had been without food for 24 hours. The time was taken having passed from the moment of placing the animals up to the moment of their nibbing at the food. We examined 11 groups of mice having past routine tests for the potency of the yellow fever vaccine. One of them had been tested twice at an interval of 54 days (table 1). The 791 mice which had passed the encephalitic infection showed an average running time of 8.90 min. The 164 controls, however, had an average running time of 4.37 min (table 2). This difference is significant (p=greater than 1/1000). The average running time is proportional to the injected virus quantity (table 3). The significance of each single virus dilution to the group of normal animals is always greater than 1/1000. The significance is more than 1/100 for each single virus dilution between 10(-1) and 10(-3) compared with the virus dilution of 10(-5). Immediately after the clinical period (21 days), no difference could be observed between the single virus dilutions. After 76 days only, the test showed the above mentioned differences (table 4). Therefore, the mice having found their food after a long running time had more serious postencephalitic lesions than those having had a shorter running time. To prove this statement, we examined histologically brains of 14 mice which had found their food after 20 min on an average and those of 16 mice having had an average running time of 6.58 min. The histological evaluation was performed in regard to eight pathological characteristica. The results were recorded on tables for each slide with a histological preparation. For this we used squared paper (fig. 2, 3). For each brain of mice, the so-called "index of lesions" was calculated by the proportion of labelled and all squares. ..... PMID:1258562

Henneberg, G; Haase, J; Museteanu, C; Zausch, G T



[First case of dengue hemorrhagic fever with shock syndrome in Martinique].  


Since mid 95, many Caribbean islands and America's countries suffer from a new outbreak of an epidemic of dengue fever and dengue haemorrhagic fever. Until today, no case of dengue haemorrhagic fever was reported in Martinique (FWI) in spite of the high prevalence of dengue fever in the island. The first identified case asserts the severity of illness. In Martinique, these arbovirosis is often underestimated. Nowadays, the disease prevention must become one of the principal targets of the medical corporation and the Public Health Authorities. Consequently, epidemiologic survey and principally vector's control must be reinforced. PMID:9053042

Mansuy, J M; Delor, R; Mehdaoui, H; Elizabeth, L



Rat-bite fever septic arthritis: illustrative case and literature review  

Microsoft Academic Search

Rat-bite fever is a rare zoonotic infection caused by Streptobacillus moniliformis or Spirillum minus, which is characterised by fever, rash and arthritis. The arthritis has previously been described as non-suppurative and isolation of the organism from synovial fluid as very uncommon. This article reports a case of septic arthritis diagnosed as rat-bite fever when the organism was cultured from synovial

C. Dendle; I. J. Woolley; T. M. Korman



Adaptation of yellow fever virus 17D to Vero cells is associated with mutations in structural and non-structural protein genes.  


Serial passaging of yellow fever virus 17D in Vero cells was employed to derive seed material for a novel inactivated vaccine, XRX-001. Two independent passaging series identified a novel lysine to arginine mutation at amino acid 160 of the envelope protein, a surface-exposed residue in structural domain I. A third passage series resulted in an isoleucine to methionine mutation at residue 113 of the NS4B protein, a central membrane spanning region of the protein which has previously been associated with Vero cell adaptation of other mosquito-borne flaviviruses. These studies confirm that flavivirus adaptation to growth in Vero cells can be mediated by structural or non-structural protein mutations. PMID:23602827

Beasley, David W C; Morin, Merribeth; Lamb, Ashley R; Hayman, Edward; Watts, Douglas M; Lee, Cynthia K; Trent, Dennis W; Monath, Thomas P



Recombinant yellow fever vaccine virus 17D expressing simian immunodeficiency virus SIVmac239 gag induces SIV-specific CD8+ T-cell responses in rhesus macaques.  


Here we describe a novel vaccine vector for expressing human immunodeficiency virus (HIV) antigens. We show that recombinant attenuated yellow fever vaccine virus 17D expressing simian immunodeficiency virus SIVmac239 Gag sequences can be used as a vector to generate SIV-specific CD8(+) T-cell responses in the rhesus macaque. Priming with recombinant BCG expressing SIV antigens increased the frequency of these SIV-specific CD8(+) T-cell responses after recombinant YF17D boosting. These recombinant YF17D-induced SIV-specific CD8(+) T cells secreted several cytokines, were largely effector memory T cells, and suppressed viral replication in CD4(+) T cells. PMID:20089645

Bonaldo, Myrna C; Martins, Mauricio A; Rudersdorf, Richard; Mudd, Philip A; Sacha, Jonah B; Piaskowski, Shari M; Costa Neves, Patrícia C; Veloso de Santana, Marlon G; Vojnov, Lara; Capuano, Saverio; Rakasz, Eva G; Wilson, Nancy A; Fulkerson, John; Sadoff, Jerald C; Watkins, David I; Galler, Ricardo



Spatial and temporal abundance of three sylvatic yellow fever vectors in the influence area of the Manso hydroelectric power plant, Mato Grosso, Brazil.  


Human biting catches of sylvatic yellow fever (SYF) vectors were conducted at eight stations in the influence area of the Manso hydroelectric power plant (Central Brazil) in sampling campaigns every 2 mo from July 2000 to November 2001. In total, 206 individuals were captured and classified as one of three species important for the transmission of SYF in Mato Grosso state: Haemagogus (Haemagogus) janthinomys (Dyar, 1921); Haemagogus (Conopostegus) leucocelaenus (Dyar & Shannon, 1924); and Sabethes (Sabethoides) chloropterus (Humboldt, 1819). The highest vector abundance was observed during the rainy season (November through March) and SYF vectors were present in all sampling points throughout the year, mainly in riparian and shadowed transitional forests at shadowed ramps. PMID:22308793

Ribeiro, A L M; Miyazaki, R D; Silva, M; Zeilhofer, P



Broad neutralization of wild-type dengue virus isolates following immunization in monkeys with a tetravalent dengue vaccine based on chimeric yellow fever 17D/dengue viruses.  


The objective of the study was to evaluate if the antibodies elicited after immunization with a tetravalent dengue vaccine, based on chimeric yellow fever 17D/dengue viruses, can neutralize a large range of dengue viruses (DENV). A panel of 82 DENVs was developed from viruses collected primarily during the last decade in 30 countries and included the four serotypes and the majority of existing genotypes. Viruses were isolated and minimally amplified before evaluation against a tetravalent polyclonal serum generated during vaccine preclinical evaluation in monkey, a model in which protection efficacy of this vaccine has been previously demonstrated (Guirakhoo et al., 2004). Neutralization was observed across all the DENV serotypes, genotypes, geographical origins and isolation years. These data indicate that antibodies elicited after immunization with this dengue vaccine candidate should widely protect against infection with contemporary DENV lineages circulating in endemic countries. PMID:22542002

Barban, Veronique; Munoz-Jordan, Jorge L; Santiago, Gilberto A; Mantel, Nathalie; Girerd, Yves; Gulia, Sandrine; Claude, Jean-Baptiste; Lang, Jean



[Dengue fever imported to Norway. Serologically confirmed cases 1991-96].  


With up to 100 million cases annually, dengue fever is today's most important arboviral disease. Dengue fever is endemic in many parts of South-East Asia, the Indian subcontinent, Oceania and the Americas. The disease mainly affects the local population, but occasionally also visitors from non-endemic areas. In this article we present epidemiological and clinical data on all 26 cases with serological confirmed dengue fever diagnosed in Norway in 1991-1996. 21 patients (81%) were infected in Asia. Typical exanthema, leucopenia, and thrombocytopenia were seen in 71%, 79% and 84% of the cases, respectively. A 37-year-old Indian-born woman developed dengue haemorrhagic fever grade 1 after a visit to New Delhi, while the remaining 25 patients had classical dengue fever. Postinfectious complications were common, and four weeks after the acute illness, hair loss, mental depression and asthenia were reported by 45%, 50% and 100% of the cases, respectively. PMID:9441467

Jensenius, M; Gundersen, S G; Vene, S; Bruu, A L



Typhoid fever in the neapolitan area: A case-control study  

Microsoft Academic Search

Typhoid fever is endemic in the Neapolitan area, where its yearly incidence rate largely exceeds the corresponding national figure. During the period from January to June, 1990, a matched case-control study was carried out in order to identify risk factors of the disease in this area; 51 subjects (mean age 27.2 years) with typhoid fever were compared with 102 controls

T. Stroffolini; G. Manzillo; R. DE SENA; E. Manzillo; P. Pagliano; M. Zaccarelli; M. Russo; M. Soscia; G. Giusti



Human cases of Sindbis fever in South Africa, 2006-2010.  


SUMMARY Sindbis virus (SINV), the prototype positive-sense RNA alphavirus, causes febrile arthritis and is present throughout Afro-Eurasia. Little is known of the epidemiology of Sindbis fever due to insufficient surveillance in most endemic countries. The epidemiological features of Sindbis fever in humans in South Africa are described here based on a retrospective study of suspected arbovirus cases submitted for laboratory investigation from 2006 to 2010. Cases were detected annually mostly during the late summer/early autumn months and an increase in cases was noted for 2010, coinciding with an outbreak of Rift Valley fever. Cases were reported most often from the central plateau of South Africa and involved mostly males. No severe or fatal cases were reported and cases were associated with febrile arthralgia as commonly reported for SINV infection. Further surveillance is required to reveal the true extent of the morbidity of Sindbis fever in South Africa. PMID:23611492

Storm, N; Weyer, J; Markotter, W; Kemp, A; Leman, P A; Dermaux-Msimang, V; Nel, L H; Paweska, J T



Surveillance of Dengue Hemorrhagic Fever Cases in Thailand.  

National Technical Information Service (NTIS)

The objective of this research was to provide laboratory confirmation of clinically diagnosed arbovirus infections reported to the Thai Ministry of Health. In Thailand Dengue Hemorrhagic Fever (DHF) remains the greatest identifiable cause of hospitalizati...

P. Gunakasem S. Jatanasen C. Chantarasri P. Simasathien S. Chaiyanunta



Immunogenicity, Genetic Stability, and Protective Efficacy of a Recombinant, Chimeric Yellow Fever-Japanese Encephalitis Virus (ChimeriVax-JE) as a Live, Attenuated Vaccine Candidate against Japanese Encephalitis  

Microsoft Academic Search

Yellow fever (YF) 17D vaccine virus, having a 60-year history of safe and effective use, is an ideal vector to deliver heterologous genes from other medically important flaviviruses. A chimeric YF\\/Japanese encephalitis (JE) virus (ChimeriVax-JE virus) was constructed by insertion of the premembrane and envelope (prME) genes of an attenuated human vaccine strain (SA14–14-2) of Japanese encephalitis (JE) virus between

F. Guirakhoo; Z.-X. Zhang; T. J. Chambers; S. Delagrave; J. Arroyo; A. D. T. Barrett; T. P. Monath



Fever of unknown origin due to dental infections: cases report and review.  


Persistent undiagnosed fever remains a common problem in clinical practice. In a variable number of cases, no definitive diagnosis is made. This lack of a clear etiology indicates that certain disorders are not being detected despite the recently developed technology usually applied in this situation. On occasion, dental disease is one potential cause of persistent fever. Oral symptoms usually are not present, thus allowing the oral cavity to be overlooked during physical examination. We describe three patients with persistent fever due to dental disease and discuss the pathogenesis of this disease. PMID:17301590

Karachaliou, Iris G; Karachalios, George N; Kanakis, Konstantinos V; Petrogiannopoulos, Constantinos L; Zacharof, Antonis K



Birth of Three Stowaway-like MITE Families via Microhomology-Mediated Miniaturization of a Tc1/Mariner Element in the Yellow Fever Mosquito  

PubMed Central

Eukaryotic genomes contain numerous DNA transposons that move by a cut-and-paste mechanism. The majority of these elements are self-insufficient and dependent on their autonomous relatives to transpose. Miniature inverted repeat transposable elements (MITEs) are often the most numerous nonautonomous DNA elements in a higher eukaryotic genome. Little is known about the origin of these MITE families as few of them are accompanied by their direct ancestral elements in a genome. Analyses of MITEs in the yellow fever mosquito identified its youngest MITE family, designated as Gnome, that contains at least 116 identical copies. Genome-wide search for direct ancestral autonomous elements of Gnome revealed an elusive single copy Tc1/Mariner-like element, named as Ozma, that encodes a transposase with a DD37E triad motif. Strikingly, Ozma also gave rise to two additional MITE families, designated as Elf and Goblin. These three MITE families were derived at different times during evolution and bear internal sequences originated from different regions of Ozma. Upon close inspection of the sequence junctions, the internal deletions during the formation of these three MITE families always occurred between two microhomologous sites (6–8 bp). These results suggest that multiple MITE families may originate from a single ancestral autonomous element, and formation of MITEs can be mediated by sequence microhomology. Ozma and its related MITEs are exceptional candidates for the long sought-after endogenous active transposon tool in genetic control of mosquitoes.

Yang, Guojun; Fattash, Isam; Lee, Chia-Ni; Liu, Kun; Cavinder, Brad



Analysis of the wild-type and mutant genes encoding the enzyme kynurenine monooxygenase of the yellow fever mosquito, Aedes aegypti  

PubMed Central

Kynurenine 3-monooxygenase (KMO) catalyses the hydroxylation of kynurenine to 3-hydroxykynurenine. KMO has a key role in tryptophan catabolism and synthesis of ommochrome pigments in mosquitoes. The gene encoding this enzyme in the yellow fever mosquito, Aedes aegypti, is called kynurenine hydroxylase (kh) and a mutant allele that produces white eyes has been designated khw. A number of cDNA clones representative of wild-type and mutant genes were isolated. Sequence analyses of the wild-type and mutant cDNAs revealed a deletion of 162 nucleotides in the mutant gene near the 3?-end of the deduced coding region. RT-PCR analyses confirm the transcription of a truncated mRNA in the mutant strain. The in-frame deletion results in a loss of 54 amino acids, which disrupts a major ?-helix and which probably accounts for the loss of activity of the enzyme. Recombinant Ae. aegypti KMO showed high substrate specificity for kynurenine with optimum activity at 40 °C and pH = 7.5. Kinetic parameters and inhibition of KMO activity by Cl? and pyridoxal-5-phosphate were determined.

Han, Q.; Calvo, E.; Marinotti, O.; Fang, J.; Rizzi, M.; James, A. A.; Li, J.



Substitution of Wild-Type Yellow Fever Asibi Sequences for 17D Vaccine Sequences in ChimeriVax-Dengue 4 Does Not Enhance Infection of Aedes aegypti Mosquitoes  

PubMed Central

To address concerns that a flavivirus vaccine/wild-type recombinant virus might have a high mosquito infectivity phenotype, the yellow fever virus (YFV) 17D backbone of the ChimeriVax– dengue 4 virus was replaced with the corresponding gene sequences of the virulent YFV Asibi strain. Field-collected and laboratory-colonized Aedes aegypti mosquitoes were fed on blood containing each of the viruses under investigation and held for 14 days after infection. Infection and dissemination rates were based on antigen detection in titrated body or head triturates. Our data indicate that, even in the highly unlikely event of recombination or substantial backbone reversion, virulent sequences do not enhance the transmissibility of ChimeriVax viruses. In light of the low-level viremias that have been observed after vaccination in human volunteers coupled with low mosquito infectivity, it is predicted that the risk of mosquito infection and transmission of ChimeriVax vaccine recombinant/revertant viruses in nature is minimal.

McGee, Charles E.; Tsetsarkin, Konstantin; Vanlandingham, Dana L.; McElroy, Kate L.; Lang, Jean; Guy, Bruno; Decelle, Thierry; Higgs, Stephen



Q fever endocarditis: A case report and review of the literature  

PubMed Central

The case of a 31-year-old man from Alberta diagnosed with Q fever endocarditis is presented. To the authors’ knowledge, this is the first case of Q fever endocarditis diagnosed in the province of Alberta. The patient had undergone open valvulotomy for congenital aortic stenosis as an infant. He presented with congestive heart failure secondary to severe aortic regurgitation and underwent mechanical aortic valve replacement. Early failure of the mechanical prosthesis and numerous laboratory abnormalities prompted an investigation for endocarditis, which was initially negative. Markedly positive serology eventually established the diagnosis of chronic Q fever. The patient subsequently underwent a second aortic valve replacement following initiation of appropriate antimicrobials directed against Coxiella burnetii. The present report reviews the clinical presentation and diagnosis of Q fever endocarditis. It highlights the insidious and nonspecific nature of the presenting symptoms, and emphasizes the use of serology for diagnosis. Increased awareness and earlier diagnosis can significantly decrease the morbidity and mortality associated with this disease.

Deyell, Marc W; Chiu, Brian; Ross, David B; Alvarez, Nanette



Socioeconomic Impact Analysis of Yellow-dust Storms: An Approach and Case Study for Beijing  

Microsoft Academic Search

Dust storms can extensively disrupt socioeconomic activities and pose hazards to human health and the ecosystem; yet no one has made a systematic analysis of dust storms from an economic perspective. Using a case study for Beijing in 2000, we present a preliminary analysis of socioeconomic impacts of yellow-dust storms, integrating regional economic analysis models with environmental-economic evaluation techniques. Our

Ning Ai; Karen R. Polenske



[Viral hemorrhagic fevers: what is the risk for travelers?].  


The term hemorrhagic fever covers a number of diseases with different clinical and epidemiologic features. All these diseases are zoonoses but their occurrence is not confined to tropical areas. Some occur in polar zones. Travelers to endemic areas for these diseases are at risk of infection. There are two modes of transmission. Arthropods are vectors for some diseases such as yellow fever, dengue fever, and Rift Valley fever which are carried by mosquitos and Congo-Crimea virus which is carried by ticks. Airborne contamination by rodent excrement is responsible for transmission of hantaviruses and arenaviruses. Nosocomial infection is a risk for health care providers. Some types of hemorrhagic fever such as Bolivian hemorrhagic fever are highly localized, while other types such as dengue are observed worldwide. Judging from the small number of cases observed in European countries, the overall risk for travelers seems low except unless high-risk activities are planned. The main exceptions are yellow fever and dengue which can easily be transmitted to tourists by mosquitos. Yellow fever can be prevented by vaccination. Typical dengue is usually self-limited but hemorrhagic forms require treatment to prevent shock. PMID:9612763

Le Guenno, B



Seek and ye shall find: a case of Q fever in an elderly woman.  


This case report concerns an elderly woman referred with a 6-month history of rising and falling fever in the range 38-40°C. She was examined repeatedly by her family doctor and given various antibiotic treatments before being hospitalized in our geriatric unit. Laboratory tests and microbiological studies led to a diagnosis of chronic Q fever, a zoonosis caused by Coxiella burnetii, a Gram-negative obligate intracellular coccobacillus; humans usually become infected by inhaling infectious airborne particles. The diagnosis of Q fever relies on serology with enzyme immunoassay (EIA). The main feature of Q fever is its clinical polymorphism: clinical signs may be aspecific and, in chronic cases, patients often do not recall having had the acute infection. As the most frequent and severe manifestation of Q fever is endocarditis, severe consequences may ensue. In our patient, broad-spectrum antibiotics were given before the serology results were available and rapid clinical improvement was achieved. This unusual disease should therefore also be considered in differential diagnosis of fever in the elderly, and age should not be considered as a contraindication for not performing all studies, because timely and adequate treatment is important partly to preserve elderly patients' self-sufficiency and to prevent them from becoming bedridden. PMID:22170110

Ruggiero, Elena; Inelmen, Emine Meral; Grosso, Giorgia; Manzato, Enzo



Case--control study to identify risk factors for paediatric endemic typhoid fever in Santiago, Chile  

PubMed Central

Typhoid fever is an important endemic health problem in Santiago, Chile. Its incidence has more than doubled in recent years, during which access to potable water and sewage disposal in the home became almost universal in the city. A matched case—control study was carried out to identify risk factors and vehicles of transmission of paediatric typhoid fever; 81 children in the 3-14-years age group with typhoid fever were compared with controls, matched with respect to age, sex, and neighbourhood. It was found that case children more frequently bought lunch at school and shared food with classmates. Also, case children more often consumed flavoured ices bought outside the home; none of 41 other food items considered in the study was associated with a higher risk of typhoid fever. Only two food handlers for cases and one for controls were positive for Salmonella typhi, indicating that persons preparing food solely for their own family were not the main source of S. typhi infection. Rather, the risk factors identified in this study are consistent with the hypothesis that paediatric endemic typhoid fever in Santiago is largely spread by consumption of food-stuffs that are prepared outside the individual's home and are shared with or sold to children.

Black, Robert E.; Cisneros, Luis; Levine, Myron M.; Banfi, Antonio; Lobos, Hernan; Rodriguez, Hector



Serotonin-induced high intracellular pH aids in alkali secretion in the anterior midgut of larval yellow fever mosquito Aedes aegypti L.  

PubMed Central

Summary The anterior midgut of the larval yellow fever mosquito Aedes aegypti generates a luminal pH in excess of 10 in vivo and similar values are attained by isolated and perfused anterior midgut segments after stimulation with submicromolar serotonin. In the present study we investigated the mechanisms of strong luminal alkalinization using the intracellular fluorescent indicator BCECF-AM. Following stimulation with serotonin, we observed that intracellular pH (pHi) of the anterior midgut increased from a mean of 6.89 to a mean of 7.62, whereas pHi of the posterior midgut did not change in response to serotonin. Moreover, a further increase of pHi to 8.58 occurred when the pH of the luminal perfusate was raised to an in vivo-like value of 10.0. Luminal Zn2+ (10 ?mol l–1), an inhibitor of conductive proton pathways, did not inhibit the increase in pHi, the transepithelial voltage, or the capacity of the isolated tissue to alkalinize the lumen. Finally, the transapical voltage did not significantly respond to luminal pH changes induced either by perfusion with pH 10 or by stopping the luminal perfusion with unbuffered solution which results in spontaneous luminal alkalinization. Together, these results seem to rule out the involvement of conductive pathways for proton absorption across the apical membrane and suggest that a serotonin-induced alkaline pHi plays an important role in the generation of an alkaline lumen.

Onken, Horst; Parks, Scott K.; Goss, Greg G.; Moffett, David F.



Dengue fever as an acute febrile disease after overseas travel: a report of two cases.  


Dengue fever (DF) is a relatively common infection in travelers, with about 100 cases being reported annually in Japan, and this number is increasing. We herein describe two patients who developed a fever after returning to Japan from Southeast Asia and who were serologically diagnosed with DF. Patient 1 was a 19-year-old man who spent 6 days in Thailand and developed diarrhea and a fever after returning to Japan. Virological studies showed dengue virus (DV) serotype 3 by reverse transcriptase PCR (RT-PCR), and anti-DV IgM and IgG antibodies were both positive by enzyme-linked immunosorbent assay (ELISA). Patient 2 was a 43-year-old man who spent time in various Asian countries and developed a fever and arthralgia after returning to Japan. Virological studies showed DV serotype 2 by RT-PCR, and anti-DV IgM and IgG antibodies were both positive by ELISA. DF and other febrile diseases, including Chikungunya fever, should be strongly suspected in patients who develop fever after returning to Japan from other Asian countries, irrespective of whether patients remember being bitten by mosquitoes. PMID:21519135

Tarumoto, Norihito; Abe, Yoshinobu; Yamaguchi, Toshiyuki; Takasaki, Tomohiko; Kurane, Ichiro; Maesaki, Shigefumi



Clinico-epidemiological profile of cases of fever with arthritis (Chikugunya) attending Urban Health Centre, Solapur.  


This communication describes the findings of a hospital and community survey conducted in the UHC catchment area of solapur city to find out clinico-epidemiological profile of cases of chikungunya fever during mid 2006. A total of 208 cases who attended UHC and 962 community members were studied. 20-44 was the mostly affected age-group and Females outnumber male hospital attendees. Major presenting features were fever, joint pain, bodyache, headache, nausea. In majority of patients, joint pain lasted for two months and subsided by 6th month. Of 21 samples tested, 19 showed IgM positivity for chikungunya. PMID:22010486

Gokhale, R M; Rayate, M V; Kotnis, S D; Sathe, P S



Sirolimus-Induced Drug Fever in a Renal Transplant Patient: A Case Report  

Microsoft Academic Search

Herein we have described the case of a male renal transplant recipient who developed drug fever apparently related to sirolimus. He had been stable under an immunosuppressive regimen of tacrolimus and mycophenolate mofetil, but developed acute cellular rejection at 5 years after transplantation due to noncompliance. Renal biopsy showed marked interstitial fibrosis, and immunosuppression was switched from mycophenolate to sirolimus,

I. Aires; D. Carvalho; F. Remédio; M. Possante; A. Ferreira; J. R. Pinto; F. Nolasco; J. R. Santos



Prosthetic Valve Endocarditis Caused by Streptobacillus moniliformis: a Case of Rat Bite Fever?  

PubMed Central

We report a case of rat bite fever caused by Streptobacillus moniliformis in Taiwan. It manifested as prosthetic valve endocarditis, which was cured by cardiac valve replacement and antimicrobial therapy. The DNA sequence of the 16S rRNA gene of S. moniliformis was detected in valve specimens by PCR and nucleotide sequencing.

Chen, Po-Lin; Lee, Nan-Yao; Yan, Jing-Jou; Yang, Yu-jen; Chen, Hung-Mo; Chang, Chia-Ming; Lee, Hsin-Chun; Ko, Nai-Ying; Lai, Chao-Han; Ko, Wen-Chien




Microsoft Academic Search

A female dog of the Shar Pei breed, aged 28 months, was euthanised due to familial shar pei fever with amyloidosis. Microscopic and ultrastructural analyses demonstrated the dog to be affected by acute pancreatitis as an outcome of renal amyloidosis and morphological lesions occurring in the liver. The presented case report depicts the microscopic and ultrastructural pattern of the dog



Hip involvement in patients with familial Mediterranean fever. A review of ten cases  

Microsoft Academic Search

Hip involvement is uncommon in familial Mediterranean fever (FMF) and can result either from a process specific to this disease or from a coexisting chronic inflammatory joint disease, usually suggestive of ankylosing spondylitis (AS). We report ten cases of FMF with radiologically-documented inflammatory hip disease. Five patients had AS and one had juvenile idiopathic arthritis. There were six men and

Mohamed Younes; Marcel-Francis Kahn; Olivier Meyer



A case of ruptured renal cortical arteriovenous malformation of the right testicular vein in hemorrhagic fever with renal syndrome  

PubMed Central

Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease characterized by fever, hemorrhage, and renal failure. Among the various hemorrhagic complications of HFRS, the spontaneous rupture of an arteriovenous malformation of the testicular vessels with a retroperitoneal hematoma is a rare finding. Here, we report a case of HFRS complicated by a massive retroperitoneal hematoma that was treated with transcatheter arterial embolization.

Lee, Seung Min; Kim, Hong Dae; Lee, Young-Ki



Confirmed malaria cases among children under five with fever and history of fever in rural western Tanzania  

PubMed Central

Background The World Health Organization recommends that malaria treatment should begin with parasitological diagnosis. This will help to control misuse of anti-malarial drugs in areas with low transmission. The present study was conducted to assess the prevalence of parasitologically confirmed malaria among children under five years of age presenting with fever or history of fever in rural western Tanzania. A finger prick blood sample was obtained from each child, and thin and thick blood smears were prepared, stained with 10% Giemsa and examined under the light microscope. A structured questionnaire was used to collect each patient's demographic information, reasons for coming to the health center; and a physical examination was carried out on all patients. Fever was defined as axillary temperature ? 37.5°C. Findings A total of 300 children with fever or a history of fever (1 or 2 weeks) were recruited, in which 54.3% (163/300, 95%CI, 48.7-59.9) were boys. A total of 76 (76/300, 25.3%, 95%CI, 22.8 - 27.8) of the children had fever. Based on a parasitological diagnosis of malaria, only 12% (36/300, 95%CI, 8.3-15.7) of the children had P. falciparum infection. Of the children with P. falciparum infection, 52.7% (19/36, 95%CI, 47.1-58.3) had fever and the remaining had no fever. The geometrical mean of the parasites was 708.62 (95%CI, 477.96-1050.62) parasites/?l and 25% (9/36, 95%CI, 10.9 -- 39.1) of the children with positive P. falciparum had ? 1001 parasites/?l. On Univariate (OR = 2.13, 95%CI, 1.02-4.43, P = 0.044) and multivariate (OR = 2.15, 95%CI, 1.03-4.49) analysis, only children above one year of age were associated with malaria infections. Conclusion Only a small proportion of the children under the age of five with fever had malaria, and with a proportion of children having non-malaria fever. Improvement of malaria diagnostic and other causes of febrile illness may provide effective measure in management of febrile illness in malaria endemic areas.



[Blackwater fever during antimalarial treatment in Abidjan (West Africa): report of 41 cases].  


Intravascular haemolysis, particularly blackwater fever is a rare but severe clinical syndrome, occurring after ingestion of antimalarials. A resurgence of this affection which occurred frequently during the colonization has lately been noticed. We have conducted a prospective study in order to identify the main antimalarials which are responsible for this syndrome. We reported 41 cases from 1996 to 2000, among which 80% of blackwater fever cases were associated with quinine ingestion or similar structural molecules. Their causal role is well established. For the other molecules it is difficult to underscore their role. The mortality rate is around 18%. The morbidity is high because 90% of patients have suffered from renal failure. Among them, 47% required dialysis. We are facing a public health issue thus a rational use of antimalarials is necessary. PMID:15787264

Daubrey-Potey, Th; Die-Kacou, H; Kamagate, M; Vamy, M; Balayssac, E; Yavo, J C



Forecasting Dengue Haemorrhagic Fever Cases in Southern Thailand using ARIMA Models  

Microsoft Academic Search

A univariate time-series analysis method has been used to model and forecast the monthly number of dengue haemorrhagic fever (DHF) cases in southern Thailand. We developed autoregressive integrated moving average (ARIMA) models on the data collected between 1994-2005 and then validated the models using the data collected between January-August 2006. The results showed that the regressive forecast curves were consistent

S. Promprou; M. Jaroensutasinee; K. Jaroensutasinee



Pathology Case Study: Fevers and Mental Status Changes  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which a woman underwent an allogenic bone marrow transplant but did not respond well. Visitors are given the autopsy information and patient history, including images, and are given the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to use to introduce or test student learning in autopsy pathology.

Torbenson, Michael; Martinez, A. Julio (Augusto Julio); Nichols, Larry



Brazilian spotted fever: real-time PCR for diagnosis of fatal cases.  


Suspicion of Brazilian spotted fever (BSF) should occur in endemic regions upon surveillance of the acute febrile icteric hemorrhagic syndrome (AFIHS). However, limitations associated with currently available laboratory tests pose a challenge to early diagnosis, especially in fatal cases. Two real-time PCR (qPCR) protocols were evaluated to diagnose BSF in 110 fatal AFIHS cases, collected in BSF-endemic regions in 2009-2010. Of these, 24 were positive and 86 negative by indirect immunofluorescence (IFA) assay (cut-off IgG and/or IgM ? 128). DNA from these samples was used in the qPCR protocols: one to detect Rickettsia spp. (citrate synthase gene) and another to determine spotted fever group (SFG) Rickettsia species (OmpA gene). Of the 24 IFA-positive samples, 5 (21%) were positive for OmpA and 9 (38%) for citrate synthase. In the IFA-negative group (n=86), OmpA and citrate synthase were positive in 23 (27%) and 27 (31%), respectively. These results showed that the 2 qPCR protocols were about twice as sensitive as the IFA test alone (93% concordance). In conclusion, qPCR is a sensitive method for the diagnosis of fatal BSF cases and should be considered for routine surveillance of AFIHS in places like Brazil, where spotted fever-related lethality is high and other endemic diseases like dengue and leptospirosis can mislead diagnosis. PMID:23168050

dos Santos, Fabiana Cristina Pereira; do Nascimento, Elvira Maria Mendes; Katz, Gizelda; Angerami, Rodrigo Nogueira; Colombo, Silvia; de Souza, Eliana Rodrigues; Labruna, Marcelo Bahia; da Silva, Marcos Vinicius



Case management of malaria fever at community pharmacies in Pakistan: a threat to rational drug use  

PubMed Central

Objective To document the case management of uncomplicated malaria fever at community pharmacies located in the two major cities of Pakistan; Islamabad (national capital) and Rawalpindi (twin city). Methods A comparative, cross-sectional study was designed to document the management of uncomplicated malaria fever at community pharmacies in twin cities of Pakistan through simulated patient visits. Visits were conducted in 238 randomly selected pharmacies to request advice for a simulated patient case of malaria. The pharmacy’s management was scored on a checklist including history taking and provision of advice and information. Kruskal-Wallis test and Mann-Whitney U test were used to compare management of uncomplicated malaria fever by different types of dispensers working at community pharmacies situated at different locations in the twin cities. Results The simulated patients were handled by salesmen (74.8%, n=178), pharmacist (5.4%, n=13) and diploma holders (19.8 %, n=47). Medication was dispensed in 83.1 % (n=198) of the visits, but only few of the treated cases were in accordance to standard treatment guidelines for malaria. However, in 14.8% (n=35) of the cases the simulated patients were directly referred to a physician. There was a significant difference observed in the process of history taking performed by different dispensers (e.g. pharmacist, pharmacy assistant, pharmacy diploma holders and salesman) while no significant differences in the provision of advice by these dispensers was observed. Pharmacists were seen more frequently involved in the process of history taking if available at the community pharmacies. On the other hand, no significant differences were observed in the case management (history taking and provision of advice) for the treatment of malaria fever among community pharmacies situated at different locations (e.g. near hospital/super market/small market) in the twin cities. Conclusions The results of the study revealed that the overall process of disease management of uncomplicated malaria fever at community pharmacies was not in accordance with the national standard treatment guidelines for malaria. Patients were being treated by untrained personnel’s at community pharmacies without any understanding of referral. However, pharmacists were more frequently involved in history taking, though their availability was low at community pharmacies.

Malik, Madeeha; Hassali, Mohamed A.; Shafie, Asrul A.; Hussain, Azhar; Aljadhey, Hisham; Saleem, Fahad


Q fever endocarditis masquerading as Mixed cryoglobulinemia type II. A case report and review of the literature  

PubMed Central

Background The clinical manifestations of Q fever endocarditis are protean in nature. Mixed cryoglobulinemia type II is rarely a facet of the presenting clinical manifestations of Q fever endocarditis. Case presentation We report a case of a 65-year-old pensioner with such an association and review the literature. As transesophageal echocardiograms are usually normal and blood cultures are usually negative in Q fever endocarditis, many of the manifestations (fever, rash, glomerulonephritis/evidence of renal disease, low serum C4 complement component, presence of mixed type II cryoglobulin, constitutional symptoms as arthralgias and fatigue) can be attributed to Mixed cryoglobulinemia type II per se. The use of Classic Duke Endocarditis Service criteria does not always suffice for the diagnosis of Q fever. Conclusion The application of the modified criteria proposed by Fournier et al for the improvement of the diagnosis of Q fever endocarditis will help to reach the diagnosis earlier and thus reduce the high mortality of the disease. We would like to stress the importance of ruling out the diagnosis of Q fever endocarditis in cases of mixed type II cryoglobulinemia.

Rafailidis, Petros I; Dourakis, Spiros P; Fourlas, Christos A



Imported Enteric Fever: Case Series from the Hospital for Tropical Diseases, London, United Kingdom  

PubMed Central

Our current knowledge of the clinical characteristics of enteric fever is drawn mainly from population-based studies in disease-endemic countries, and there are limited data published on cases in returning travelers. We report the clinical characteristics of enteric fever in 92 travelers returning to London, United Kingdom. Salmonella typhi and S. paratyphi resulted in an almost indistinguishable clinical picture. Rose spots and relative bradycardia were found only in a few patients. A total of 91% of the patients had a normal leukocyte count, which was associated with a markedly increased level of alanine aminotransferase in 82%. A total of 57% of the S. typhi isolates had decreased susceptibility to ciprofloxacin and resistance to nalidixic acid; these isolates were from southern Asia. Thirty percent were multidrug resistant; all were from southern Asia and Nigeria. None of the paratyphoid isolates were multidrug resistant but rates of decreased susceptibility to fluoroquinolones were higher than in S. typhi (74%).

Patel, Trupti A.; Armstrong, Margaret; Morris-Jones, Stephen D.; Wright, Stephen G.; Doherty, Tom



Evaluation of PPGIS empowerment--a case study of Meinong Yellow Butterfly Valley in Taiwan.  


As a tool of public policy making, PPGIS (public participation geographic information system) makes its biggest impact in regard to empowerment. Quite few methods are available for making a complete evaluation of the empowerment. Using the Meinong Yellow Butterfly Valley as a case study, this article analyzes how the processes and outcomes of the PPGIS make an impact on empowerment in terms of three aspects indicated by the questions: "What is empowered?" "Who are empowered?" and "How to empower?" The results show that we are able to completely grasp the impact of PPGIS empowerment by analyzing what, who and how aspects simultaneously. They also indicate that PPGIS empowerment involves mutual transfers of knowledge, capabilities and power among all of the stakeholders, which can't simply be given by outsiders. PMID:23321371

Tsai, Bor-Wen; Lu, Dau-Jye; Chung, Ming-Kuang; Lien, Mei-Chih



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

PubMed Central

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



[The role of FDG PET/CT for detecting the cause of fever of unknown origin in a clinical case].  


The fever of unknown origin from time to time constitutes a serious clinical problem and nearly all diagnostic methods are involved to discover urgently its cause. According to literature data (18)F-fluoro-deoxyglucose PET/CT was successful in 25-70% of cases even in patients without any positive findings with conventional diagnostic techniques. The Hungarian National Health Fund does not include fever of unknown origin in the list of reimbursed (18)F-fluoro-deoxyglucose PET/CT indications. The authors try to illustrate the clinical problem with this case report. Fever of unknown origin persisted in a patient for a year, but conventional diagnostic procedures were unsuccessful to find the cause of the fever. Finally, (18)F-fluoro-deoxyglucose PET/CT indicated a metabolically active focus between the pancreas tail and the spleen. After a long-lasting antibiotic therapy the patient became symptomfree. PMID:22296927

Szucs, Bernadett; Nagy, Edit; Talev, Stefan; Garai, Ildikó; Galuska, László



Acute pancreatitis associated with hemorrhagic fever with renal syndrome: clinical analysis of 12 cases.  


Abstract Background: Acute pancreatitis is one of the rare complications of hemorrhagic fever with renal syndrome (HFRS), which easy to be misdiagnosed as acute abdomen, usually critically ill, poor treatment effect, highly mortality. In this study, we retrospectively analyzed to explore the clinical characteristics, 12 cases of hemorrhagic fever with renal syndrome complicated with acute pancreatitis treatment methods and prognosis. Methods: We conducted a retrospective study of HFRS in patients complicated with acute pancreatitis. 12 cases were collected from Ningbo first hospital between January 2001 and December 2012. Clinical information and laboratory parameters were obtained by reviewing literature and records. Results: Twelve from 156 cases (7.69%) HFRS complicated with acute pancreatitis. Men comprised more than half (75%) of the sample population, the mean age was (38?±?19) years. Abdominal pain was the main clinical manifestations in all the patients, all of their serum amylase and serum lipase were increased, 10 patients were given the total abdomen CT examination, eight cases showed enlargement of the pancreas and surrounding leakage, two cases showed pancreatic necrosis and hemorrhage. Three cases complicated with pulmonary edema. In 12 cases, four of them received hemodialysis treatment, one gives surgical intervention. Eight cases were complete remission, three cases were partial remission and one case was death. Conclusions: Acute pancreatitis is one of rare of the serious complications of HFRS, whereas the correct diagnosis and clear the cause of disease is critical for improve the quality of life of patients and reduce the mortality, timely hemodialysis treatment is effective, early intervention can improve the prognosis. PMID:23964665

Fan, Heng; Zhao, Yu; Song, Fu-Chun



[Typhoid fever with intestinal hemorrhage, drug-induced fever, DIC, ARDS and psychiatric disorder (a case report)].  


A 40-year-old poor nutritional Japanese male was admitted to our hospital on June 5, 1989, with a 31-day history of fever. He had been working as a crew member of a ship in South East Asia. Salmonella typhi was isolated from his blood culture. In the course of the disease, intestinal hemorrhage, drug-induced fever and liver dysfunction, DIC, ARDS, and psychiatric disorder were identified. Intestinal hemorrhage occurred after the coagulation test became normal, so it was thought that the intestinal hemorrhage did not correlate with DIC. The patient was treated with CP, ABPC and supportive therapy. He became well, and ARDS and psychiatric disorder were disappeared. He was discharged on the 118th day of illness. Drug-induced fever was thought as one of the allergic reaction and the causative drug was not identified by LST. It was suspected that psychiatric disorder correlated with poor nutrition. Supportive therapy such as mandatory bed rest, intravenous hyperalimentation and low-volume blood transfusions, as well as an antimicrobial treatment were important for the inhibition of shock and/or intestinal perforation. PMID:2258653

Ohnishi, K; Murata, M



A case of ruptured renal cortical arteriovenous malformation of the right testicular vein in hemorrhagic fever with renal syndrome.  


Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease characterized by fever, hemorrhage, and renal failure. Among the various hemorrhagic complications of HFRS, the spontaneous rupture of an arteriovenous malformation of the testicular vessels with a retroperitoneal hematoma is a rare finding. Here, we report a case of HFRS complicated by a massive retroperitoneal hematoma that was treated with transcatheter arterial embolization. PMID:23682233

Lee, Seung Min; Kim, Hong Dae; Lee, Young-Ki; Noh, Jung Woo



Chapare Virus, a Newly Discovered Arenavirus Isolated from a Fatal Hemorrhagic Fever Case in Bolivia  

PubMed Central

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

Delgado, Simon; Erickson, Bobbie R.; Agudo, Roberto; Blair, Patrick J.; Vallejo, Efrain; Albarino, Cesar G.; Vargas, Jorge; Comer, James A.; Rollin, Pierre E.; Ksiazek, Thomas G.; Olson, James G.; Nichol, Stuart T.



Allergies and Diabetes as Risk Factors for Dengue Hemorrhagic Fever: Results of a Case Control Study  

PubMed Central

Background The physiopathology of dengue hemorrhagic fever (DHF), a severe form of Dengue Fever, is poorly understood. We are unable to identify patients likely to progress to DHF for closer monitoring and early intervention during epidemics, so most cases are sent home. This study explored whether patients with selected co-morbidities are at higher risk of developing DHF. Methods A matched case-control study was conducted in a dengue sero-positive population in two Brazilian cities. For each case of DHF, 7 sero-positive controls were selected. Cases and controls were interviewed and information collected on demographic and socio-economic status, reported co-morbidities (diabetes, hypertension, allergy) and use of medication. Conditional logistic regression was used to calculate the strength of the association between the co-morbidities and occurrence of DHF. Results 170 cases of DHF and 1,175 controls were included. Significant associations were found between DHF and white ethnicity (OR?=?4.70; 2.17–10.20), high income (OR?=?6.84; 4.09–11.43), high education (OR?=?4.67; 2.35–9.27), reported diabetes (OR?=?2.75; 1.12–6.73) and reported allergy treated with steroids (OR?=?2.94; 1.01–8.54). Black individuals who reported being treated for hypertension had 13 times higher risk of DHF then black individuals reporting no hypertension. Conclusions This is the first study to find an association between DHF and diabetes, allergy and hypertension. Given the high case fatality rate of DHF (1–5%), we believe that the evidence produced in this study, when confirmed in other studies, suggests that screening criteria might be used to identify adult patients at a greater risk of developing DHF with a recommendation that they remain under observation and monitoring in hospital.

Figueiredo, Maria Aparecida A.; Rodrigues, Laura C.; Barreto, Mauricio L.; Lima, Jose Wellington O.; Costa, Maria C. N.; Morato, Vanessa; Blanton, Ronald; Vasconcelos, Pedro F. C.; Nunes, Marcio R. T.; Teixeira, Maria Gloria



Typhoid fever  

Microsoft Academic Search

Typhoid fever is caused by infection with Salmonella enterica serovar Typhi. The completion of the genome sequence of two Salmonella enterica serovar Typhi isolates is leading to new insights into the biology of this pathogen. Approximately 16 million cases occur\\u000a worldwide each year. The lack of culture facilities in endemic areas and the poor performance of the Widal test means

Christopher M. Parry



A Reassortant Bunyavirus Isolated from Acute Hemorrhagic Fever Cases in Kenya and Somalia  

Microsoft Academic Search

In late 1997 and early 1998, a large outbreak of hemorrhagic fever occurred in East Africa. Clinical samples were collected in Kenya and southern Somalia, and 27 of 115 (23%) hemorrhagic fever patients tested showed evidence of acute infection with Rift Valley fever (RVF) virus as determined by IgM detection, virus isolation, detection of virus RNA by reverse transcription-polymerase chain

Michael D. Bowen; Sam G. Trappier; Angela J. Sanchez; Richard F. Meyer; Cynthia S. Goldsmith; Sherif R. Zaki; Lee M. Dunster; C. J. Peters; Thomas G. Ksiazek; Stuart T. Nichol



Chronic Q Fever-Related Dual-Pathogen Endocarditis: Case Series of Three Patients?  

PubMed Central

Following Coxiella burnetii infection, there is a 1 to 5% risk of chronic Q fever. Endocarditis, mycotic aneurysm, and vascular prosthesis infection are common manifestations. We present three patients with endocarditis by C. burnetii concomitant with another bacterial pathogen. Chronic Q fever should therefore be considered in all endocarditis patients in regions where Q fever is endemic.

Kampschreur, Linda M.; Oosterheert, Jan Jelrik; de Vries Feyens, Cornelia A.; Delsing, Corine E.; Hermans, Mirjam H. A.; van Sluisveld, Ingrid L. L.; Lestrade, Peter J.; Renders, Nicole H. M.; Elsman, Peter; Wever, Peter C.



[A case of Crimean-Congo hemorrhagic fever with long incubation period in Kocaeli, Turkey].  


Crimean-Congo hemorrhagic fever (CCHF) is a viral hemorrhagic disease with high mortality rate. CCHF is endemic in Central Anatolia and East and Central Black Sea parts of Turkey, however sporadic cases have been detected in the other regions. The incubation period of the disease is between 1-3 days (maximum 12 days). In this report, a very rare CCHF case with a long incubation period of 30 days, was reported. A 40-year-old female patient living in a village of Kocaeli, Turkey was admitted to a health center in June 2010 with the complaints of headache, myalgia, nausea, vomiting, fatigue and fever. Since laboratory results revealed severe thrombocytopenia (18.300/mm3), the patient was referred to the university hospital in Kocaeli. It was learned from her history that she had been working in the garden and removed a tick from the skin of gluteal area a month ago without seeking any medical help. Physical examination of the patient revealed that her general condition was well, oriented and cooperative, body temperature was 36.6°C, pulse 82/minute, trombocyte count 69.400/mm3 and liver enzymes were elevated (ALT: 194 U/L, AST: 499 U/L, GGT: 384 U/L, LDH: 1290 U/L). Petecchial lesions were seen on hard palate and extremities and a hyperemic lesion was detected at the gluteal area where the tick had attached. In-house real-time polymerase chain reaction test for CCHF, performed at Refik Saydam National Public Health Agency, Virology Reference and Research Laboratory, revealed positive result. This case was presented to withdraw attention to a long incubation period CCHF and also of its epidemiological importance since it was the first case in Kocaeli province, Turkey. PMID:22399182

Meriç Koç, Meliha; Willke, Ay?e



Rhabdomyosarcoma in adrenal region of a child with hypertension and fever: a case report and literature review.  


Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children but rarely involves the adrenal. We describe a case of alveolar rhabdomyosarcoma (ARMS) of the right adrenal in a 5-year-old boy with a characteristic history of hypertension and recurrent fever. On surveillance imaging, a right adrenal mass was incidentally detected, and a right adrenalectomy was subsequently performed. After the surgery, the fever disappeared simultaneously, and the blood pressure gradually returned to normal level. This is the first reported case in children. PMID:23480948

Yi, Xiaoping; Long, Xueying; Xiao, Desheng; Zai, Hongyan; Li, Yixiong



Bio-optical properties of high chlorophyll Case 1 waters and of yellow-substance-dominated Case 2 waters  

NASA Astrophysics Data System (ADS)

Case 1 waters with high chlorophyll content can be encountered as soon as the nutrient availability is high enough and the terrestrial influence by land drainage is negligible. Offshore oceanic blooms and upwelling zones along arid coasts are instances of such waters. Their bio-optical properties are less documented compared to those of mesotrophic or oligotrophic waters. A coherent set of measurements of bio-geochemical properties (algal pigments, suspended particulate matter), inherent optical properties (absorption and scattering by water bodies and by particulate material), and apparent optical properties (hyperspectral reflectance and diffuse attenuation coefficients) was obtained within the Benguela Current, i.e. in an upwelling area with arid climate and no runoff. These data allow the bio-optical relationships in eutrophic Case 1 waters to be analyzed, and their natural variability to be compared with that previously observed in less productive waters. In addition, a comparison between eutrophic Case 1 waters and yellow substance dominated Case 2 waters can be made, since such waters are also present in the area under investigation. The coherence between the inherent and apparent optical properties is also analyzed via inversion. Despite some deficiencies in their parameterization, the existing bio-optical models for Case 1 waters were proven to be valid such that they can be extended without significant discontinuities toward the domain of high concentration (up to 30 mg m -3). In particular, those models in use for the interpretation of remotely sensed ocean color continue to apply, even if the sensitivity of current algorithms for the chlorophyll retrieval weakens owing to inescapable physical limitations in the case of high concentrations.

Morel, André; Gentili, Bernard; Chami, Malik; Ras, Joséphine



A single amino acid substitution in the envelope protein of chimeric yellow fever-dengue 1 vaccine virus reduces neurovirulence for suckling mice and viremia/viscerotropism for monkeys.  


A chimeric yellow fever-dengue 1 (ChimeriVax-DEN1) virus was produced by the transfection of Vero cells with chimeric in vitro RNA transcripts. The cell culture supernatant was subjected to plaque purification for the identification of a vaccine candidate without mutations. Of 10 plaque-purified clones, 1 containing no mutation (clone J) was selected for production of the vaccine virus. During subsequent cell culture passaging of this clone for vaccine production, a single amino acid substitution (K to R) occurred in the envelope (E) protein at residue 204 (E204) (F. Guirakhoo, K. Pugachev, Z. Zhang, G. Myers, I. Levenbook, K. Draper, J. Lang, S. Ocran, F. Mitchell, M. Parsons, N. Brown, S. Brandler, C. Fournier, B. Barrere, F. Rizvi, A. Travassos, R. Nichols, D. Trent, and T. Monath, J. Virol. 78:4761-4775, 2004). The same mutation was observed in another clone (clone E). This mutation attenuated the virus in 4-day-old suckling mice inoculated by the intracerebral (i.c.) route and led to reduced viremia in monkeys inoculated by the subcutaneous or i.c. route. The histopathology scores of lesions in the brain tissue of monkeys inoculated with either the E204K or E204R virus were reduced compared to those for monkeys inoculated with the reference virus, a commercial yellow fever 17D vaccine (YF-VAX). Both viruses grew to significantly lower titers than YF-VAX in HepG2, a human hepatoma cell line. After intrathoracic inoculation into mosquitoes, both viruses grew to a similar level as YF-VAX, which was significantly lower than that of their wild-type DEN1 parent virus. A comparison of the E-protein structures of nonmutant and mutant viruses suggested the appearance of new intramolecular bonds between residues 204R, 261H, and 257E in the mutant virus. These changes may be responsible for virus attenuation through a change in the pH threshold for virus envelope fusion with the host cell membrane. PMID:15331733

Guirakhoo, F; Zhang, Z; Myers, G; Johnson, B W; Pugachev, K; Nichols, R; Brown, N; Levenbook, I; Draper, K; Cyrek, S; Lang, J; Fournier, C; Barrere, B; Delagrave, S; Monath, T P



A Single Amino Acid Substitution in the Envelope Protein of Chimeric Yellow Fever-Dengue 1 Vaccine Virus Reduces Neurovirulence for Suckling Mice and Viremia/Viscerotropism for Monkeys  

PubMed Central

A chimeric yellow fever-dengue 1 (ChimeriVax-DEN1) virus was produced by the transfection of Vero cells with chimeric in vitro RNA transcripts. The cell culture supernatant was subjected to plaque purification for the identification of a vaccine candidate without mutations. Of 10 plaque-purified clones, 1 containing no mutation (clone J) was selected for production of the vaccine virus. During subsequent cell culture passaging of this clone for vaccine production, a single amino acid substitution (K to R) occurred in the envelope (E) protein at residue 204 (E204) (F. Guirakhoo, K. Pugachev, Z. Zhang, G. Myers, I. Levenbook, K. Draper, J. Lang, S. Ocran, F. Mitchell, M. Parsons, N. Brown, S. Brandler, C. Fournier, B. Barrere, F. Rizvi, A. Travassos, R. Nichols, D. Trent, and T. Monath, J. Virol. 78:4761-4775, 2004). The same mutation was observed in another clone (clone E). This mutation attenuated the virus in 4-day-old suckling mice inoculated by the intracerebral (i.c.) route and led to reduced viremia in monkeys inoculated by the subcutaneous or i.c. route. The histopathology scores of lesions in the brain tissue of monkeys inoculated with either the E204K or E204R virus were reduced compared to those for monkeys inoculated with the reference virus, a commercial yellow fever 17D vaccine (YF-VAX). Both viruses grew to significantly lower titers than YF-VAX in HepG2, a human hepatoma cell line. After intrathoracic inoculation into mosquitoes, both viruses grew to a similar level as YF-VAX, which was significantly lower than that of their wild-type DEN1 parent virus. A comparison of the E-protein structures of nonmutant and mutant viruses suggested the appearance of new intramolecular bonds between residues 204R, 261H, and 257E in the mutant virus. These changes may be responsible for virus attenuation through a change in the pH threshold for virus envelope fusion with the host cell membrane.

Guirakhoo, F.; Zhang, Z.; Myers, G.; Johnson, B. W.; Pugachev, K.; Nichols, R.; Brown, N.; Levenbook, I.; Draper, K.; Cyrek, S.; Lang, J.; Fournier, C.; Barrere, B.; Delagrave, S.; Monath, T. P.



The impact of a program for strengthening dengue hemorrhagic fever case management on the clinical outcome of dengue hemorrhagic fever patients.  


This study compared the case fatality ratio (CFR) of dengue shock syndrome (DSS) patients admitted to Buri Ram Hospital, an area with CFR of 0.11, 0.43 and 0.23% in 2002, 2003 and 2004, respectively, to obtain a provincial model for dengue case management using the I. development of a special program for strengthening dengue hemorrhagic fever (DHF) case management (No deaths in DSS patients), II. a retrospective review of the medical records of dengue fever (DF), DHF and DSS patients referred to Buri Ram Hospital. We compared the data during the 3 periods of the implementation of this program. Data was statistically analyzed using chi2 or Fisher's exact test for categorical variables, one-way ANOVA for continuous data with normal distribution and Kruskal-Wallis test for nonparametric variables. The numbers of DF, DHF and DSS cases in Buri Ram were 1332, 1700 and 1630 person, respectively, during 2006-2008. The number of DSS patients increased after implementation of the program: 12.2, 51.2 and 47.22 for 2006, 2007 and 2008, respectively, but the complications of the disease decreased. The CFR during 2006, 2007 and 2008 were 0.15, 0 and 0.06% (p > 0.05). The program for strengthening DHF case management did improve clinical outcomes in dengue patients after the implementation. The CFR in 2008 was only 0.06%, lower than the goal of the Ministry of Public Health (<0.13%). This program is still running, sustaining low CFR in dengue patients. It may be used as a model for other provinces in Thailand that have high dengue deaths. PMID:21073059

Mayurasakorn, Saengdao; Suttipun, Nipar



Disseminated Mycobacterium abscessus infection manifesting as fever of unknown origin and intra-abdominal lymphadenitis: Case report and literature review  

Microsoft Academic Search

Mycobacterium abscessus is a rapidly growing mycobacterium found in soil and water throughout the world. Disease in immunocompetent patients usually consists of localized skin and soft tissue infections. In contrast, disseminated disease is uncommon, usually presents with rash, and almost always occurs in an immunocompromised host. We describe an unusual case of disseminated M. abscessus infection manifesting as fever of

Paul S. Mueller; Randall S. Edson



Influenza or not influenza: Analysis of a case of high fever that happened 2000 years ago in Biblical time  

Microsoft Academic Search

The Bible describes the case of a woman with high fever cured by our Lord Jesus Christ. Based on the information provided by the gospels of Mark, Matthew and Luke, the diagnosis and the possible etiology of the febrile illness is discussed. Infectious diseases continue to be a threat to humanity, and influenza has been with us since the dawn

Kam LE Hon; Pak C Ng; Ting F Leung



The protean manifestations of hemorrhagic fever with renal syndrome. A retrospective review of 26 cases from Korea.  


Twenty-six cases of hemorrhagic fever with renal syndrome from 1981 to 1986 were retrospectively reviewed to determine the scope of clinical presentation and the unique complications of the illness. The diagnosis was confirmed by detection of Hantaan virus antibody in 25 cases and by characteristic autopsy findings in 1 case. The illness could be classified into three distinct clinical subgroups. Fever was universally present. Two patients presented with intractable shock and diffuse hemorrhage and died within 6 days from multi-organ system failure, mimicking the clinical picture of overwhelming sepsis. Eighteen patients presented with acute renal failure with an illness lasting a mean of 21 days (range, 10 to 36 days). Resolution of thrombocytopenia heralded recovery of renal function. At discharge, the serum creatinine level was normal in 13 patients; 5 patients had evidence of minimal renal dysfunction. Acute pulmonary edema requiring hemodialysis and retroperitoneal hemorrhage were the major complications in this subgroup. Six patients had an undifferentiated febrile illness with normal renal function. Fever, thrombocytopenia, abnormal urinalysis, hypertransaminasemia, and a benign clinical course characterized the third clinical pattern. The recent availability of serodiagnostic methods to detect Hantavirus group antibody facilitates the diagnosis of hemorrhagic fever with renal syndrome. Application of this test in the described clinical settings will identify unsuspected cases, broaden the knowledge of the geographic distribution of Hantavirus infection, and increase physician awareness of its protean manifestations. PMID:1974404

Bruno, P; Hassell, L H; Brown, J; Tanner, W; Lau, A



Evaluation of antibiotic sensitivity pattern in cases of enteric fever in north west Rajasthan.  


A total of 50 cases of blood culture proved enteric fever were studied for clinical response to the treatment and compared with in vivo antibiotic sensitivity pattern. Out of 50 Salmonella strains isolated, 37 were S typhi and 13 S paratyphi A. All S typhi isolates were sensitive in vitro to gentamicin and ceftriaxone while sensitivity to ciprofloxacin was 73%, ampicillin 29.7%, chloromphenicol 27%, tetracycline 27% and co-trimoxazole 13.5%. Multidrug resistance (Ampicillin, Chloramphenicol, Cotrimoxazale and Tetracycline) was observed in 62% isolates. All Sparatyphi A isolates were sensitive to all the antibiotics. Clinical response to the antibiotic therapy was as follows: Group I--Ampicillin + Gentamicin: 15 cases, clinical response (CR), 9.1% (S typhi) and 75% (S paratyphi A), mean day of defervescence 5.33 days. Group II--Ciprofloxacin: 29 cases, clinical response 47.6% (S typhi) and 75% (S paratyphi A), mean day of defervescence--5.22 days. Group--III Ceftriaxone: 30 cases, clinical response 100% in all, mean day of defervescence--4.93 days. Thus we observed highly significant discrepancy in antibiotic sensitivity pattern of the isolates and clinical response. Most importantly we observed significantly delayed clinical response to the ceftriaxone. This may be indicative of evolving resistance to ceftriaxone. PMID:18975514

Saharan, Gopi; Gupta, Anjli; Gupta, B K; Sharma, B P; Kochar, D K; Purohit, V P



Cholestatic hepatitis in a patient with typhoid fever - a case report  

PubMed Central

Typhoid fever is a very common infectious disease, particularly in developing countries such as Sri Lanka. Although multiple organs are known to be affected by the disease, hepatic involvement could be considered the most important as studies have showed that it is associated with a higher relapse rate. We report a young patient who presented with fever and jaundice and found to have cholestatic hepatitis secondary to typhoid fever.



Human cytotoxic T lymphocyte responses to live attenuated 17D yellow fever vaccine: identification of HLA-B35-restricted CTL epitopes on nonstructural proteins NS1, NS2b, NS3, and the structural protein E.  


Yellow fever virus (YFV) is a re-emerging problem despite the existence of an effective live-attenuated vaccine. The induction of YFV-neutralizing antibodies undoubtedly contributes to vaccine efficacy, but T lymphocyte responses to YFV likely play a role in long-term efficacy. We studied the T lymphocyte responses to YFV in four vaccinees. Proliferation and cytolytic responses to YFV were demonstrated in all subjects. We isolated 13 YFV-specific CD8(+) CTL lines that recognized epitopes on the E, NS1, NS2b, and NS3 proteins; eight CTL lines were HLA-B35-restricted. YFV-specific T cell responses were detectable by IFN gamma ELISPOT assays 14 days postvaccination, with T cell frequencies sustained for up to 19 months. To our knowledge, this is the first report of human T lymphocyte responses following YFV vaccination. These results indicate that the live 17D YFV vaccine induced CD8(+) T cell responses directed against at least four different HLA-B35-restricted YFV epitopes. PMID:11853408

Co, Mary Dawn T; Terajima, Masanori; Cruz, John; Ennis, Francis A; Rothman, Alan L



[A case report of acute Q fever showing Kawasaki disease-like symptoms in a 9-year-old girl].  


A 9-year-old girl developing fever and hyperemia of both bulbar conjunctiva 5 days before admission to the Saitama Children's Medical Center after antibiotics proved ineffective was found on admission to have general fatigue and a temperature of 39 degrees C. Physical examination showed hyperemia of the bulbar conjunctiva, fissures of the lips, redness of the pharynx, and swelling of the cervical lymph nodes. Laboratory tests detected neutrophilia (11,200/microL), mild anemia (11.4g/dL), thrombocytopenia (110,000/microL), and elevated serum aspartate aminotransferase (242IU/L), alanine aminotransferase (328IU/L), and C-rective protein (25.2 mg/dL). Autoantibodies such as anti-nuclear, anti-SS-A/Ro, and anti-Jo-1 were also found. Echocardiography showed no abnormality of the coronary arteries. She was diagnosed as having incomplete Kawasaki disease on day 7 of illness, necessitating that a high dose of immunoglobulin be given intravenously. Her temperature dropped temporarily to 37 degrees C, but she developed erythema of the cheek and fever. Intravenous immunoglobulin was restarted, and minocycline introduced because her daily contact with a pet cat indicated richettsial infection such as Q fever. Mild fever, muscle pain, and elevated C-reactive protein did not improve, but clinical signs and symptoms gradually lessened after ibuprofen was given, then disappeared. A definitive diagnosis of Q fever was made through an over 4-fold rise in phase II IgG antibody titers against Coxiella burnetii, titer of less than 1 : 16 on day 14 of illness, and titer of 1 : 256 on day 34. This case study describes on atypical case of Q fever with clinical manifestations mimicking Kawasaki disease. PMID:19522308

Ohgimi, Chikara; Tanaka, Risa; Oh-ishi, Tsutomu



Influence of hydrology process on wetland landscape pattern: A case study in the Yellow River Delta  

Microsoft Academic Search

A comprehensive study using ecological engineering analysis was conducted on the influence of the hydrology process in the Yellow River Delta. It was found that water and sediment played an important role in the formation and maintenance of the estuarine wetland. Based on hydrological data (1950–2005), meteorological data (1954–2005) and landscape data produced from integrated Landsat TM images of the

Sheng-nan Li; Gen-xu Wang; Wei Deng; Yuan-man Hu; Wei-Wei Hu



Q Fever  


... on Diagnosis and Management of Q Fever 2013 Q Fever Topics Symptoms, Diagnosis, and Treatment Signs of ... New guidelines on the diagnosis and management of Q fever File Formats Help: How do I view ...


A possible case of caprine-associated malignant catarrhal fever in a domestic water buffalo (Bubalus bubalis) in Switzerland  

PubMed Central

Background Malignant catarrhal fever (MCF) is a fatal herpesvirus infection, affecting various wild and domestic ruminants all over the world. Water buffaloes were reported to be particularly susceptible for the ovine herpesvirus-2 (OvHV-2) causing the sheep-associated form of MCF (SA-MCF). This report describes the first case of possibly caprine-associated malignant catarrhal fever symptoms in a domestic water buffalo in Switzerland. Case presentation The buffalo cow presented with persistent fever, dyspnoea, nasal bleeding and haematuria. Despite symptomatic therapy, the buffalo died and was submitted to post mortem examination. Major findings were an abomasal ulceration, a mild haemorrhagic cystitis and multifocal haemorrhages on the epicardium and on serosal and mucosal surfaces. Eyes and oral cavity were not affected. Histopathology revealed a mild to moderate lymphohistiocytic vasculitis limited to the brain and the urinary bladder. Although these findings are typical for MCF, OvHV-2 DNA was not detected in peripheral blood lymphocytes or in paraffin-embedded brain, using an OvHV-2 specific real time PCR. With the aid of a panherpesvirus PCR, a caprine herpesvirus-2 (CpHV-2) sequence could be amplified from both samples. Conclusions To our knowledge, this is the first report of malignant catarrhal fever in the subfamily Bovinae, where the presence of CpHV-2 could be demonstrated. The etiological context has yet to be evaluated.



[A case of acroparesthesias, asthenia and fever. A new mutation in Fabry's disease].  


Fabry disease is an X-linked hereditary metabolic storage disorder, due to the deficiency in lysosomal alpha-galactosidase A, with the consequent glycosphingolipids accumulation, primarily globotriaosylceramide, at cellular level. Multiorganic involvement occurs progressively, leading to severe manifestations and even premature mortality. We describe a case of a 20 year-old man who was sent to Rheumatology because of inespecific symptoms that lasted for years, namely acroparesthesias and diffuse hand pain and autolimited flares of high fever and general muscular weakness. Despite denying cutaneous findings, a remarkable purplish-red rash of slightly raised angiectases in the lower trunk was present. This rash was diagnosed as angiokeratomas, and blood measurement of alpha-galactosidase A confirmed the suspicion of Fabry disease. He was referred to a rare disease consultation, where the evaluation revealed the presence of other characteristic findings, such as cornea verticilata and cerebral lacunar infarction sequelae. The authors want to remark the importance of physical examination in these cases of inespecific long-lasting symptoms, with no diagnosis and with functional impairment, and the importance of multidisciplinary evaluation and collaboration. We also highlight that this mutation was not as yet described. PMID:22472932

Cruz, Margarida; Araújo, Francisco; Nogueira, David; Neves, Fernanda


Fiebre de Oropuche en Iquitos: Reporte Preliminar de 5 Casos (Oropouche Fever in Iquitos: Preliminary Report of 5 Cases). (Reannouncement with New Availability Information).  

National Technical Information Service (NTIS)

Oropuche fever in Iquitos: Preliminary report of 5 cases. Rev Farmacol Terap (Lime) 2((I): 12-14). 1992. Oropuche fever was isolated for the first lime in Peru in January 1992 in the serum of 5 patients living in Iquitos, that did not travell out of the c...

R. Chavez E. Colan I. Phillips



Recurrence of Epidemic Dengue Hemorrhagic Fever in an Insular Setting.  

National Technical Information Service (NTIS)

Epidemic dengue hemorrhagic fever recurred in 1967 on an island in the Gulf of Thailand. All cases seen were categorized by clinical syndrome as shock, hemorrhagic fever, dengue fever, or undifferentiated fever. Paired serum samples were examined for HI, ...

P. E. Winter S. Nantapanich A. Nisalak S. Udomsakdi R. W. Dewey



A case report of crimean congo hemorrhagic Fever in ostriches in iran.  


Crimean Congo hemorrhagic fever (CCHF) is a viral zoonosis, which is usually transmitted via tick bites or close contact with infected blood or tissue. This disease can cause a case fatality rate of up to 25%-30% in humans. CCHF Infection in birds is less documented. An ostrich can reproduce viruses and can also play the role of a mechanical vector, by transporting infected ticks without becoming ill. In March 2007, three butchers and one worker in an ostrich farm were infected with CCHF in central part of Iran. Considering the role ostriches play in transmitting the disease, serum samples from five ostriches of that farm were taken and sent to the laboratory for CCHF ELISA tests. The result of the IgG test was positive for one (20%) of the ostriches. At the same time, serum samples of eight sheep from the same farm were sent for IgG testing, two (25%) of which were positive. This was the first report of CCHF infection of an ostrich in Iran and tracing CCHF IgG against this ostrich and the afore-mentioned sheep may have revealed that the disease in the worker was the cause of transmission of this disease from these animals or their ticks. PMID:24015162

Mostafavi, Ehsan; Chinikar, Sadegh; Moradi, Maryam; Bayat, Neda; Meshkat, Mohsen; Fard, Mohammad Khalili; Ghiasi, Seyyed Mojtaba



A Case Report of Crimean Congo Hemorrhagic Fever in Ostriches in Iran  

PubMed Central

Crimean Congo hemorrhagic fever (CCHF) is a viral zoonosis, which is usually transmitted via tick bites or close contact with infected blood or tissue. This disease can cause a case fatality rate of up to 25%-30% in humans. CCHF Infection in birds is less documented. An ostrich can reproduce viruses and can also play the role of a mechanical vector, by transporting infected ticks without becoming ill. In March 2007, three butchers and one worker in an ostrich farm were infected with CCHF in central part of Iran. Considering the role ostriches play in transmitting the disease, serum samples from five ostriches of that farm were taken and sent to the laboratory for CCHF ELISA tests. The result of the IgG test was positive for one (20%) of the ostriches. At the same time, serum samples of eight sheep from the same farm were sent for IgG testing, two (25%) of which were positive. This was the first report of CCHF infection of an ostrich in Iran and tracing CCHF IgG against this ostrich and the afore-mentioned sheep may have revealed that the disease in the worker was the cause of transmission of this disease from these animals or their ticks.

Mostafavi, Ehsan; Chinikar, Sadegh; Moradi, Maryam; Bayat, Neda; Meshkat, Mohsen; Fard, Mohammad Khalili; Ghiasi, Seyyed Mojtaba



Fatal Fever of Unknown Origin in Acute Cervical Spinal Cord Injury: Five Cases  

PubMed Central

Background/Objective: Patients with traumatic upper thoracic and cervical spinal cord injuries are at increased risk for the development of autonomic dysfunction, including thermodysregulation. Thermoregulation is identified as an autonomic function, although the exact mechanisms of thermodysregulation have not been completely recognized. Quad fever is a hyperthermic thermoregulatory disorder that occurs in people with acute cervical and upper thoracic spinal cord injuries. First described in 1982, it has not been widely discussed in the literature. Methods: Case reports of 5 patients with cervical spinal cord injury (SCI). Results: Five of 18 patients (28%) with acute cervical SCI who were admitted during a 1-year period had fatal complications caused by persistent hyperthermia of unknown origin. Conclusions: Patients with acute traumatic cervical and upper thoracic SCI are at risk for thermoregulatory dysfunction. Changes in the hypothalamic axis may be implicated, especially in the light of modification in hypothalamic afferent nerves, but this hypothesis has not yet been explored. Thermodysregulation may be an early sign of autonomic dysfunction. A comprehensive guideline is needed for the management of elevated body temperature in critically ill patients with cervical SCI, because this condition may be fatal.

Ulger, Fatma; Dilek, Ahmet; Karakaya, Deniz; Senel, Alparslan; Sarihasan, Binnur



A rare case of fever of unknown origin: inflammatory myofibroblastic tumor of the liver. Case report and review of the literature.  


We present the case of a rare cause of fever of unknown origin (FUO). FUO is challenging for patients as well as for physicians as there are more than 200 differential diagnoses of FUO (1,2). Pointing out a diagnosis often requires numerous noninvasive and invasive procedures that sometimes even fail to explain the fever. Our patient was admitted twice to our hospital due to remitting fever rising up to 40 degrees C without any subjective discomfort. At the first presentation no clinical focus could be identified. This included the examination of multiple blood and urine cultures, serology, autoimmune serology, transesophageal echocardiography, CT-scan of the lung and the abdomen, and bone scintigraphy. Elevated C-reactive protein (268 mg/l) decreased spontaneously and fever disappeared after 4 weeks. However, the patient was re-admitted 4 months later with identical symptoms. Multiple blood and urine cultures, serology, bone marrow examination, CT-scan of the lung and the abdomen, esophago-gastro-duodenoscopy and colonoscopy still showed no pathological findings. MRI-scan of the abdomen identified a liver tumor of 3.3 cm in diameter in segment 6 without typical signs of an adenoma, focal nodular hyperplasia or hepatocellular carcinoma. Biopsy of the suspect liver lesion revealed an inflammatory myofibroblastic tumor (inflammatory pseudotumor). After surgical resection of the tumor elevated inflammation markers as C-reactive protein normalized and fever disappeared. One year after surgery no more episodes of fever re-occurred. An inflammatory myofibroblastic tumor of the liver can be a rare cause of fever of unknown origin. MRI-scan can be an additional imaging tool to identify previously not recognized liver tumors. PMID:23402091

Kruth, Jens; Michaely, Henrik; Trunk, Markus; Niedergethmann, Marco; Rupf, Ann-Katrin; Krämer, Bernhard K; Göttmann, Uwe



Chikungunya fever diagnosed among international travelers--United States, 2005-2006.  


Chikungunya virus (CHIKV) is an alphavirus indigenous to tropical Africa and Asia, where it is transmitted to humans by the bite of infected mosquitoes, usually of the genus Aedes. Chikungunya (CHIK) fever, the disease caused by CHIKV, was first recognized in epidemic form in East Africa during 1952-1953. The word "chikungunya" is thought to derive from description in local dialect of the contorted posture of patients afflicted with the severe joint pain associated with this disease. Because CHIK fever epidemics are sustained by human-mosquito-human transmission, the epidemic cycle is similar to those of dengue and urban yellow fever. Large outbreaks of CHIK fever have been reported recently on several islands in the Indian Ocean and in India. In 2006, CHIK fever cases also have been reported in travelers returning from known outbreak areas to Europe, Canada, the Caribbean (Martinique), and South America (French Guyana). During 2005-2006, 12 cases of CHIK fever were diagnosed serologically and virologically at CDC in travelers who arrived in the United States from areas known to be epidemic or endemic for CHIK fever. This report describes four of these cases and provides guidance to health-care providers. Clinicians should be alert for additional cases among travelers, and public health officials should be alert to evidence of local transmission of chikungunya virus (CHIKV), introduced through infection of local mosquitoes by a person with viremia. PMID:17008866



Q fever endocarditis in Romania: the first cases confirmed by direct sequencing.  


Infective endocarditis (IE) is a serious, life-threatening disease with highly variable clinical signs, making its diagnostic a real challenge. A diagnosis is readily made if blood cultures are positive, but in 2.5 to 31% of all infective endocarditis cases, routine blood cultures are negative. In such situations, alternative diagnostic approaches are necessary. Coxiella burnetii and Bartonella spp. are the etiological agents of blood culture-negative endocarditis (BCNE) most frequently identified by serology. The purpose of this study is to investigate the usefulness of molecular assays, as complementary methods to the conventional serologic methods for the rapid confirmatory diagnostic of Q fever endocarditis in patients with BCNE. Currently, detection of C. burnetii by culture or an antiphase I IgG antibody titers >800 represents a major Duke criterion for defining IE, while a titers of >800 for IgG antibodies to either B. henselae or B. quintana is used for the diagnosis of endocarditis due to Bartonella spp. We used indirect immunofluorescence assays for the detection of IgG titers for C. burnetii, B. henselae and B. quintana in 57 serum samples from patients with clinical suspicion of IE. Thirty three samples originated from BCNE patients, whereas 24 were tested before obtaining the blood cultures results, which finally were positive. The results of serologic testing showed that nine out of 33 BCNE cases exhibited antiphase I C. burnetii IgG antibody titer >800, whereas none has IgG for B. henselae or B. quintana. Subsequently, we used nested-PCR assay for the amplification of C. burnetii DNA in the nine positive serum samples, and we obtained positive PCR results for all analyzed cases. Afterwards we used the DNA sequencing of amplicons for the repetitive element associated to htpAB gene to confirm the results of nested-PCR. The results of sequencing allowed us to confirm that C. burnetii is the causative microorganism responsible for BCNE. In conclusion, the nested PCR amplification followed by direct sequencing is a reliable and accurate method when applied to serum samples, and it may be used as an additional test to the serological methods for the confirmatory diagnosis of BCNE cases determined by C. burnetii. PMID:22272146

Cotar, Ani Ioana; Badescu, Daniela; Oprea, Mihaela; Dinu, Sorin; Banu, Otilia; Dobreanu, Dan; Dobreanu, Minodora; Ionac, Adina; Flonta, Mirela; Straut, Monica



Typhoid and paratyphoid fever  

Microsoft Academic Search

Typhoid fever is estimated to have caused 21·6 million illnesses and 216 500 deaths globally in 2000, affecting all ages. There is also one case of paratyphoid fever for every four of typhoid. The global emergence of multidrug- resistant strains and of strains with reduced susceptibility to fluoroquinolones is of great concern. We discuss the occurrence of poor clinical response

MK Bhan; Rajiv Bahl; Shinjini Bhatnagar



Serological characterization of dengue virus infections observed among dengue hemorrhagic fever/dengue shock syndrome cases in upper Myanmar.  


In Myanmar, dengue fever (DF)/dengue hemorrhagic fever (DHF) is one of the leading causes of morbidity and mortality among children. From Pyinmana Hospital in 2004 and Mandalay Children Hospital in 2006, 160 patients diagnosed clinically to have DHF/dengue shock syndrome (DSS) were examined for immunoglobulin M (IgM) and IgG levels. A focus reduction neutralization test was also used to determine primary or secondary dengue virus (DENV) infection. By using IgM-capture ELISA, 139 cases were confirmed as DENV infections. Of these IgM-positives, 94 samples were collected 7-24 days from the onset of illness, to which 13 (14%) and 81 (86%) were determined to be primary and secondary DENV infections, respectively. The 13 primary DENV infection cases were spread among the various severity groups (DHF grade I-IV and DSS) and represented age groups ranging from <1 year of age to 9 years of age. The patients in these primary infection cases showed a remarkably high IgM with a low IgG titer response compared with the secondary infection cases. No significant differences were observed in IgG titers with clinical severity. The data obtained in this study suggest that primary DENV infection cases exist certainly among DHF/DSS cases in Myanmar, and that additional mechanism(s) aside from the antibody-dependent enhancement mechanism could have influenced the clinical severity in DHF/DSS cases. PMID:23595687

Ngwe Tun, Mya Myat; Thant, Kyaw Zin; Inoue, Shingo; Kurosawa, Yae; Lwin, Yee Yee; Lin, Sanda; Aye, Kay Thi; Thet Khin, Pe; Myint, Tin; Htwe, Khin; Mapua, Cynthia A; Natividad, Filipinas F; Hirayama, Kenji; Morita, Kouichi



Hantavirus infection--hemorrhagic fever with renal syndrome: the first case series reported in Romania and review of the literature.  


Hemorrhagic fever with renal syndrome (HFRS) is a zoonotic infectious disease caused by Hantaviruses, a group of RNA viruses belonging to the Bunyaviridae family. Humans may get the disease by contamination with excreta of carrier rodents. The disease typically manifests with the triad fever-thrombocytopenia-acute kidney injury (AKI). Although its global prevalence seems to be increasing, Hantavirus infection is still commonly overlooked, because of its clinical polymorphism and non-specific symptoms, particularly in mild cases. Until recently, the disease was virtually unknown in Romania, due to lack of physicians' awareness and of adequate laboratory diagnostic techniques. In this article, we present the first six cases of HFRS diagnosed in our country, based on serology testing. We review the existing literature on HFRS and discuss our findings in comparison with other reports. All our patients presented with fever, flu syndrome, bleeding, gastrointestinal symptoms, and oliguria. Among laboratory abnormalities, elevated serum creatinine and liver enzymes, high C-reactive protein, leukocytosis, low platelet count, and hematuria were constantly seen. Five patients required hemodialysis. All patients survived and five of them completely recovered their renal function, while only one patient retained a mild impairment of the glomerular filtration rate. From a clinical viewpoint, we believe that Hantavirus infection should be considered in all patients presenting with fever, thrombocytopenia, and AKI, when specific serology testing would be indicated. From a public health perspective, we suggest that future efforts in our country should be directed toward (1) increasing the understanding and the awareness of this disease among health care professionals, (2) educating the population at risk on the application of prophylactic measures, (3) expanding the availability of diagnostic laboratory tools, and (4) developing research on national zoonotic virus reservoirs. PMID:21678038

Maftei, Irinel-Doina; Segall, Liviu; Panculescu-Gatej, Raluca; Ceianu, Cornelia; Covic, Adrian



Analysis of human skin emanations by gas chromatography/mass spectrometry. 1. Thermal desorption of attractants for the yellow fever mosquito (Aedes aegypti) from handled glass beads.  


Handled glass has the ability to collect and concentrate nonaqueous human skin emanations while minimizing the collection of aqueous perspiration. Compounds originating from the skin and collected on glass have previously been found to attract the Aedes aegypti species of mosquito. Therefore, glass beads were used as the medium to collect skin emanations from humans for subsequent chemical analysis. This process consisted of a 5-15-min collection of sample on glass beads, followed by loading the beads into a gas chromatograph (GC) injector insert for subsequent desorption of the collected compounds onto the GC column. After cryofocusing by liquid nitrogen at the head of the column, the thermally desorbed compounds were analyzed by GC/MS. Microscale purge and trap introduction was also used to provide complementary information. In this case, the beads are held in a round-bottom flask, purged with nitrogen, and heated as the concentrator collects the headspace above the beads. The chromatograms produced by both of these sample introduction methods demonstrate good resolution of a complex sample. Cryofocusing volatiles from handled glass allowed identification of lactic acid, aliphatic fatty acids, and other polar to nonpolar compounds of moderate volatility while purge and trap allowed detection of nonpolar to moderately polar compounds of high volatility. PMID:9921122

Bernier, U R; Booth, M M; Yost, R A



Probabilistic scenario-based water resource planning and management:A case study in the Yellow River Basin, China  

NASA Astrophysics Data System (ADS)

Water resource planning and management is subject to large uncertainties with respect to the impact of climate change and socio-economic development on water systems. In order to deal with these uncertainties, probabilistic climate and socio-economic scenarios were developed based on the Principle of Maximum Entropy, as defined within information theory, and as inputs to hydrological models to construct probabilistic water scenarios using Monte Carlo simulation. Probabilistic scenarios provide more explicit information than equally-likely scenarios for decision-making in water resource management. A case was developed for the Yellow River Basin, China, where future water availability and water demand are affected by both climate change and socio-economic development. Climate scenarios of future precipitation and temperature were developed based on the results of multiple Global climate models; and socio-economic scenarios were downscaled from existing large-scale scenarios. Probability distributions were assigned to these scenarios to explicitly represent a full set of future possibilities. Probabilistic climate scenarios were used as input to a rainfall-runoff model to simulate future river discharge and socio-economic scenarios for calculating water demand. A full set of possible future water supply-demand scenarios and their associated probability distributions were generated. This set can feed the further analysis of the future water balance, which can be used as a basis to plan and manage water resources in the Yellow River Basin. Key words: Probabilistic scenarios, climate change, socio-economic development, water management

Dong, C.; Schoups, G.; van de Giesen, N.



A case of Crimean Congo hemorrhagic fever complicated with acalculous cholecystitis and intraabdominal abscess  

Microsoft Academic Search

Crimean Congo hemorrhagic fever is a fatal systemic viral infection which is an important health problem in Turkey. Since it leads to diffuse endothelial damage, many complications can be seen during the course of the disease. We report here an atypical presentation of CCHF with acute acalculous cholecystitis and intraabdominal abscess.

R. Guner; I. Hasanoglu; D. Yapar; M. A. Tasyaran




Center for Biologics Evaluation and Research (CBER)

Text Version... this vaccine is propagated in chicken embryos, YF-VAX vaccine should not be ... or localized manifestations of allergy to eggs or to feathers are not ... More results from


Quantitative plant resistance in cultivar mixtures: wheat yellow rust as a modeling case study.  


Unlike qualitative plant resistance, which confers immunity to disease, quantitative resistance confers only a reduction in disease severity and this can be nonspecific. Consequently, the outcome of its deployment in cultivar mixtures is not easy to predict, as on the one hand it may reduce the heterogeneity of the mixture, but on the other it may induce competition between nonspecialized strains of the pathogen. To clarify the principles for the successful use of quantitative plant resistance in disease management, we built a parsimonious model describing the dynamics of competing pathogen strains spreading through a mixture of cultivars carrying nonspecific quantitative resistance. Using the parameterized model for a wheat-yellow rust system, we demonstrate that a more effective use of quantitative resistance in mixtures involves reinforcing the effect of the highly resistant cultivars rather than replacing them. We highlight the fact that the judicious deployment of the quantitative resistance in two- or three-component mixtures makes it possible to reduce disease severity using only small proportions of the highly resistant cultivar. Our results provide insights into the effects on pathogen dynamics of deploying quantitative plant resistance, and can provide guidance for choosing appropriate associations of cultivars and optimizing diversification strategies. PMID:23875842

Sapoukhina, Natalia; Paillard, Sophie; Dedryver, Françoise; de Vallavieille-Pope, Claude



[Isolated case of haemorrhagic fever observed in Gabon during the 2002 outbreak of Ebola but distant from epidemic zones].  


During the last outbreak of Ebola virus haemorrhagic fever that occurred concurrently in Gabon and Congo, several primary foci were identified in the Ogooue Ivindo province (Northeast Gabon), where previous outbreaks had occurred. A 48-year-old woman living in Franceville located 580 Km from the epicentre presented fever with haemorrhagic signs. She was evacuated to Libreville where Ebola infection was suspected. Diagnosis was confirmed at the Centre International de Recherches Médicales of Franceville on the basis of detection of specific antibodies. Symptoms had already subsided by the time diagnosis was documented. An epidemiological investigation was undertaken to identify the source of contamination and detect secondary cases. No human or nonhuman primate source of contamination could be formally identified. Direct contact with the virus reservoir could not be ruled out. No secondary cases were detected. The favourable outcome, absence of secondary, and failure to identify a source of contamination suggest that epidemiologically undefined cases may go unnoticed during and outside of outbreaks. PMID:16548488

Nkoghe, D; Nnegue, S; Mve, M Toung; Formenty, P; Thompson, G; Iba Ba, J; Okome Nkoumou, M; Leroy, E



Molecular approaches for the treatment of hemorrhagic fever virus infections.  


Viruses causing hemorrhagic fevers in man belong to the following virus groups: togavirus (Chikungunya), flavivirus (dengue, yellow fever, Kyasanur Forest disease, Omsk hemorrhagic fever), arenavirus (Argentinian hemorrhagic fever, Bolivian hemorrhagic fever, Lassa fever), filovirus (Ebola, Marburg), phlebovirus (Rift Valley fever), nairovirus (Crimian-Congo hemorrhagic fever) and hantavirus (hemorrhagic fever with renal syndrome, nephropathic epidemia). Hemorrhagic fever virus infections can be approached by different therapeutic strategies: (i) vaccination; (ii) administration of high-titered antibodies; and (iii) treatment with antiviral drugs. Depending on the molecular target of their interaction, antiviral agents could be classified as follows: IMP dehydrogenase inhibitors (i.e., ribavirin and its derivatives); OMP decarboxylase inhibitors (i.e., pyrazofurin); CTP synthetase inhibitors (i.e., cyclopentylcytosine and cyclopentenylcytosine); SAH hydrolase inhibitors (i.e., neplanocin A); polyanionic substances (i.e., sulfated polymers); interferon and immunomodulators. PMID:8250543

Andrei, G; De Clercq, E



El Ni?o Southern Oscillation and vegetation dynamics as predictors of dengue fever cases in Costa Rica  

PubMed Central

Dengue fever (DF) and dengue hemorrhagic fever (DHF) are growing health concerns throughout Latin America and the Caribbean. This study focuses on Costa Rica, which experienced over 100 000 cases of DF/DHF from 2003 to 2007. We utilized data on sea-surface temperature anomalies related to the El Niño Southern Oscillation (ENSO) and two vegetation indices derived from the Moderate Resolution Imaging Spectrometer (MODIS) from the Terra satellite to model the influence of climate and vegetation dynamics on DF/DHF cases in Costa Rica. Cross-correlations were calculated to evaluate both positive and negative lag effects on the relationships between independent variables and DF/DHF cases. The model, which utilizes a sinusoid and non-linear least squares to fit case data, was able to explain 83% of the variance in weekly DF/DHF cases when independent variables were shifted backwards in time. When the independent variables were shifted forward in time, consistently with a forecasting approach, the model explained 64% of the variance. Importantly, when five ENSO and two vegetation indices were included, the model reproduced a major DF/DHF epidemic of 2005. The unexplained variance in the model may be due to herd immunity and vector control measures, although information regarding these aspects of the disease system are generally lacking. Our analysis suggests that the model may be used to predict DF/DHF outbreaks as early as 40 weeks in advance and may also provide valuable information on the magnitude of future epidemics. In its current form it may be used to inform national vector control programs and policies regarding control measures; it is the first climate-based dengue model developed for this country and is potentially scalable to the broader region of Latin America and the Caribbean where dramatic increases in DF/DHF incidence and spread have been observed.

Troyo, A; Beier, J C



Associations between dogs that were serologically positive for Rickettsia conorii relative to the residences of two human cases of Mediterranean spotted fever in Piemonte (Italy)  

Microsoft Academic Search

A geographic information system and K-function analysis were used to evaluate the spatial association of canine serological results for Rickettsia conorii, the causative agent of Mediterranean spotted fever (MSF), and clinical cases of MSF in humans in Piemonte, northwest Italy. The residences of dog owners were clustered in two rural villages in the province of Cuneo, where two human cases

A. Mannelli; M. L. Mandola; P. Pedri; M. Tripoli; P. Nebbia



Yellow nails (image)  


Yellow nails are seen in the 'yellow nail syndrome' in which there is thickening and yellow to yellow-green discoloration of all nails. Lymphedema, especially of the ankles, and compromised respiration ...


Phenotype 2 familial mediterranean fever: evaluation of 22 case series and review of the literature on phenotype 2 FMF.  


Familial Mediterranean fever (FMF) is an autosomal recessive autoimmune disorder characterized by recurrent bouts of fever and serosal inflammation. FMF may be complicated by AA-type amyloidosis, worsening the prognosis, with associated renal failure in some patients. Complication rate varies with race, being as high as 60% in Turks and as low as 2% in Armenians. In a few cases of patients with FMF (phenotype 2), amyloid nephropathy may be the presenting manifestation. This study included 420 patients who were admitted to the Nephrology and Rheumatology Departments of Atatürk Education and Research Hospital with unexplained proteinuria/nephrotic syndrome. The initial screening test for amyloidosis was the presence of significant proteinuria (300 mg/24 h). All MEFV gene exons were screened for causative mutations by direct DNA sequencing to check for any mutations. There were 22 phenotype 2 FMF patients with 27 allelic variants. The most prevalent allelic variants were M694V (10/27, 37%) and E148Q (7/27, 26%). Phenotype 2 FMF is not as rare as it was thought before; this should be kept in mind for all patients with unexplained proteinuria and/or acute phase response in high-risk ethnic groups for FMF. PMID:23228227

Altuno?lu, Alpaslan; Erten, ?ükran; Canoz, Mujdat Batur; Yuksel, Aydan; Ceylan, Gulay Gulec; Balci, Serdar; Dogan, Hayriye Tatli



A case study: The New York City yellow cab System of Systems  

Microsoft Academic Search

In recent years there has been a significant increase in the amount of research done in the field of system of systems engineering. Despite many attempts, there is still a lack of a unified definition and standards for Systems of Systems (SoS). Case study research provides us with an opportunity to extract best practices from real life system of systems

S. Jimmy Gandhi; Alex Gorod; Brian Sauser



Current trends in typhoid fever  

Microsoft Academic Search

Typhoid fever, a systemic infection caused by Salmonella enterica serotype typhi, remains an important worldwide cause of morbidity and mortality. Endemic cases in the United States are unusual, with most\\u000a following foreign travel to the Indian subcontinent, Africa, Asia, or Latin America. The classic findings of typhoid fever\\u000a include rose spots, relative bradycardia, and stepwise fevers, but unfortunately these signs

Nancy F. Crum



Bolivian Hemorrhagic Fever: A Pathologic Description.  

National Technical Information Service (NTIS)

In 1963, an epidemic of viral hemorrhagic fever affected several hundred natives in San Joaquin, Bolivia. The mortality was 18%. This report describes the pathologic changes of Bolivian hemorrhagic fever based upon observations on eight cases that were au...

P. L. Child R. B. MacKenzie L. R. Valverde K. M. Johsnon



Genome Sequence of Ex-Afghanistan Crimean-Congo Hemorrhagic Fever Virus SCT Strain, from an Imported United Kingdom Case in October 2012  

PubMed Central

Crimean-Congo hemorrhagic fever (CCHF) virus is a serious human pathogen causing severe hemorrhagic disease with a fatality rate of up to approximately 30%. We have determined the viral genomic sequence from an isolate that caused a fatal case of imported CCHF in the United Kingdom in October 2012.

Chamberlain, John; Atkinson, Barry; Logue, Christopher H.; Latham, Jennie; Newman, Edmund N. C.



Arenaviral haemorrhagic fevers.  


Three arenaviruses--Lassa, Junin and Machupo--cause severe haemorrhagic disease in humans: Lassa fever, Argentine haemorrhagic fever and Bolivian haemorrhagic fever, respectively. These conditions are a source of considerable economic hardship in endemic areas and remain a worldwide concern for public-health officials. They are characterised by an insidious onset of influenza-like symptoms followed, in severe cases, by a generalised bleeding diathesis, encephalopathy and death. Central to studies of their pathogenesis is evidence for cellular dysfunction disproportionate to overt histopathology. Recent studies of patients with Lassa fever indicate that platelet and possibly endothelial-cell dysfunction play an important role in the bleeding tendency. The platelet defect appears to be mediated by an inhibitory factor in plasma; the nature of this is uncertain but it seems to be neither viral protein nor virus antibody. A similar inhibitor has since been demonstrated in patients with Argentine haemorrhagic fever. Plasma from patients with Lassa fever also profoundly modulates the amount of superoxide generated by normal neutrophils in response to the chemotactic peptide f-met-leu-phe, suggesting the inhibitor(s) has global effects on cellular function. These findings may have important implications for future therapeutic strategies. PMID:1777745

Cummins, D



Q fever  


... bacteria Coxiella burnetii . The bacteria infects sheep, goats, cattle, dogs, cats, birds, rodents, and ticks , as well ... Hepatitis Pneumonia Q fever is diagnosed with a blood antibody test (serology).


Typhoid Fever.  

National Technical Information Service (NTIS)

Between one and five percent of travelers from industrialized countries to the developing world seek medical attention during or immediately after their travel. International travelers who present to the emergency department (ED) with fever pose a unique ...

J. M. Schofer



Typhoid fever  


The bacteria that cause typhoid fever -- S. typhi -- spread through contaminated food, drink, or water. If you eat or drink something that is contaminated, the bacteria enter your body. They travel into ...


Hay Fever  


... and throat. This can trigger a type of allergy called hay fever. Symptoms can include Sneezing, often ... to use distilled or sterilized water with saline. Allergy shots can help make you less sensitive to ...


Dengue Fever  


... DEET Safe for Kids? Malaria Dehydration Instruction Sheet West Nile Virus Staying Healthy While You Travel Cholera What ... Travel Tips Bug Bites and Stings Dengue Fever West Nile Virus Contact Us Print Additional resources Send to ...


Valley fever  


... that occurs when the spores of the fungus Coccidioides immitis enter your body through the lungs. ... this disease include: Blood test to check for coccidioides infection (the fungus that causes Valley fever) Chest ...


Rheumatic fever  


... ASO test) Complete blood count Electrocardiogram Sedimentation rate (ESR) Several major and minor criteria have been developed ... erythema marginatum) The minor criteria include: Fever High ESR Joint pain Abnormal EKG You'll likely be ...


Lassa Fever  


... virus from infected rodents to humans. How do humans get Lassa fever? There are a number of ... the virus may be transmitted, or spread, to humans. The Mastomys rodents shed the virus in urine ...


Q Fever  

PubMed Central

Q fever is a zoonosis with a worldwide distribution with the exception of New Zealand. The disease is caused by Coxiella burnetii, a strictly intracellular, gram-negative bacterium. Many species of mammals, birds, and ticks are reservoirs of C. burnetii in nature. C. burnetii infection is most often latent in animals, with persistent shedding of bacteria into the environment. However, in females intermittent high-level shedding occurs at the time of parturition, with millions of bacteria being released per gram of placenta. Humans are usually infected by contaminated aerosols from domestic animals, particularly after contact with parturient females and their birth products. Although often asymptomatic, Q fever may manifest in humans as an acute disease (mainly as a self-limited febrile illness, pneumonia, or hepatitis) or as a chronic disease (mainly endocarditis), especially in patients with previous valvulopathy and to a lesser extent in immunocompromised hosts and in pregnant women. Specific diagnosis of Q fever remains based upon serology. Immunoglobulin M (IgM) and IgG antiphase II antibodies are detected 2 to 3 weeks after infection with C. burnetii, whereas the presence of IgG antiphase I C. burnetii antibodies at titers of ?1:800 by microimmunofluorescence is indicative of chronic Q fever. The tetracyclines are still considered the mainstay of antibiotic therapy of acute Q fever, whereas antibiotic combinations administered over prolonged periods are necessary to prevent relapses in Q fever endocarditis patients. Although the protective role of Q fever vaccination with whole-cell extracts has been established, the population which should be primarily vaccinated remains to be clearly identified. Vaccination should probably be considered in the population at high risk for Q fever endocarditis.

Maurin, M.; Raoult, D.



Probe into the method of regional ecological risk assessment-a case study of wetland in the Yellow River Delta in China.  


Ecological risk assessment (ERA) is a new field of study for evaluating the risks associated with a possible eco-environmental hazard under uncertainty. Regional ERA is more complex than general ERA, as it requires that risk receptors, risk sources, risk exposure, uncertainty and especially spatial heterogeneity all be taken into account. In this paper, a five-step process of regional ERA is developed and tested through a wetland case study in the Yellow River Delta in China. First, indices and formulas are established for measuring degrees of ecological risk and damage to ecosystems. Using a combination of remote sensing data, historical records and survey data, and with the assistance of GIS techniques, the indices and formulas are then applied to the wetland in the study area. On the basis of the assessment results, we propose a number of countermeasures for the various risk zones in the Yellow River Delta. PMID:15036697

Xu, Xuegong; Lin, Huiping; Fu, Zaiyi



Dengue and Dengue Hemorrhagic Fever  

PubMed Central

Dengue fever, a very old disease, has reemerged in the past 20 years with an expanded geographic distribution of both the viruses and the mosquito vectors, increased epidemic activity, the development of hyperendemicity (the cocirculation of multiple serotypes), and the emergence of dengue hemorrhagic fever in new geographic regions. In 1998 this mosquito-borne disease is the most important tropical infectious disease after malaria, with an estimated 100 million cases of dengue fever, 500,000 cases of dengue hemorrhagic fever, and 25,000 deaths annually. The reasons for this resurgence and emergence of dengue hemorrhagic fever in the waning years of the 20th century are complex and not fully understood, but demographic, societal, and public health infrastructure changes in the past 30 years have contributed greatly. This paper reviews the changing epidemiology of dengue and dengue hemorrhagic fever by geographic region, the natural history and transmission cycles, clinical diagnosis of both dengue fever and dengue hemorrhagic fever, serologic and virologic laboratory diagnoses, pathogenesis, surveillance, prevention, and control. A major challenge for public health officials in all tropical areas of the world is to devleop and implement sustainable prevention and control programs that will reverse the trend of emergent dengue hemorrhagic fever.

Gubler, Duane J.



Acidophilic Bodies: Their Chemical and Physical Nature in Patients with Bolivian Hemorrhagic Fever.  

National Technical Information Service (NTIS)

The nature of acidophilic bodies in the livers of patients with Bolivian hemorrhagic fever has been studied and compared with that of similar bodies seen in other hemorrhagic fevers, as in yellow fever, and in paracentral necrosis of nonviral cause (schis...

P. L. Child A. Ruiz



Rocky Mountain Spotted Fever, Colombia  

PubMed Central

We investigated 2 fatal cases of Rocky Mountain spotted fever that occurred in 2003 and 2004 near the same locality in Colombia where the disease was first reported in the 1930s. A retrospective serosurvey of febrile patients showed that >21% of the serum samples had antibodies against spotted fever group rickettsiae.

Hidalgo, Marylin; Orejuela, Leonora; Fuya, Patricia; Carrillo, Pilar; Hernandez, Jorge; Parra, Edgar; Keng, Colette; Small, Melissa; Olano, Juan P.; Bouyer, Donald; Castaneda, Elizabeth; Walker, David



Yellow nail syndrome (image)  


Yellow nail syndrome is characterized by yellow nails that lack a cuticle, grow slowly, and are loose or detached (onycholysis). Yellow nail syndrome is most commonly associated with lung disorders, and ...


Raman identification of yellow synthetic organic pigments in modern and contemporary paintings: reference spectra and case studies.  


The characterization of the binding media and pigments in modern and contemporary paintings is important for designing safe conservation treatments, as well as for determining suitable environmental conditions for display, storage and transport. Raman spectroscopy is a suitable technique for the in situ non-destructive identification of synthetic organic pigments in the presence of the complex binding media characteristic of synthetic resin paints or colour lithographic inks. The precise identification of a pigment by comparing its spectrum to that of a reference is necessary when conservation treatments with aqueous solutions or organic solvents are being considered for a work of art, since solubility properties can sometimes vary within the same pigment group. The Raman spectra of 21 yellow synthetic organic pigments, belonging to the monoazo, monoazo lakes, diarylide, disazo condensation, benzimidazolone, bisacetoacetarylide, azo-methine metal complex, isoindolinone and isoindoline groups are presented. Since modern artists frequently mixed paint developed for other applications, in addition to colorants developed as artists' paints, other synthetic organic pigments were included in the spectral database. Two monoazo pigments, Pigment Yellow 1 and Pigment Yellow 3, a benzimidazolone, Pigment Yellow 154 and a phthalocynanine, Pigment Green 7, were identified in sample cross-sections from four modern and contemporary paintings in the collection of The Museum of Modern Art in Ljubljana, Slovenia. PMID:17590389

Ropret, Polonca; Centeno, Silvia A; Bukovec, Peter



The Unfortunate Nurse A Case Study of Dengue Fever and Social Policy  

NSDL National Science Digital Library

Based on an actual incident in which dengue virus was transmitted by an accidental needlestick, this case study introduces students to “emerging pathogens” and other concepts in parasitology, immunology, epidemiology, and public policy. Students also read a primary paper and learn about two modern techniques widely used in medical and research settings (i.e., EIA and Taqman RT-PCR). The case is suitable for general education biology, cell biology, microbiology, immunology, and science and public policy courses.

Aguirre, Karen M.



Adams-Stokes attack as the first symptom of acute rheumatic fever: report of an adolescent case and review of the literature  

PubMed Central

Background Acquired complete heart block, in pediatric age is mainly the results of direct injury to conduction tissue during cardiac surgery or cardiac catheterisation. It can also be observed in different clinical settings as infectious diseases, neoplasia, and inflammatory diseases. It has a wide range of presentation and in some settings it can appear a dramatic event. Although a rare finding during acute rheumatic fever, with a transient course, it may need a specific and intensive treatment. Case presentation We report the case of an Adams-Stokes attack in an adolescent with acute rheumatic carditis and complete atrio-ventricular block. The attack was the first symptom of carditis. We reviewed the literature and could find 25 cases of complete atrio-ventricular block due to rheumatic fever. Ten of the 25 patients experienced an Adams-Stokes attack. Nineteen of the 25 patients were certainly in the pediatric age group. Seven of the 19 pediatric cases experienced an Adams-Stokes attack. In 16/25 cases, the duration of the atrio-ventricular block was reported: it lasted from a few minutes to ten days. Pacemaker implantation was necessary in 7 cases. Conclusion Rheumatic fever must be kept in mind in the diagnostic work-up of patients with acquired complete atrio-ventricular block, particularly when it occurs in pediatric patients. The insertion of a temporary pacemaker should be considered when complete atrio-ventricular block determines Adams-Stokes attacks. Complete heart block during acute rheumatic fever is rare and is usually transient. Along with endocarditis, myocarditis and pericarditis, complete atrio-ventricular block has been recognized, rarely, during the course of acute rheumatic carditis.



A timely reminder--rheumatic fever.  


Rheumatic fever is a disease diagnosed using the Jones criteria. The Jones criteria were designed using data from areas with a low prevalence of rheumatic fever. In New Zealand there is a high prevalence of rheumatic fever amongst Maori and Pacific peoples. A case is presented where a child of Samoan ethnicity is diagnosed and treated for rheumatic fever without fulfilling the Jones criteria. Evidence supporting the broadening of the diagnostic criteria in high prevalence areas is highlighted. PMID:23797082

Lilic, Nikola; Kumar, Priyanka



Fever therapy revisited  

PubMed Central

The phenomenon of spontaneous regression and remission from cancer has been observed by many physicians and was described in hundreds of publications. However, suggestive clues on cause or trigger are sparse and not substantiated by much experimental evidence. In this review, literature is surveyed and summarised and possible causes are discussed. At least in a larger fraction of cases a hefty feverish infection is linked with spontaneous regression in time and is investigated as putative trigger. Epidemiological and immunological evidence is put into perspective. An online forum to discuss the possible application of fever therapy in the future can be accessed at

Hobohm, U



Fever of unknown origin: a case of post obstructive pneumonia complicating mature teratoma.  


Mediastinal teratomas are rare germ cell tumors in children accounting for only 4.3% of all germ cell tumours. Here, we describe a three year old child who was misdiagnosed as a case of pulmonary tuberculosis at periphery despite of his chest X ray showing large homogenous opacification of left hemithorax with areas of calcifications and subsequently diagnosed as a case of benign mature teratoma with post obstructive pneumonia. Our case highlights the need for careful evaluation of chest X-ray (CXR) by the treating physicians, especially when CXR had a large homogenous opacity with shifting of mediastinum and presence of a few calcified shadows, which may clinch a rare diagnosis of an uncommon disorder. PMID:24116336

Bhatt, Gc; Nandan, D; Sen, A; Kanaujia, P



Crimean-Congo hemorrhagic fever nosocomial infection in a immunosuppressed patient, Pakistan: case report and virological investigation.  


Crimean-Congo hemorrhagic fever (CCHF) is endemic in the Baluchistan province, Pakistan. Sporadic outbreaks of CCHF occur throughout the year especially in individuals in contact with infected livestock. Nosocomial transmission remains a risk due to difficulties in the diagnosis of CCHF and limited availability of facilities for the isolation of suspected patients. Rapid diagnosis of CCHF virus infection is required for early management of the disease and to prevent transmission. This study describes the case of a 43-year-old surgeon who contracted CCHF during a surgical procedure in Quetta, Baluchistan and who was transferred to a tertiary care facility at the Aga Khan University Hospital, Karachi within 1 week of contracting the infection. Diagnosis of CCHF was made using a rapid real-time reverse transcription polymerase chain reaction (RT-PCR) assay for CCHF viral RNA. The patient had chronic hepatitis B and hepatitis D infection for which he had previously received a liver transplant. He proceeded to develop classic hemorrhagic manifestations and succumbed to the infection 14 days post-onset of disease. There was no further nosocomial transmission of the CCHF during the hospital treatment of the surgeon. Early diagnosis of CCHF enables rapid engagement of appropriate isolation, barrier nursing and infection control measures thus preventing nosocomial transmission of the virus. PMID:23172105

Hasan, Zahra; Mahmood, Faisal; Jamil, Bushra; Atkinson, Barry; Mohammed, Murtaza; Samreen, Azra; Altaf, Lamia; Moatter, Tariq; Hewson, Roger



Oil spill detection with the RADARSAT SAR in the waters of the Yellow and East China Sea: A case study  

Microsoft Academic Search

This application study highlights the potential of wide-swath synthetic aperture radar (SAR) imagery for the regional oil pollution monitoring. As a pre-phase of the pilot-project this paper presents the preliminary results of the oil spill observations with SAR in the Yellow and East China Sea. A set of full - resolution Radarsat (ScanSAR Narrow) SAR images collected between November 15

Andrei IVANOV; Ming-Xia HE; Ming-Qiang FANG


Zoonoses and haemorrhagic fever.  


Virus zoonoses causing haemorrhagic fever have been recognized in three major families: Arenaviridae, Bunyaviridae and Filoviridae. All are negative-stranded RNA viruses, with genomes in two segments, three segments, or non-segmented, respectively. Acquisition of haemorrhagic fever in man generally requires close contact with a vertebrate vector species, usually rodents, for the arenaviruses and bunyaviruses. In the case of filoviruses, the vector is currently unknown, but these viruses may infect monkeys, and may contaminate cell cultures prepared from them. Both bunyavirus and arenavirus haemorrhagic fevers have arisen in humans following exposure to rodents, and in the case of Hantaan, a virus causing haemorrhagic fever with renal syndrome (HFRS), there have been numerous laboratory-acquired infections among animal care workers. As the technology to differentiate virus species has improved, it has become clear that there are numerous potentially hazardous viruses capable of causing HFRS or hantavirus pulmonary syndrome (HPS) within the feral rodent population. In many cases it would be desirable to introduce screening methods for such viruses before preparing cell cultures from these rodent or simian species that will be used to prepare biological products for human use. PMID:9737374

Mahy, B W



Orchid Fever  

ERIC Educational Resources Information Center

|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…

Oliver, Phillip



Dengue Hemorrhagic Fever: the sensitivity and specificity of the WHO definition in identifying severe dengue cases in Thailand, 1994-2005  

PubMed Central

Summary Background Dengue virus infection causes a spectrum of clinical manifestations, usually classified according to the World Health Organization (WHO) guidelines into dengue fever (DF) and dengue hemorrhagic fever (DHF). Its ability to categorize severe dengue illness has recently been questioned. Methods We evaluated dengue case definitions in a prospective study at a pediatric hospital in Bangkok from 1994-2005. One thousand and thirteen children were enrolled within the first three days of fever and followed with standardized data collection. Cases were classified based on application of the strict WHO criteria. All dengue virus infections were laboratory confirmed. We retrospectively grouped patients based on whether they received significant intervention based on the fluid replacement and/or requirements for blood transfusion. Results Fifty eight percent (85/150), 15% (40/264), and 12% (73/599) of DHF, DF and other febrile illnesses (OFI) cases, respectively, received significant intervention. Sixty-eight percent of dengue cases requiring intervention met strict WHO criteria for DHF. In contrast, only 1% of OFI cases met WHO criteria for DHF. Plasma leakage and thrombocytopenia were the two components contributing to the specificity of the WHO case definition and identified dengue cases that required intervention. Hemorrhagic tendency did not reliably differentiate DF and DHF. In DF cases, thrombocytopenia and bleeding were associated with severity. Conclusions Dengue illness is heterogeneous in severity, and severe clinical features occurred in patients that were not characterized as DHF. The WHO case definition of DHF demonstrates 62% sensitivity and 92% specificity in identifying dengue illness requiring intervention without the need for laboratory confirmation of dengue virus infection in endemic areas.

Srikiatkhachorn, Anon; Gibbons, Robert V.; Green, Sharone; Libraty, Daniel H.; Thomas, Stephen J.; Endy, Timothy P.; Vaughn, David W.; Nisalak, Ananda; Ennis, Francis A.; Rothman, Alan L.; Nimmannitaya, Suchitra; Kalayanarooj, Siripen



Review of Dengue Hemorrhagic Fever Fatal Cases Seen Among Adults: A Retrospective Study  

PubMed Central

Background Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The disease affects mainly children, but in recent years it is becoming more of an adult disease. Malaysia experienced a large dengue outbreak in 2006 to 2007, involving mostly adults, with a high number of deaths. Methodology/Principal Findings We undertook a retrospective study to examine dengue death cases in our hospital from June 2006 to October 2007 with a view to determine if there have been changes in the presentation of severe to fatal dengue. Nine of ten fatal cases involved adult females with a median age of 32 years. All had secondary dengue infection. The mean duration of illness prior to hospitalization was 4.7 days and deaths occurred at an average of 2.4 days post-admission. Gastrointestinal pain, vomiting, diarrhea, intravascular leakages and bleeding occurred in the majority of cases. DSS complicated with severe bleeding, multi-organ failure and coagulopathy were the primary causes of deaths. Seven patients presented with thrombocytopenia and hypoalbuminemia, five of which had hemoconcentration and increased ALT and AST indicative of liver damage. Co-morbidities particularly diabetes mellitus was common in our cohort. Prominent unusual presentations included acute renal failure, acute respiratory distress syndrome, myocarditis with pericarditis, and hemorrhages over the brain and heart. Conclusions In our cohort, dengue fatalities are seen primarily in adult females with secondary dengue infection. The majority of the patients presented with common clinical and laboratory warning signs of severe dengue. Underlying co-morbidities may contribute to the rapid clinical deterioration in severe dengue. The uncommon presentations of dengue are likely a reflection of the changing demographics where adults are now more likely to contract dengue in dengue endemic regions.

Sam, Sing-Sin; Omar, Sharifah Faridah Syed; Teoh, Boon-Teong; Abd-Jamil, Juraina; AbuBakar, Sazaly



Dietary treatment of chylous ascites in yellow nail syndrome.  

PubMed Central

Chylous ascites has rarely been reported in yellow nail syndrome. A case of chylous ascites in yellow nail syndrome is described which was treated successfully with dietary restriction of fat and supplements of medium chained triglycerides.

Tan, W C



Genome Analysis of Rift Valley Fever Virus, Mayotte  

PubMed Central

As further confirmation of a first human case of Rift Valley fever in 2007 in Comoros, we isolated Rift Valley fever virus in suspected human cases. These viruses are genetically closely linked to the 2006–2007 isolates from Kenya.

Zeller, Herve; Grandadam, Marc; Caro, Valerie; Pettinelli, Francois; Bouloy, Michele; Cardinale, Eric; Albina, Emmanuel



Arm pain and fever as an unusual presentation of lobar pneumonia in a 3-year-old girl: case report.  


Children with pneumonia presenting with extrathoracic pain, such as abdominal pain, have been previously described. In this report, we describe a 3-year-old girl with fever and right arm pain who was found to have an apical lobar pneumonia. PMID:21546807

Bechtel, Kirsten; Siew, Lawrence



Clinical Manifestations and Case Management of Ebola Haemorrhagic Fever Caused by a Newly Identified Virus Strain, Bundibugyo, Uganda, 2007-2008  

PubMed Central

A confirmed Ebola haemorrhagic fever (EHF) outbreak in Bundibugyo, Uganda, November 2007–February 2008, was caused by a putative new species (Bundibugyo ebolavirus). It included 93 putative cases, 56 laboratory-confirmed cases, and 37 deaths (CFR?=?25%). Study objectives are to describe clinical manifestations and case management for 26 hospitalised laboratory-confirmed EHF patients. Clinical findings are congruous with previously reported EHF infections. The most frequently experienced symptoms were non-bloody diarrhoea (81%), severe headache (81%), and asthenia (77%). Seven patients reported or were observed with haemorrhagic symptoms, six of whom died. Ebola care remains difficult due to the resource-poor setting of outbreaks and the infection-control procedures required. However, quality data collection is essential to evaluate case definitions and therapeutic interventions, and needs improvement in future epidemics. Organizations usually involved in EHF case management have a particular responsibility in this respect.

Roddy, Paul; Howard, Natasha; Van Kerkhove, Maria D.; Lutwama, Julius; Wamala, Joseph; Yoti, Zabulon; Colebunders, Robert; Palma, Pedro Pablo; Sterk, Esther; Jeffs, Benjamin; Van Herp, Michel; Borchert, Matthias



Yellow Jackie  

NSDL National Science Digital Library

You, the reader, are helping Terry sail a yacht from South America to New Zealand. You are asked to investigate an outbreak of disease on board a second yacht. You interview the crew members, consult a medical reference, and observe other clues to determine what diseases the ill crew members have. The solution involves medical science, sports science, human health, biology, microbiology, infectious diseases, epidemiology, and hygiene. The mystery tests literacy, problem solving skills and deductive reasoning. The mystery has three parts. In the first part, you meet the characters and enter the story. In the second part, you interview the characters, investigate the facts, and attempt to solve the case. When you solve the case, you enter the third part, which concludes the story, and summarizes the scientific analysis needed to solve the case. The narrative is fictional, but the scenario is based on actual events and contemporary science research and discoveries.

Ken Eklund (WriterGuy REV)



[Bolivian hemorrhagic fever].  


Analysis of data of the available literature on epidemiology of Bolivian hemorrhagic fever, manifestations of human disease, biological properties of the causative agent and development carried out abroad of means and methods of diagnostics, prophylaxis and therapy of this infection that presents a potential threat for the population and economy of the Russian Federation in case of introduction of the causative agent is presented. PMID:24000605

Markin, V A; Pantiukhov, V B; Markov, V I; Bondarev, V P


Q fever in Bulgaria and Slovakia.  

PubMed Central

As a result of dramatic political and economic changes in the beginning of the 1990s, Q-fever epidemiology in Bulgaria has changed. The number of goats almost tripled; contact between goat owners (and their families) and goats, as well as goats and other animals, increased; consumption of raw goat milk and its products increased; and goats replaced cattle and sheep as the main source of human Coxiella burnetii infections. Hundreds of overt, serologically confirmed human cases of acute Q fever have occurred. Chronic forms of Q fever manifesting as endocarditis were also observed. In contrast, in Slovakia, Q fever does not pose a serious public health problem, and the chronic form of infection has not been found either in follow-ups of a Q-fever epidemic connected with goats imported from Bulgaria and other previous Q-fever outbreaks or in a serologic survey. Serologic diagnosis as well as control and prevention of Q fever are discussed.

Serbezov, V. S.; Kazar, J.; Novkirishki, V.; Gatcheva, N.; Kovacova, E.; Voynova, V.



Typhoid fever  

Microsoft Academic Search

http:\\/\\/\\/pqdweb?did=252411801&sid=1&Fmt=4&cli entId=12520&RQT=309&VName=PQD Abstract (Document Summary) In 1948 chloramphenicol became the standard antibiotic for treating typhoid.5 Although resistance emerged within two years after its introduction, it was not until 1972 that chloramphenicol-resistant typhoid fever became a major problem.6 Outbreaks occurred in Mexico, India, Vietnam, Thailand, Korea, and Peru.6 Chloramphenicol resistance was associated with high-molecular-weight, self-transferable, IncHI plasmids. Full Text (8258 words)

Christopher M Parry; Tran Tinh Hien; Gordon Dougan; Nicholas J White; Jeremy J Farrar



Pericardial involvement in familial Mediterranean fever.  

PubMed Central

Two patients with familial Mediterranean fever showed the classic features of pericardial involvement and one of them (Case 2) had pericardial effusion detected by echocardiography. These and previously published cases show that familial Mediterranean fever should be considered as a cause of pericarditis and/or pericardial effusion.

Erol, C.; Sonel, A.; Candan, I.; Omurlu, K.; Akyol, T.



An outbreak of Q fever in Bulgaria  

Microsoft Academic Search

Summary. Q fever is an acute febrile illness due to Coxiella burnetii. In the Balkans, Q fever in humans has been reported since World War II, and in countries such as Bulgaria the number of cases has increased since the early 1990s. We report an investigation of an outbreak in the town of Botevgrad, Western Bulgaria. Overall, 220 cases were

Stefan Panaiotov; Massimo Ciccozzi; Nadia Brankova; Victoria Levterova; Mayda Mitova-Tiholova; Massimo Amicosante; Giovanni Rezza; Todor Kantardjiev


Mevalonate Kinase Deficiency (Hyper IgD Syndrome with Periodic Fever) - Different Faces with Separate Treatments: Two Cases and Review of the Literature.  


The hyperimmunoglobulinemia D syndrome (HIDS), so-called mevalonate kinase deficiency, is caused by recessive mutations in the gene encoding mevalonate kinase enzyme. HIDS is characterized by recurrent fever attacks of 3-7 days that begin in infancy and recur every 4-6 weeks. The febrile period is accompanied by lymphadenopathy, arthralgia, abdominal pain, diarrhea, aphthous ulcers, and varying degree of skin involvement. The course and severity of the disease may be quite different. There is no effective or proven therapy for HIDS. We report two cases with HIDS, which had separate clinical findings and treatment strategies. PMID:23692791

Gençp?nar, P?nar; Makay, Balahan B; Gattorno, Marco; Caroli, Francesco; Unsal, Erbil


[Rift Valley fever].  


Rift Valley Fever (RVF) is a zoonotic arbovirosis. Among animals, it mainly affects ruminants, causing abortions in gravid females and mortality among young animals. In humans, RVF virus infection is usually asymptomatic or characterized by a moderate fever. However, in 1 to 3% of cases, more severe forms of the disease (hepatitis, encephalitis, retinitis, hemorrhagic fever) can lead to the death of infected individuals or to major sequels. The RVF virus (Bunyaviridae, genus Phlebovirus) was identified for the first time in the 1930s in Kenya. It then spread over almost all African countries, sometimes causing major epizootics/epidemics. In 2000, the virus was carried out of Africa, in the Middle East Arabian Peninsula. In 2007-2008, Eastern-African countries, including Madagascar, reported significant episodes of RVF virus, this was also the case for the Comoros archipelago and the French island of Mayotte. This ability to spread associated with many vectors, including in Europe, and high viral loads in infected animals led the health authorities worldwide to warn about the potential emergence of RVF virus in areas with a temperate climate. The awareness has increased in recent years with climate changes, which may possibly modify the vector distribution and competence, and prompted many RVF virus-free countries to better prepare for a potential implantation of RVF. PMID:21295425

Pépin, M



Ebola haemorrhagic fever  

PubMed Central

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.

Feldmann, Heinz; Geisbert, Thomas W



Relapsing fever in Jordan  

PubMed Central

The author reports on a survey carried out by him in 1954 on relapsing fever in Jordan. In that country the disease is largely tick-borne, the main vector being Ornithodoros tholozani. Some of the frequent cases in the town of Nablus and the village of Marda in West Jordan may, however, be caused by O. coniceps. The centres of infection are some of the numerous caves scattered throughout the hilly areas and certain houses in which chickens are kept. It is believed that the vector ticks could be successfully exterminated by the use of insecticides and by the adoption of certain procedures outlined by the author. Arsenobenzol compounds and penicillin have been shown not to be very effective for the treatment of relapsing fever, but good results have been obtained with Aureomycin and Terramycin. ImagesFIG. 1FIG. 4

Babudieri, B.



Ebola haemorrhagic fever.  


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

Feldmann, Heinz; Geisbert, Thomas W



Psychological stress contributed to the development of low-grade fever in a patient with chronic fatigue syndrome: a case report  

PubMed Central

Background Low-grade fever is a common symptom in patients with chronic fatigue syndrome (CFS), but the mechanisms responsible for its development are poorly understood. We submit this case report that suggests that psychological stress contributes to low-grade fever in CFS. Case presentation A 26-year-old female nurse with CFS was admitted to our hospital. She had been recording her axillary temperature regularly and found that it was especially high when she felt stress at work. To assess how psychological stress affects temperature and to investigate the possible mechanisms for this hyperthermia, we conducted a 60-minute stress interview and observed the changes in the following parameters: axillary temperature, fingertip temperature, systolic blood pressure, diastolic blood pressure, heart rate, plasma catecholamine levels, and serum levels of interleukin (IL)-1? and IL-6 (pyretic cytokines), tumor necrosis factor-? and IL-10 (antipyretic cytokines). The stress interview consisted of recalling and talking about stressful events. Her axillary temperature at baseline was 37.2°C, increasing to 38.2°C by the end of the interview. In contrast, her fingertip temperature decreased during the interview. Her heart rate, systolic and diastolic blood pressures, and plasma levels of noradrenaline and adrenaline increased during the interview; there were no significant changes in either pyretic or antipyretic cytokines during or after the interview. Conclusions A stress interview induced a 1.0°C increase in axillary temperature in a CFS patient. Negative emotion-associated sympathetic activation, rather than pyretic cytokine production, contributed to the increase in temperature induced by the stress interview. This suggests that psychological stress may contribute to the development or the exacerbation of low-grade fever in some CFS patients.



Meningitis associated with familial Mediterranean fever.  


Neurologic involvement in patients with familial Mediterranean fever is relatively uncommon, and rarely described in the literature. Although headache occurs frequently, meningitis and convulsions are rare. We describe the case of a 30-year-old man with attacks of meningitis. After colchicine therapy, no further recurrence of fever and meningitis were observed. These findings suggest that meningitis should be considered as an unusual manifestation of familial Mediterranean fever. PMID:15875625

Karachaliou, I; Karachalios, G; Charalabopoulos, A; Charalabopoulos, K



Risk factors for typhoid and paratyphoid fever in Jakarta, Indonesia  

Microsoft Academic Search

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 coincide and current typhoid vaccines do not protect against paratyphoid fever. OBJECTIVE: To determine risk

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



Azathioprine-induced fever in autoimmune hepatitis  

PubMed Central

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.

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



Evaluation of the influence of yellow substance absorption on the remote sensing of water quality in the Gulf of Naples: a case study  

Microsoft Academic Search

The yellow substance absorption in the coastal waters of the Gulf of Naples was measured by a method combining beam transmission and induced fluorescence measurements. A water optical model specific to that test area, derived from experimentation carried out in situ has been used to evaluate the impact of the measured yellow substance absorption on the remote sensing of water

G. M. Ferrari; S. Tassan



Anti-TNF agents in familial Mediterranean fever: report of three cases and review of the literature.  


Familial Mediterranean fever (FMF) is an autoinflammatory disease characterized by recurrent fever, peritonitis/pleuritis, or arthritis attacks. Patients may have FMF-associated mutations of pyrin. The role of biologics such as anti-tumor necrosis factor (TNF) agents (infliximab, etanercept, adalimumab, golimumab) and anakinra, canakinumab, or rilonacept in the treatment of FMF needs to be clarified. Herein we present reports of three patients (all were positive for HLA B27) with typical spondylitis associated with FMF who were successfully managed with anti-TNF agents, along with a literature review. The patients were a 37-year-old man with concomitant Crohn's disease and amyloidosis who was treated with infliximab (INF, 5 mg/kg for 3 years) and switched to adalimumab (ADA), and two female patients (a 24-year-old and a 31-year-old) with FMF who developed severe spondylitis and who were also treated with ADA. Anti-TNF agents can control FMF attacks quite effectively and they reveal a promising role in the treatment of FMF-associated amyloidosis and spondylitis. PMID:21567247

Ozgocmen, Salih; Akgul, Ozgur



Novel Spotted Fever Group Rickettsiosis, Brazil  

PubMed Central

We report a clinical case of spotted fever group rickettsiosis acquired in São Paulo, Brazil. Definitive diagnosis was supported by seroconversion between acute-phase and convalescent-phase serum samples. Molecular analysis of skin samples indicated the agent was a novel spotted fever group strain closely related to Rickettsia africae, R. parkeri, and R. sibirica.

Spolidorio, Mariana G.; Mantovani, Elenice; Brandao, Paulo E.; Richtzenhain, Leonardo J.; Yoshinari, Natalino H.



Staphylococcal enterotoxins in scarlet fever complicating chickenpox  

Microsoft Academic Search

Two cases of scarlet fever are described, both following super-infection of chickenpox. Enterotoxin B and C producing staphylococci were the only pathogens identified. The role of staphylococcal and streptococcal toxins in the pathogenesis of scarlet fever and toxic shock syndrome is discussed.

M. G. Brook; B. A. Bannister



Q fever endocarditis: an unusual presentation.  


Coxiella burnetii, the agent of Q fever, is an obligate intracellular pathogen typically associated with exposure to livestock. This organism may present with acute or chronic manifestations, the most typical chronic manifestation being endocarditis. We report a highly unusual case of Q fever endocarditis acquired in the United States marked by atypical cardiac manifestations. PMID:23090066

Griffin, Allen T; Espinosa, Martin; Nakamatsu, Raul



Integrated Community Case Management of Fever in Children under Five Using Rapid Diagnostic Tests and Respiratory Rate Counting: A Multi-Country Cluster Randomized Trial  

PubMed Central

Evidence on the impact of using diagnostic tests in community case management of febrile children is limited. This effectiveness trial conducted in Burkina Faso, Ghana, and Uganda, compared a diagnostic and treatment package for malaria and pneumonia with presumptive treatment with anti-malarial drugs; artemisinin combination therapy (ACT). We enrolled 4,216 febrile children between 4 and 59 months of age in 2009–2010. Compliance with the malaria rapid diagnostic test (RDT) results was high in the intervention arm across the three countries, with only 4.9% (17 of 344) of RDT-negative children prescribed an ACT. Antibiotic overuse was more common: 0.9% (4 of 446) in Uganda, 38.5% (114 of 296) in Burkina Faso, and 44.6% (197 of 442) in Ghana. Fever clearance was high in both intervention and control arms at both Day 3 (97.8% versus 96.9%, P = 0.17) and Day 7 (99.2% versus 98.8%, P = 0.17). The use of diagnostic tests limits overuse of ACTs. Its impact on antibiotic overuse and on fever clearance is uncertain.

Mukanga, David; Tiono, Alfred B.; Anyorigiya, Thomas; Kallander, Karin; Konate, Amadou T.; Oduro, Abraham R.; Tibenderana, James K.; Amenga-Etego, Lucas; Sirima, Sodiomon B.; Cousens, Simon; Barnish, Guy; Pagnoni, Franco



Integrated community case management of fever in children under five using rapid diagnostic tests and respiratory rate counting: a multi-country cluster randomized trial.  


Evidence on the impact of using diagnostic tests in community case management of febrile children is limited. This effectiveness trial conducted in Burkina Faso, Ghana, and Uganda, compared a diagnostic and treatment package for malaria and pneumonia with presumptive treatment with anti-malarial drugs; artemisinin combination therapy (ACT). We enrolled 4,216 febrile children between 4 and 59 months of age in 2009-2010. Compliance with the malaria rapid diagnostic test (RDT) results was high in the intervention arm across the three countries, with only 4.9% (17 of 344) of RDT-negative children prescribed an ACT. Antibiotic overuse was more common: 0.9% (4 of 446) in Uganda, 38.5% (114 of 296) in Burkina Faso, and 44.6% (197 of 442) in Ghana. Fever clearance was high in both intervention and control arms at both Day 3 (97.8% versus 96.9%, P = 0.17) and Day 7 (99.2% versus 98.8%, P = 0.17). The use of diagnostic tests limits overuse of ACTs. Its impact on antibiotic overuse and on fever clearance is uncertain. PMID:23136274

Mukanga, David; Tiono, Alfred B; Anyorigiya, Thomas; Källander, Karin; Konaté, Amadou T; Oduro, Abraham R; Tibenderana, James K; Amenga-Etego, Lucas; Sirima, Sodiomon B; Cousens, Simon; Barnish, Guy; Pagnoni, Franco



Case-fatality ratio and effectiveness of ribavirin therapy among hospitalized patients in china who had severe Fever with thrombocytopenia syndrome.  


Background.?The wide distribution and high case-fatality ratio of severe fever with thrombocytopenia syndrome (SFTS) have made it a significant public health problem. This study was designed to identify the predictors of fatal outcomes and to evaluate the effectiveness of antiviral therapy in treating SFTS virus (SFTSV)-infected patients. Methods.?A cross-sectional study was performed in a general hospital located in Xinyang city, whereas the largest number of patients with SFTS in China were treated during 2011-2012. The primary outcome for the treatment effect analysis was death. Other outcomes included sequential platelet levels and viral loads observed throughout the hospitalization and the interval between the initiation of ribavirin therapy and the return of the platelet count to a normal level. Results.?A total of 311 SFTSV-infected patients were included in the study. The most frequent clinical presentations were fever, weakness, myalgia, and gastrointestinal symptoms. Each patient had thrombocytopenia, leukopenia, or both. The case-fatality ratio (CFR) was 17.4% (95% confidence interval [CI], 13.1%-21.6%). Older age (odds ratio [OR], 1.061; 95% CI, 1.023-1.099; P = .001), decreased level of consciousness (OR, 5.397; 95% CI, 2.660-10.948; P < .001), and elevated levels of lactate dehydrogenase (>1200 U/L; OR, 2.620; 95% CI, 1.073-6.399; P = .035) and creatine kinase (>800 U/L; OR, 2.328; 95% CI, 1.129-4.800; P = .022) were significantly associated with fatal outcome. The CFRs were similar between patients who received ribavirin and those who did not. Ribavirin treatment showed no significant effect on either platelet counts or viral loads during hospitalization of patients with fatal or nonfatal cases. Conclusions.?These findings can improve knowledge about the characteristics of patients with fatal outcomes and the use of antiviral drug for SFTS. PMID:23965284

Liu, Wei; Lu, Qing-Bin; Cui, Ning; Li, Hao; Wang, Li-Yuan; Liu, Kun; Yang, Zhen-Dong; Wang, Bing-Jun; Wang, Hong-Yu; Zhang, Yao-Yun; Zhuang, Lu; Hu, Chun-Yan; Yuan, Chun; Fan, Xue-Juan; Wang, Zhen; Zhang, Lan; Zhang, Xiao-Ai; Walker, David H; Cao, Wu-Chun




Microsoft Academic Search

A report of 19 cases of serologically-proven dengue hemorrhagic fever (DHF) in infants aged 3-12 months who were admitted to the Department of Pediatrics, Chon Buri Regional Hospital, Thailand, during 1995 to 1998. Subjects were 8 males and 11 females, with the peak age of 8 months. Four cases (21%) had DHF and other common co-infections ie pneumonia (2 cases),

Suchat Hongsiriwon



The first clinical case due to AP92 like strain of Crimean-Congo Hemorrhagic Fever virus and a field survey  

PubMed Central

Background Crimean-Congo Hemorrhagic Fever (CCHF) is a fatal infection, but no clinical case due to AP92 strain was reported. We described the first clinical case due to AP92 like CCHFV. Methods A case infected by a AP92 like CCHFV was detected in Balkanian part of Turkey. Diagnosis was confirmed by RT-PCR and sequencing. A human serologic and tick survey studies were performed in the region, where the case detected. Results Thirty eight individuals out of 741 were found to be anti CCHFV IgM positive. The attack rate for overall CCHFV was calculated as 5.2%. In univariate analyses, CCHFV IgM positivity was found to be associated with the age (p < 0.001), male gender (p = 0.001), agricultural activity (p = 0.036), and history of tick bite (p = 0.014). In multivariate analysis, older age (OR: 1.03, CI:1.01–1.05, p < 0.001), male gender were found to be the risk factors (OR: 2.5, CI:1.15–5.63, p = 0.020) for CCHFV infection. Conclusion This is the first human case with AP92 like CCHFV infection. Furthermore, this is the first report of AP92 like strain in Turkey. In the region, elderly males carry the highest risk for CCHFV infection.



Typhoid Fever in Young Children  

Microsoft Academic Search

One hundred and fifty cases of typhoid in infants and young children are reported. In children over 5 years of age the features resembled those in adults, but in those under this age they were often nonspecific including fever, convulsions, diarrhoea, and vomiting. Attention is drawn to the importance of a blood culture in anaemic afebrile children who develop rigors

T. O. Mulligan



Dengue fever: diagnosis and treatment.  


Dengue fever is a common tropical infection. This acute febrile illness can be a deadly infection in cases of severe manifestation, causing dengue hemorrhagic shock. In this brief article, I will summarize and discuss the diagnosis and treatment of this disease. For diagnosis of dengue, most tropical doctors make use of presumptive diagnosis; however, the definite diagnosis should be based on immunodiagnosis or viral study. Focusing on treatment, symptomatic and supportive treatment is the main therapeutic approach. The role of antiviral drugs in the treatment of dengue fever has been limited, but is currently widely studied. PMID:20586568

Wiwanitkit, Viroj



Dengue fever outbreak in Lahore.  


Dengue fever has now affected all the major cities of country. About 41,354 patients underwent antibody screening for dengue fever from Shaukat Khanum Memorial Cancer Hospital, Lahore, during the epidemic period (October 1st 2010 to December 20th 2010). Out of them, 1294 (3.1%) patients were positive for IgM antibodies, and 124 (0.3%) for IgG antibodies. A total of 722 (1.7%) patients were borderline positive for IgM antibodies and 108 (0.26%) were borderline positive for IgG antibodies. Dengue fever has emerged as a global problem over the last 5 years. It has also hit Lahore badly especially after the floods in 2010. High index of suspicion should be there in case of related symptoms. PMID:23458054

Hassan, Usman; Loya, Asif; Mehmood, Muhammad Tariq; Nazeer, Hammad; Sultan, Faisal



Allergic Rhinitis (Hay Fever)  


... Español About Otolaryngology ENT History Fact Sheet: Allergic Rhinitis (Hay Fever) Allergic rhinitis (hay fever) is an especially common chronic nasal ... to foods and indoor allergens. What causes allergic rhinitis? Allergic rhinitis typically results from two conditions: family ...


Colorado tick fever  


Colorado tick fever is an acute viral infection spread by the bite of the Dermacentor andersoni wood ... are recent outdoor activity and recent tick bite . Colorado tick fever is seen most often in Colorado. ...



PubMed Central

Utilizing techniques of passive transfer, we have investigated the factors responsible for production of fever when tuberculin is given intravenously to specifically sensitized rabbits. The ability to develop a febrile response to tuberculin could be passively transferred to normal recipients with viable mononuclear cells from peritoneal exudates, spleen, or lymph nodes of donor rabbits sensitized with BCG. Sensitivity was usually apparent 48 hr after transfer, maximal at 7 to 14 days, and rapidly declined thereafter. Granulocytes and nonviable, sonicated, mononuclear cells from similarly sensitized donors were unable to transfer this form of reactivity. Passive transfer of reactivity was also effected with plasma and serum, suggesting that the reaction of antibody with antigen contained in tuberculin is one of the initial steps by which the host cells are activated to release the endogenous pyrogen (EP) that mediates this form of hypersensitivity fever. An intravenous infusion of granulocytes, as well as of several types of mononuclear cells from sensitized donors, made most recipients responsive to the pyrogenic effect of old tuberculin (OT) given 2 hr later. Some of these passively transferred cells, such as the granulocyte and alveolar macrophage, may be activated in vivo by OT, as they are in vitro. However, in the case of splenic and lymph node cells that cannot be activated by OT to produce EP in vitro, it seems likely that an intravenous injection of OT causes these transferred, sensitized cells to liberate an intermediate substance that either directly, or in association with antigen, activates the host's normal cells to produce EP. In support of previous suggestions that leukocytes of several types, as well as phagocytic cells of the reticuloendothelial system, serve as potential sources of EP in tuberculin-induced fever, evidence was presented that OT also activates both granulocytes and mononuclear cells from sterile exudates of BCG-sensitized donors to produce EP in vitro.

Hall, William J.; Francis, Lorraine; Atkins, Elisha



Climate impacts on environmental risks evaluated from space: a conceptual approach to the case of Rift Valley Fever in Senegal  

PubMed Central

Background Climate and environment vary across many spatio-temporal scales, including the concept of climate change, which impact on ecosystems, vector-borne diseases and public health worldwide. Objectives To develop a conceptual approach by mapping climatic and environmental conditions from space and studying their linkages with Rift Valley Fever (RVF) epidemics in Senegal. Design Ponds in which mosquitoes could thrive were identified from remote sensing using high-resolution SPOT-5 satellite images. Additional data on pond dynamics and rainfall events (obtained from the Tropical Rainfall Measuring Mission) were combined with hydrological in-situ data. Localisation of vulnerable hosts such as penned cattle (from QuickBird satellite) were also used. Results Dynamic spatio-temporal distribution of Aedes vexans density (one of the main RVF vectors) is based on the total rainfall amount and ponds’ dynamics. While Zones Potentially Occupied by Mosquitoes are mapped, detailed risk areas, i.e. zones where hazards and vulnerability occur, are expressed in percentages of areas where cattle are potentially exposed to mosquitoes’ bites. Conclusions This new conceptual approach, using precise remote-sensing techniques, simply relies upon rainfall distribution also evaluated from space. It is meant to contribute to the implementation of operational early warning systems for RVF based on both natural and anthropogenic climatic and environmental changes. In a climate change context, this approach could also be applied to other vector-borne diseases and places worldwide.

Tourre, Yves M.; Lacaux, Jean-Pierre; Vignolles, Cecile; Lafaye, Murielle



Fever and limp: thinking outside the box.  


Fever and limp is a common presentation in the pediatric emergency department. We describe a case of a 21-month-old female patient with prolonged fever and difficulty bearing weight, ultimately diagnosed with a large intracranial abscess. Intracranial abscesses are a rare cause of limp and an uncommon diagnosis in pediatric patients without underlying congenital heart disease. This case highlights the importance of differentiating the features of limp secondary to pain from limp secondary to weakness, which is particularly difficult in the preschool-aged group. It is imperative for practitioners to consider disease of the central nervous system when evaluating acutely nonambulatory children with fevers. PMID:23222105

Mathison, David J; Troy, April; Levy, Michael



A review of the physiology of fever in birds.  


While fever is known to occur in invertebrates and vertebrates, the mechanisms of fever in animals other than mammals have received scant attention. We look initially at the recognition, by the avian immune system, of pathogen associated molecular patterns and the likely role of toll-like receptors in signaling the presence of bacteria and viruses. Several mediators of fever are subsequently released by immune cells, including interleukin-6 and interleukin-1?, that eventually reach the brain and alter thermoregulatory function. As is the case in mammals, prostaglandins appear to be the ultimate mediators of fever in birds, since the febrile response is attenuated when prostaglandin synthesis is inhibited. Ambient temperature modulates the fever response, with larger fevers at higher, and smaller fevers at lower ambient temperatures. Glucocorticoid levels are increased during fever and seem to play an important role by modulating the extent of fever generation, possibly playing a role in the attenuation of fever after repeated exposure to a pathogen in a process termed tolerance, suggesting that the fever process can be phenotypically adapted to likely future conditions. While fever has an ancient phylogenetic history and many of the underling mechanisms in birds appear similar to mammals, there are several important differences that suggest fever has evolved quite differently in these two homeothermic classes. PMID:23160839

Gray, David A; Marais, Manette; Maloney, Shane K



9 CFR 96.2 - Prohibition of casings due to African swine fever and bovine spongiform encephalopathy.  

Code of Federal Regulations, 2013 CFR

...this subchapter may be imported, provided, if the casings are derived from the small intestine, the casings are derived from that part of the small intestine that is eligible for use as human food in accordance with the requirements...



Immunity of the African Negro from Yellow Fever  

Microsoft Academic Search

THIS point, interesting to anthropologists, is raised anew by a writer on the history of epidemics (NATURE, June 16), who asks whether the alleged protection is supported by all recent authorities. Recent authorities are not so well placed for judging of this matter as the earlier; for the reason that immunity is not alleged except for the African negro of

C. Creighton



Vitelline envelope genes of the yellow fever mosquito, Aedes aegypti  

Microsoft Academic Search

Vitelline envelope genes from the mosquito Aedes aegypti were analyzed with respect to their DNA sequences, genomic representation, temporal and spatial expression profiles and response to 20-hydroxyecdysone. Genomic clones of three vitelline envelope genes, 15a-1, 15a-2 and 15a-3 were isolated. Southern analysis indicates that all three genes are represented by a single copy in the genome. The deduced amino acid

Marten J. Edwards; David W. Severson; Henry H. Hagedorn



Vector-Borne Transmission: Malaria, Dengue, and Yellow Fever  

Microsoft Academic Search

\\u000a At least 2 billion people live in malarious areas (Snow et al. 2005). The disease primarily affects poor populations in tropical\\u000a and subtropical areas, where the temperature and rainfall are most suitable for the development of the alariacausing Plasmodium\\u000a parasites in Anopheles mosquitoes. This limited geographic distribution is no necessity: malaria once occurred widely in temperate\\u000a areas, including Western Europe

Tomas Jelinek


Yellow Legged Frog  

USGS Multimedia Gallery

USGS scientists found this adult mountain yellow-legged frog on June 10 in Tahquitz Creek, a rediscovered population of the endangered frog in the San Jacinto Wilderness, San Bernardino National Forest, California....



Persistent fever, neck swelling, and small vessel vasculitis following tonsillectomy in a patient with Beh?et's disease: a case report  

PubMed Central

Introduction Behçet’s disease commonly presents with recurrent oral and genital mucocutaneous ulcerations, uveitis and various skin manifestations. Other clinical symptoms include gastrointestinal ulcerations, arthritis, venous thrombosis, arterial aneurysms and central nervous system affection. Vasculitis underlies most clinical symptoms of Behçet’s disease. Case presentation We report the case of a 62-year-old European Caucasian woman with Behçet’s disease who presented with persistent fever and neck soft-tissue swelling, despite broad antibiotic treatment, two weeks after acute tonsillitis and a tonsillectomy. Diffuse epi- and mesopharyngeal swelling shown on a computed tomography scan of her neck and persistently elevated serum markers of inflammation initially prompted suspicion of an infectious etiology. Magnet resonance imaging of her neck and a neck tissue biopsy finally confirmed small vessel vasculitis involving skin, subcutaneous tissue and muscle. Considering the clinical presentation, past medical history and histological findings, we interpreted our patient’s symptoms as a flare of Behçet’s disease. Immunosuppressive treatment led to rapid clinical improvement. Conclusion A patient with Behçet’s disease developed small vessel vasculitis of the soft tissue of her neck after tonsillitis and a tonsillectomy. Infection and surgery probably triggered a flare of Behçet’s disease.



Mediterranean spotted fever presenting as an acute pancreatitis.  


Mediterranean spotted fever (MSF) is an infectious disease, caused by Rickettsia conorii. It can have a serious course, even deadly, with many types of complications. Described is a case of a 70-year-old man, hospitalized for fever, abdominal pain, amylase and lipase elevation, and ultrasound hypoechoic pancreas. The working diagnosis at admission was acute pancreatitis. 2 days after admission, the patient developed signs of MSF: fever, maculopapular rash, and "tache noire". Treatment with oral doxycycline was started. After 5 days of therapy, there was complete remission of epigastric pain and fever. Gastrointestinal and hepatic complications are described in association with Mediterranean spotted fever. Much more rare is pancreatic involvement. PMID:21563660

Rombola, Ferdinando



Isolated fever induced by mesalamine treatment.  


Adverse reactions to mesalamine, a treatment used to induce and maintain remission in inflammatory bowel diseases, particularly ulcerative colitis, have been described in the literature as case reports. This case illustrates an unusual adverse reaction. Our patient developed an isolated fever of unexplained etiology, which was found to be related to mesalamine treatment. A 22-year-old patient diagnosed with ulcerative colitis developed a fever with rigors and anorexia 10 d after starting oral mesalamine while his colitis was clinically resolving. Testing revealed no infection. A mesalamine-induced fever was considered, and treatment was stopped, which led to spontaneous resolution of the fever. The diagnosis was confirmed by reintroducing the mesalamine. One year later, this side effect was noticed again in the same patient after he was administered topical mesalamine. This reaction to mesalamine seems to be idiosyncratic, and the mechanism that induces fever remains unclear. Fever encountered in the course of a mesalamine treatment in ulcerative colitis must be considered a mesalamine-induced fever when it cannot be explained by the disease activity, an associated extraintestinal manifestation, or an infectious etiology. PMID:23467507

Slim, Rita; Amara, Joseph; Nasnas, Roy; Honein, Khalil; Jaoude, Joseph Bou; Yaghi, Cesar; Daniel, Fady; Sayegh, Raymond



Enterobacter agglomerans--associated cotton fever.  


Cotton fever is usually a benign febrile, leukocytic syndrome of unknown etiology seen in intravenous narcotic abusers. Cotton and cotton plants are heavily colonized with Enterobacter agglomerans. We report a case of cotton fever associated with E agglomerans in which the organism was first isolated from the patient's blood and secondarily from cotton that he had used to filter heroin. Enterobacter agglomerans is with most probability the causal agent of cotton fever. Patients presenting with the classic history should have blood cultures performed and should be started on a regimen of empiric antibiotic therapy. PMID:8215743

Ferguson, R; Feeney, C; Chirurgi, V A



Epidemiology of typhoid fever in Singapore.  

PubMed Central

A total of 1452 cases of typhoid fever was notified in Singapore from 1980-9. The morbidity rates of indigenous cases showed a steady decline from 5.9 per 100,000 population in 1980 to 1.2 per 100,000 population in 1989. The mean case fatality was 0.8%. Children, adolescents and young adults were most susceptible to typhoid fever. There was no significant difference in morbidity rates between the major ethnic groups. The vast majority of indigenous cases were sporadic while outbreaks accounted for almost one third of them. Food was the main vehicle of transmission. The commonest indigenous phage types were B1, D1 and A. Antimicrobial resistance was infrequently seen. The proportion of imported cases rose from 32% in 1980 to 72% in 1989. Almost half (48.5%) of all imported cases were local residents who contracted typhoid fever while travelling in endemic countries. As imported cases assume greater importance in the epidemiology of typhoid fever in Singapore, further drop in typhoid fever incidence would require reduction of travel-related cases through greater awareness of food hygiene and effective vaccination.

Yew, F. S.; Goh, K. T.; Lim, Y. S.



Q Fever: An Old but Still a Poorly Understood Disease  

PubMed Central

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.

Honarmand, Hamidreza



Typhoid fever and paratyphoid fever: Systematic review to estimate global morbidity and mortality for 2010  

PubMed Central

Background Typhoid and paratyphoid fever remain important causes of morbidity worldwide. Accurate disease burden estimates are needed to guide policy decisions and prevention and control strategies. Methods We conducted a systematic literature review of the PubMed and Scopus databases using pre-defined criteria to identify population-based studies with typhoid fever incidence data published between 1980 and 2009. We also abstracted data from annual reports of notifiable diseases in countries with advanced surveillance systems. Typhoid and paratyphoid fever input data were grouped into regions and regional incidence and mortality rates were estimated. Incidence data were extrapolated across regions for those lacking data. Age-specific incidence rates were derived for regions where age-specific data were available. Crude and adjusted estimates of the global typhoid fever burden were calculated. Results Twenty-five studies were identified, all of which contained incidence data on typhoid fever and 12 on paratyphoid fever. Five advanced surveillance systems contributed data on typhoid fever; 2 on paratyphoid fever. Regional typhoid fever incidence rates ranged from <0.1/100?000 cases/y in Central and Eastern Europe and Central Asia to 724.6/100?000 cases/y in Sub-Saharan Africa. Regional paratyphoid incidence rates ranged from 0.8/100?000 cases/y in North Africa/Middle East to 77.4/100?000 cases/y in Sub-Saharan Africa and South Asia. The estimated total number of typhoid fever episodes in 2010 was 13.5 million (interquartile range 9.1–17.8 million). The adjusted estimate accounting for the low sensitivity of blood cultures for isolation of the bacteria was 26.9 million (interquartile range 18.3–35.7 million) episodes. These findings are comparable to the most recent analysis of global typhoid fever morbidity, which reported crude and adjusted estimates of 10.8 million and 21.7 million typhoid fever episodes globally in 2000. Conclusion Typhoid fever remains a significant health burden, especially in low- and middle-income countries. Despite the availability of more recent data on both enteric fevers, additional research is needed in many regions, particularly Africa, Latin America and other developing countries.

Buckle, Geoffrey C.; Walker, Christa L. Fischer; Black, Robert E.



Acute atrial fibrillation during dengue hemorrhagic fever.  


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. PMID:14636482

Horta Veloso, Henrique; Ferreira Júnior, João Anísio; Braga de Paiva, Joyce Morgana; Faria Honório, Júlio; Junqueira Bellei, Nancy C; Vicenzo de Paola, Angelo Amato



Management of dengue fever in ICU  

Microsoft Academic Search

Dengue virus infection can cause a wide spectrum of illness. Thrombocytopenia with concurrent haemoconcentration differentiates\\u000a dengue haemorrhagic fever from classical dengue fever. Only cases with shock or unstable vitals signs need admission in the\\u000a pediatric intensive care. The management is essentially supportive and symptomatic. The key to success is frequent monitoring\\u000a and changing strategies. A rise in hematocrit of 20%

Arun Soni; Krishan Chugh; Anil Sachdev; Dhiren Gupta



Climate impacts on environmental risks evaluated from space: a contribution to social benefits within the GEOSS Health Area: The case of Rift Valley Fever in Senegal  

NASA Astrophysics Data System (ADS)

Climate and environment vary on many spatio-temporal scales, including climate change, with impacts on ecosystems, vector-borne diseases and public health worldwide. This study is to enable societal benefits from a conceptual approach by mapping climatic and environmental conditions from space and understanding the mechanisms within the Health Social Benefit GEOSS area. The case study is for Rift Valley Fever (RVF) epidemics in Senegal is presented. Ponds contributing to mosquitoes’ thriving, were identified from remote sensing using high-resolution SPOT-5 satellite images. Additional data on ponds’ dynamics and rainfall events (obtained from the Tropical Rainfall Measuring Mission) were combined with hydrological in-situ data. Localization of vulnerable hosts such as parked cattle (from QuickBird satellite) are also used. Dynamic spatio-temporal distribution of Aedes vexans density (one of the main RVF vectors) is based on the total rainfall amount and ponds’ dynamics. While Zones Potentially Occupied by Mosquitoes (ZPOM) are mapped, detailed risks areas, i.e. zones where hazards and vulnerability occur, are expressed in percentages of parks where cattle is potentially exposed to mosquitoes’ bites. This new conceptual approach, using remote-sensing techniques belonging to GEOSS, simply relies upon rainfall distribution also evaluated from space. It is meant to contribute to the implementation of integrated operational early warning system within the health application communities since climatic and environmental conditions (both natural and anthropogenic) are changing rapidly.

Tourre, Y. M.



High Household Economic Burden Caused by Hospitalization of Patients with Severe Dengue Fever Cases in Can Tho Province, Vietnam  

PubMed Central

During 2006–2007, a cohort of 144 confirmed dengue cases in Can Tho Province, Vietnam were compared with a matching set of 144 households that had no dengue cases. Approximately 6–9 months after sickness, there were no significant differences in terms of knowledge of the etiology of dengue, mosquito breeding habitats, and prevention measures in respondents from both sets of households. There was also no difference in the abundance of Aedes aegypti (Linn.) adults but the average numbers of late instar and pupal Ae. aegypti per household were greater in the negative control houses. Thus, the risk seemed to be no higher in case households, although it is conceivable that changes may have occurred in either group over the intervening period. The average cost for a dengue patient was 2,798,000 Vietnamese Dong (VND) (US$167.77), 2,154,000 VND for direct costs, and 644,000 VND for indirect costs. There was a 22% difference in cost for those with and without health insurance. In terms of impact on family economies, 47.2% had to borrow money for treatment, and after 6 months, 71.7% had not begun or had only managed part repayments. Approximately 72.9% indicated that the cost of supporting a dengue patient had impacted on the family economy, with the loss averaging 36% of the annual income in the lowest economic quartile.

Tam, Pham Thi; Dat, Nguyen Tan; Huu, Le Minh; Thi, Xuan Cuc Pham; Duc, Hoang Minh; Tu, Tran Cong; Kutcher, Simon; Ryan, Peter A.; Kay, Brian H.



A Case Report of AA Amyloidosis Associated With Familial Periodic Fever Syndrome Diagnosed After Kidney Transplantation: Never Say Never.  


Recurrent or "de novo" AA amyloidosis in the renal allograft is rarely described. We describe a case of severe nephrotic syndrome in a recipient of a kidney graft with a previous diagnosis of polycystic nephropathy caused by AA amyloidosis diagnosed only after the renal transplantation. The disease was possibly a tumor necrosis factor receptor-associated periodic syndrome (TRAPS). TRAPS is a rare hereditary inflammatory disease never reported to the best of our knowledge, as a de novo diagnosis in the transplantation setting. Biopsy of the renal graft, indicated for the onset of heavy proteinuria, and genetic investigation provided the clues for diagnosis. PMID:24034047

Messina, M; Daidola, G; Restagno, G; Lavacca, A; Ranghino, A; Biancone, L; Segoloni, G P



Media Online Yellow Pages  

NSDL National Science Digital Library

The Media Online Yellow Pages is another good place (along with the Big List and Newslink mentioned last week) to find media sources on the Internet. Does not appear to be searchable but the index is well-organized for browsing.


Typhoid Fever and Invasive Nontyphoid Salmonellosis, Malawi and South Africa  

PubMed Central

To determine the prevalence of invasive nontyphoid salmonellosis and typhoid fever in Malawi and South Africa, we compared case frequency and patient age distribution. Invasive nontyphoid salmonellosis showed a clear bimodal age distribution; the infection developed in women at a younger age than in men. Case frequency for typhoid fever was lower than for salmonellosis.

Feasey, Nicholas A.; Archer, Brett N.; Heyderman, Robert S.; Sooka, Arvinda; Dennis, Brigitte; Keddy, Karen H.



Prevalence of Rift Valley Fever among Ruminants, Mayotte  

PubMed Central

Rift Valley fever threatens human and animal health. After a human case was confirmed in Comoros in 2007, 4 serosurveys among ruminants in Mayotte suggested that Rift Valley fever virus had been circulating at low levels since 2004, although no clinical cases occurred in animals. Entomologic and ecologic studies will help determine outbreak potential.

Pedarrieu, Aurelie; Guis, Helene; Defernez, Cedric; Bouloy, Michele; Favre, Jacques; Girard, Sebastien; Cardinale, Eric; Albina, Emmanuel



Prevalence of Rift Valley Fever among ruminants, Mayotte.  


Rift Valley fever threatens human and animal health. After a human case was confirmed in Comoros in 2007, 4 serosurveys among ruminants in Mayotte suggested that Rift Valley fever virus had been circulating at low levels since 2004, although no clinical cases occurred in animals. Entomologic and ecologic studies will help determine outbreak potential. PMID:22607651

Cêtre-Sossah, Catherine; Pédarrieu, Aurélie; Guis, Hélène; Defernez, Cédric; Bouloy, Michèle; Favre, Jacques; Girard, Sébastien; Cardinale, Eric; Albina, Emmanuel



Genome analysis of Rift Valley fever virus, Mayotte.  


As further confirmation of a first human case of Rift Valley fever in 2007 in Comoros, we isolated Rift Valley fever virus in suspected human cases. These viruses are genetically closely linked to the 2006-2007 isolates from Kenya. PMID:22608405

Cêtre-Sossah, Catherine; Zeller, Hervé; Grandadam, Marc; Caro, Valérie; Pettinelli, François; Bouloy, Michèle; Cardinale, Eric; Albina, Emmanuel



Q Fever Endocarditis in HIV-Infected Patient  

PubMed Central

We describe a case of Q fever endocarditis in an HIV-infected patient. The case was treated successfully with valvular replacement and a combination of doxycycline and hydroxychloroquine. We review the current literature on Q fever endocarditis, with an emphasis on the co-infection of HIV and Coxiella burnetii.

Pulvirenti, Joseph; Sekosan, Marin; Paddock, Christopher D.; Zaki, Sherif R.



Vaccines against typhoid fever  

Microsoft Academic Search

Because of high infectivity and significant disease burden, typhoid fever constitutes a major global health problem. Implementation of adequate food handling practices and establishment of safe water supplies are the cornerstone for the development of an effective prevention program. However, vaccination against typhoid fever remains an essential tool for the effective management of this disease. Currently, there are two well

Carlos A. Guzman; Stefan Borsutzky; Monika Griot-Wenk; Ian C. Metcalfe; Jon Pearman; Andre Collioud; Didier Favre; Guido Dietrich



Fevers and the rheumatologist.  


Fevers in children are mainly due to infection, malignancy or inflammatory conditions. Rheumatologists have an important role in the care of inflammatory conditions, many of which are associated with fevers. Seven conditions, the hereditary recurrent fever syndromes, have been defined with the presenting symptom of recurring fever, and for which mutation of a single gene has been defined: Chronic infantile neurological articular syndrome (CINCA), Familial cold autoinflammatory syndrome (FACS), Familial Mediterranean fever (FMF), hyperimmunoglobulinemia D (HIDS), Muckle-Wells syndrome (MWS), Pyogenic sterile arthritis and Pyoderma gangrenosum (PAPA) and Tumour necrosis factor receptor-associated periodic syndrome (TRAPS) . These conditions will be discussed in detail in regard to how they fit into the wider picture of pediatric rheumatological conditions, how the diagnoses may be established and the current recommended treatments for each condition. PMID:20953850

Manners, Prudence Joan; Guttinger, Robin



Tick-borne relapsing fever in children.  


Three cases of tick-borne fever diagnosed during the summer of 1979 are reported and the ecoepidemiology, clinical manifestations, and treatment of this infection are reviewed. Although challenging, the diagnosis can be made easily if specific historical clues are sought and the patient's blood smear is carefully examined. The diagnosis of this condition early in its course can save clinicians and patients the anxiety and cost of the work-up of a "fever of unknown origin." Since vacationing in the national parks and forests has become increasingly popular among many American families, tick-borne relapsing fever should be considered in any patient with an acute or recurrent fever of unknown origin who exhibits nonspecific symptoms of an undifferentiated "viral illness," and who gives a history of sleeping overnight in log cabins in the coniferous forests of the Western mountains of the United States. PMID:7454488

Le, C T



An unusual etiology of fever of unknown origin: Foley catheter.  


Fever may appear due to known causes such as infections, but may sometimes occur as a result of unknown pathologies. These pathologies can be included in a miscellaneous group of fever of unknown origin. We report one case of bladder stone including a foreign body in a 40-year-old man with a stroke admitted for high fever, blocked miction and bladder symptoms. PMID:19669975

Aslan, Sahin; Katirci, Yavuz; Yapano?lu, Turgut; Kandi?, Hayati; Uzkeser, Mustafa




Microsoft Academic Search

The usefulness of single Widal test in the di- agnosis of typhoid fever was investigated. The test was done on 50 normal children, 50 children with non typhoidal fevers and 30 culture proved typhoid cases. Twenty one (70%) and nine (30%) of thirty typhoid fever cases had 'O' and 'H' agglutinin liter levels of more than or equal to 1:160,

M. L. Kulkarni; S. J. Rego



Septic arthritis and concern for osteomyelitis in a child with rat bite fever.  


Rat bite fever is a rare infection usually caused by Streptobacillus moniliformis. A case of septic arthritis and possible osteomyelitis as sequelae of rat bite fever in a pediatric patient is described. PMID:23554193

Flannery, Dustin D; Akinboyo, Ibukunoluwa; Ty, Jennifer M; Averill, Lauren W; Freedman, Abigail



Mixed Epizootic of Tularemia and Omsk Hemorrhagic Fever in Muskrats in Western Siberia.  

National Technical Information Service (NTIS)

CONCLUSIONS: (1) The possibility of mixed epizootics of tularemia and Omsk hemorrhagic fever in the muskrat population was exposed. (2) Cases of simultaneous infection of muskrats with tularemia and Omsk hemorrhagic fever are possible. (3) Epizootics of b...

L. S. Egorova P. V. Korsh O. V. Ravdonikas T. N. Fedorova



Scarlet Fever Epidemic, Hong Kong, 2011  

PubMed Central

More than 900 cases of scarlet fever were recorded in Hong Kong during January–July, 2011. Six cases were complicated by toxic shock syndrome, of which 2 were fatal. Pulsed-field gel electrophoresis patterns suggested a multiclonal epidemic; emm12 was the predominant circulating type. We recommend genetic testing of and antimicrobial resistance monitoring for this reportable disease.

Lo, Janice Y.C.; Li, Amy Z.L.; Lau, Michael C.K.; Cheung, Terence K.M.; Wong, Alice Y.M.; Wong, Monica M.H.; Wong, Christine W.; Chuang, Shuk-kwan; Tsang, Thomas



Scarlet fever epidemic, Hong Kong, 2011.  


More than 900 cases of scarlet fever were recorded in Hong Kong during January-July, 2011. Six cases were complicated by toxic shock syndrome, of which 2 were fatal. Pulsed-field gel electrophoresis patterns suggested a multiclonal epidemic; emm12 was the predominant circulating type. We recommend genetic testing of and antimicrobial resistance monitoring for this reportable disease. PMID:23018120

Luk, Emma Y Y; Lo, Janice Y C; Li, Amy Z L; Lau, Michael C K; Cheung, Terence K M; Wong, Alice Y M; Wong, Monica M H; Wong, Christine W; Chuang, Shuk-kwan; Tsang, Thomas



Rift Valley fever, Mayotte, 2007-2008.  


After the 2006-2007 epidemic wave of Rift Valley fever (RVF) in East Africa and its circulation in the Comoros, laboratory case-finding of RVF was conducted in Mayotte from September 2007 through May 2008. Ten recent human RVF cases were detected, which confirms the indigenous transmission of RFV virus in Mayotte. PMID:19331733

Sissoko, Daouda; Giry, Claude; Gabrie, Philippe; Tarantola, Arnaud; Pettinelli, François; Collet, Louis; D'Ortenzio, Eric; Renault, Philippe; Pierre, Vincent



Latin American hemorrhagic fever.  


Several viral and bacterial agents are responsible for hemorrhagic fever in Latin America, but there are three agents that are only present in this region: (1) the Junin virus, (2) the Machupo virus, and (3) the Guanaritovirus, members of the Tacaribe complex of the family Arenaviridae and responsible for the Argentinian, Bolivian, and Venezuelan hemorrhagic fever. The clinical manifestations of hemorrhagic fever are similar for the three viruses, mainly myalgia, arthralgia, headache, relative bradycardia, conjunctivitis, nausea, vomiting, diarrhea, and hemorrhagic disorders. In this article, the three viruses, their causes, and manifestations are discussed. PMID:8021448

Vainrub, B; Salas, R



Lime-yellow color as related to reduction of serious fire apparatus accidents--the case for visibility in emergency vehicle accident avoidance.  


Fire departments have long used red as the traditional color for fire apparatus and have been reluctant to change. Optometric research and literature offers ample proof that red is a poorly detected color. This paper views the shortcomings of red. Simultaneously, it reports that the ancillary equipment and markings used to make fire vehicles detectable are not as effective as previously thought. These safety measures include flashing lights, strobe lights, retroreflective material, and audible alarms. Lime-yellow has been found to be a distinctive, highly visible safety color. Research reveals it can reduce or prevent serious fire apparatus accidents through early detection. PMID:2081824

Solomon, S S



African Swine Fever.  

National Technical Information Service (NTIS)

Contents: Historical information; Etiology; Stability of the virus; Epizootology; Mutual relationship between the agent of African swine fever and agents of similar diseases which occur in other countries; Clinical picture; Pathological anatomical changes...

N. V. Likhachev



Lassa Fever Immune Plasma.  

National Technical Information Service (NTIS)

Lassa fever immune plasma is being obtained in Liberia, West Africa for the U.S. Army Medical Institute of Infectious Diseases by Columbia University associated with the Liberian Institute for Biomedical Research (LIBR). Additionally, epidemiological inve...

J. D. Frame



Simian hemorrhagic fever virus  

Technology Transfer Automated Retrieval System (TEKTRAN)

This book chapter describes the taxonomic classification of Simian hemorrhagic fever virus (SHFV). Included are: host, genome, classification, morphology, physicochemical and physical properties, nucleic acid, proteins, lipids, carbohydrates, geographic range, phylogenetic properties, biological pro...


Rocky Mountain Spotted Fever  

Microsoft Academic Search

\\u000a Rocky Mountain spotted fever is an acute febrile illness transmitted to man by ticks infected with Rickettsia rickettsii. Usually sudden in onset, it is characterized by chills, headache, and fever lasting 2 or more weeks. A characteristic rash\\u000a appears on the extremities on about the 4th febrile day and spreads to the trunk. The exanthem and other anatomical manifestations\\u000a result

Aaron Milstone; J. Stephen Dumler


A Prospective Nested Case-Control Study of Dengue in Infants: Rethinking and Refining the Antibody-Dependent Enhancement Dengue Hemorrhagic Fever Model  

Microsoft Academic Search

BACKGROUND: Dengue hemorrhagic fever (DHF) is the severe and life-threatening syndrome that can develop after infection with any one of the four dengue virus (DENV) serotypes. DHF occurs almost exclusively in individuals with secondary heterologous DENV infections and infants with primary DENV infections born to dengue immune mothers. The widely accepted explanation for the pathogenesis of DHF in these settings,

Daniel H. Libraty; Luz P. Acosta; Veronica Tallo; Edelwisa Segubre-Mercado; Analisa Bautista; James A. Potts; Richard G. Jarman; In-Kyu Yoon; Robert V. Gibbons; Job D. Brion; Rosario Z. Capeding



Emergence of Q fever  

PubMed Central

Q fever is a worldwide zoonosis with many acute and chronic manifestations caused by the pathogen Coxiella burnetii. Farm animals and pets are the main reservoirs of infection, and transmission to human beings is mainly accomplished through inhalation of contaminated aerosols. Persons at greatest risk are those in contact with farm animals and include farmers, abattoir workers, and veterinarians. The organs most commonly affected during Q fever are the heart, the arteries, the bones and the liver. The most common clinical presentation is an influenza-like illness with varying degrees of pneumonia and hepatitis. Although acute disease is usually self-limiting, people do occasionally die from this condition. Endocarditis is the most serious and most frequent clinical presentation of chronic Q fever. Vascular infection is the second most frequent presentation of Q fever. The diagnosis of Q fever is based on a significant increase in serum antibody titers. The treatment is effective and well tolerated, but must be adapted to the acute or chronic pattern with the tetracyclines to be considered the mainstay of antibiotic therapy. For the treatment of Q fever during pregnancy the use of long-term cotrimoxazole therapy is proposed.

Angelakis, E; Raoult, D



An Insular Outbreak of Dengue Hemorrhagic Fever. I. Epidemiologic Observations.  

National Technical Information Service (NTIS)

Between 10 July and 23 October 1966 an epidemic of dengue hemorrhagic fever occurred on an island in the Gulf of Thailand. Fourteen cases of dengue-shock syndrome (with one death) and 20 of hemorrhagic-fever syndrome due to dengue occurred. An additional ...

P. E. Winter T. M. Yuill S. Udomaskdi D. Gould S. Nantapanich



Behaviors Associated With Fever in Children With Autism Spectrum Disorders  

Microsoft Academic Search

OBJECTIVE. 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. METHODS. We

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



Causes of fever and value of C-reactive protein and procalcitonin in differentiating infections from paraneoplastic fever  

Microsoft Academic Search

Objective The aims of our retrospective study were to study first the causes of 245 febrile episodes in cancer patients and then the value of procalcitonin (PCT) and C-reactive protein (CRP) in differentiating infections from paraneoplastic fever. Method The causes of fever were studied in 245 consecutive cases observed between January and December 2002, and PCT and CRP diagnostic value

Nicolas Penel; Charles Fournier; Stéphanie Clisant; Michèle N’Guyen



A study in yellow: mona caird's “ The yellow drawing room”  

Microsoft Academic Search

This article aims to further our understanding of Mona Caird, an important feminist writer in the late nineteenth century, whose work merits further consideration. Caird's short story “The Yellow Drawing-Room” is of interest because it highlights the significance of the colour yellow in the 1890s, and also introduces some of the key themes that preoccupied women writers at that time.

Stephanie Forward



Modeling valley fever (coccidioidomycosis) incidence on the basis of climate conditions  

Microsoft Academic Search

Valley fever (coccidioidomycosis) is a disease endemic to arid regions within the Western Hemisphere, and is caused by a soil-dwelling fungus, Coccidioides immitis. Incidence data for Pima County, reported to the Arizona Department of Health Services as new cases of valley fever, were used to conduct exploratory analyses and develop monthly multivariate models of relationships between valley fever incidence and

Korine N. Kolivras; Andrew C. Comrie



Clinical and Pathologic Changes in a Guinea Pig Aerosol Challenge Model of Acute Q Fever  

Microsoft Academic Search

Acute Q fever is a zoonotic disease caused by the obligate intracellular bacterium Coxiella burnetii and can manifest as a flu-like illness, pneumonia, or hepatitis. A need exists in Q fever research for animal models mimicking both the typical route of infection (inhalation) and the clinical illness seen in human cases of Q fever. A guinea pig aerosol challenge model

K. E. Russell-Lodrigue; G. Q. Zhang; D. N. McMurray; J. E. Samuel



The economic impact of dengue hemorrhagic fever on family level in Southern Vietnam  

Microsoft Academic Search

Dengue fever is a viral infection transmitted by mosquitoes (Aedes Aegypti). WHO estimates that 40% of the world's population live in areas endemic for dengue fever, and that there are approximately 50 million cases of dengue in- fection worldwide every year. This study aims to measure the economic consequences of dengue hemor- rhagic fever in Southern Vietnam on family level.

Mette Lønstrup Harving; Ho Chi


Murine typhus and spotted fever in israel in the eighties: Retrospective analysis  

Microsoft Academic Search

Summary One hundred and twenty-one cases of murine typhus and spotted fever in Israel between 1976 and 1985 in the Chaim Sheba Medical Center are reviewed. Clinical manifestations of murine typhus were similar to those described previously, but those of spotted fever were different from classical Mediterranean spotted fever: rash was present in 87% but eschar was noted in only

Y. Shaked; Y. Samra; M. K. Maeir; E. Rubinstein



Epidemiologic and clinical features of sporadic Salmonella enteric fever.  

PubMed Central

Twenty-seven cases of enteric fever were diagnosed between January 1961 and February 1977 at a medium-sized urban hospital. Nineteen of the patients had recently travelled abroad. Fever was the only constant finding, and four patients noted fever and headache as their only symptoms. Splenomegaly was present in 30% and rose spots in just 11%. Enteric fever was initially suspected in only 63% of cases, and a mean of 4.8 days elapsed after admission before specific therapy was instituted. Salmonella was cultured from blood samples in 19 of 24 patients and from stool specimens in 21 of 27, but was never isolated from the urine. Serum O agglutinins, while eventually present in 54% of the patients tested, did not help in establishing an early diagnosis. No deaths occurred, though two patients sustained relapses. Sporadic enteric fever is unlikely to be suspected unless associated with recent foreign travel, but is easily diagnosed by usual culture methods.

Briedis, D. J.; Robson, H. G.



Classical swine fever (CSF) marker vaccine  

Microsoft Academic Search

Two commercial marker vaccines against classical swine fever virus (CSFV) and companion diagnostic tests were examined in 160 conventional pigs. To test the vaccines in a “worst case scenario”, group of 10 weaners were vaccinated using a single dose of an E2 (gp55) based vaccine at days ?21, ?14, ?10 or ?7, and subsequently challenged at day 0. The challenge

Åse Uttenthal; Marie-Frédérique Le Potier; Luis Romero; Gian Mario De Mia; Gundula Floegel-Niesmann



A Prospective Nested Case-Control Study of Dengue in Infants: Rethinking and Refining the Antibody-Dependent Enhancement Dengue Hemorrhagic Fever Model  

PubMed Central

Background Dengue hemorrhagic fever (DHF) is the severe and life-threatening syndrome that can develop after infection with any one of the four dengue virus (DENV) serotypes. DHF occurs almost exclusively in individuals with secondary heterologous DENV infections and infants with primary DENV infections born to dengue immune mothers. The widely accepted explanation for the pathogenesis of DHF in these settings, particularly during infancy, is antibody-dependent enhancement (ADE) of DENV infection. Methods and Findings We conducted a prospective nested case-control study of DENV infections during infancy. Clinical data and blood samples were collected from 4,441 mothers and infants in up to two pre-illness study visits, and surveillance was performed for symptomatic and inapparent DENV infections. Pre-illness plasma samples were used to measure the associations between maternally derived anti-DENV3 antibody-neutralizing and -enhancing capacities at the time of DENV3 infection and development of infant DHF. The study captured 60 infants with DENV infections across a wide spectrum of disease severity. DENV3 was the predominant serotype among the infants with symptomatic (35/40) and inapparent (15/20) DENV infections, and 59/60 infants had a primary DENV infection. The estimated in vitro anti-DENV3 neutralizing capacity at birth positively correlated with the age of symptomatic primary DENV3 illness in infants. At the time of symptomatic DENV3 infection, essentially all infants had low anti-DENV3 neutralizing activity (50% plaque reduction neutralizing titers [PRNT50] ?50) and measurable DENV3 ADE activity. The infants who developed DHF did not have significantly higher frequencies or levels of DENV3 ADE activity compared to symptomatic infants without DHF. A higher weight-for-age in the first 3 mo of life and at illness presentation was associated with a greater risk for DHF from a primary DENV infection during infancy. Conclusions This prospective nested case-control study of primarily DENV3 infections during infancy has shown that infants exhibit a full range of disease severity after primary DENV infections. The results support an initial in vivo protective role for maternally derived antibody, and suggest that a DENV3 PRNT50 >50 is associated with protection from symptomatic DENV3 illness. We did not find a significant association between DENV3 ADE activity at illness onset and the development of DHF compared with less severe symptomatic illness. The results of this study should encourage rethinking or refinement of the current ADE pathogenesis model for infant DHF and stimulate new directions of research into mechanisms responsible for the development of DHF during infancy. Trial registration NCT00377754 Please see later in the article for the Editors' Summary

Libraty, Daniel H.; Acosta, Luz P.; Tallo, Veronica; Segubre-Mercado, Edelwisa; Bautista, Analisa; Potts, James A.; Jarman, Richard G.; Yoon, In-Kyu; Gibbons, Robert V.; Brion, Job D.; Capeding, Rosario Z.



[Management of prolonged fever in infants].  


Prolonged fever is defined as an unexplained fever of more than 5 days duration. In infancy and early childhood, it is most often of infectious origin, viral infections being the most frequent. Mycoplasma pneumoniae infections, urinary tract infection and otitis media are also commonly involved. Kawasaki disease is the main inflammatory etiology, juvenile rhumatoïd arthritis in its systemic form (Still's disease) being much rarer. In most cases the etiological diagnosis can be made with a limited number of laboratory and/or imaging investigations based upon a careful clinical evaluation and an oriented chronological strategy. PMID:10191905

Bourrillon, A




Technology Transfer Automated Retrieval System (TEKTRAN)

Iris yellow spot, caused by Iris yellow spot tospovirus, is an emerging disease of onion in the U.S. and world. Yield losses vary, but may range from undetectable to nearly 100% in onion seed crops. This article presents recent advances in understanding the etiology, epidemiology, and management o...


Fever in honeybee colonies  

NASA Astrophysics Data System (ADS)

Honeybees, Apis spp., maintain elevated temperatures inside their nests to accelerate brood development and to facilitate defense against predators. We present an additional defensive function of elevating nest temperature: honeybees generate a brood-comb fever in response to colonial infection by the heat-sensitive pathogen Ascosphaera apis. This response occurs before larvae are killed, suggesting that either honeybee workers detect the infection before symptoms are visible, or that larvae communicate the ingestion of the pathogen. This response is a striking example of convergent evolution between this "superorganism" and other fever-producing animals.

Starks, P. T.; Blackie, Caroline A.; Seeley, Thomas D.


The Pathogenesis of Rift Valley Fever  

PubMed Central

Rift Valley fever (RVF) is an emerging zoonotic disease distributed in sub-Saharan African countries and the Arabian Peninsula. The disease is caused by the Rift Valley fever virus (RVFV) of the family Bunyaviridae and the genus Phlebovirus. The virus is transmitted by mosquitoes, and virus replication in domestic ruminant results in high rates of mortality and abortion. RVFV infection in humans usually causes a self-limiting, acute and febrile illness; however, a small number of cases progress to neurological disorders, partial or complete blindness, hemorrhagic fever, or thrombosis. This review describes the pathology of RVF in human patients and several animal models, and summarizes the role of viral virulence factors and host factors that affect RVFV pathogenesis.

Ikegami, Tetsuro; Makino, Shinji



Symptoms of Coccidioidomycosis (Valley Fever)  


... Favorites Delicious Digg Google Bookmarks Symptoms of Coccidioidomycosis (Valley Fever) Skin lesions due to Coccidioides immitis . Most people ... TTY: (888) 232-6348 Contact CDC–INFO Coccidioidomycosis (Valley Fever) Definition Symptoms People at Risk & Prevention Sources of ...


Parameter tolerance to forcing data, case study of Coupled Routing and Excess STorage (CREST) hydrological model in Head region of Yellow River of China  

NASA Astrophysics Data System (ADS)

Most of the hydrological models need be calibrated based on the gauged runoff at the catchment outlet. Calibration is a process that optimizing parameters to get the best reproduction of nature runoff for certain forcing data. This means different forcing data could result in similar simulation after calibration, it is called parameter tolerance to forcing data in this paper. This study chooses head region of Yellow River of China as an example, uses the CREST (Coupled Routing and Excess STorage distributed model) for hydrological simulation and ARS (Adaptive Random Search algorithm) for deriving parameters automatically, evaluates the response of forcing data fluctuation after calibration; compares three different forcing data sets: station gauge, TRMM-based Multi-satellite Precipitation Analysis (TMPA) calibration rainfall data (3B42V6) and Real-Time rainfall data (3B42RT), and their simulations after calibrated separately. Results indicate that most of the forcing data fluctuation can be eliminated by parameter optimization until model collapse for extreme input. Considering parameter tolerance to forcing data, TRMMV6 is better than station gauge for its strong point in spatial description, and difference between TRMMV6 and TRMMRT in driving CREST is tiny. These results could vary in other basins or models, further comparison between basins and models is recommended. Keywords: Hydrological modeling; Parameter; forcing data; CREST; Automated calibration

Li, Li; Wang, Jiahu; Hao, Zhenchun



Human Spotted Fever Rickettsial Infections  

PubMed Central

Serum specimens from patients at 4 sites in Peru were tested for evidence of spotted fever group rickettsial infection. Results showed that 30 (18%) of 170 patients had spotted fever group rickettsial infections, which likely caused their illnesses. These findings document laboratory-confirmed spotted fever from diverse areas of Peru.

Schoeler, George B.; Moron, Cecilia; Richards, Allen; Blair, Patrick J.



Ebola fever: The African emergency  

Microsoft Academic Search

The Ebola virus produces one of Africa's most lethal viral hemorrhagic fever (VHF) infections. Statistically, Ebola fever is at the bottom of Africa's list of infectious diseases, but the speed with which it induces agonizing death puts Ebola fever at the top of Africa's emergencies. Many aspects of the virus are unknown and have eluded medical scientists for 3 decades.

J. Bruce; P. Brysiewicz



Q Fever Update, Maritime Canada  

PubMed Central

Since the 1990s, reports of Q fever in Nova Scotia, Canada, have declined. Passive surveillance for Q fever in Nova Scotia and its neighboring provinces in eastern Canada indicates that the clinical manifestation of Q fever in the Maritime provinces is pneumonia and that incidence of the disease may fluctuate.

Marrie, Thomas J.; Campbell, Nancy; McNeil, Shelly A.; Webster, Duncan



Rheumatic fever in Minnesota. II. Evaluation of hospitalized patients and utilization of a State Rheumatic Fever Registry.  

PubMed Central

We studied the hospital records of 124 patients with a discharge diagnosis of acute rheumatic fever who were hospitalized in 21 Minneapolis-St. Paul hospitals during 1975 and 1976. After careful review of the hospital records, we found that 83 (67 per cent) of these patients did not have an acute illness. Seventeen (41 per cent) of the 41 cases with an acute illness were thought to adequately fulfill the Jones' Criteria for acute rheumatic fever. Upon review of the rheumatic fever registry of the Minnesota State Health Department, we found that less than one-half of the hospitalized patients had been reported to the registry. Cases that fulfilled and did not fulfill the Jones' Criteria were reported with equal frequency, indicating significant underreporting and overreporting of rheumatic fever. Evaluation of secondary rheumatic fever prophylaxis, both in those patients with acute rheumatic fever as well as in those with rheumatic heart disease, indicated that many patients who, in theory, should be receiving prophylaxis were not receiving it. These studies indicate a need for more thorough evaluation of the current epidemiology of rheumatic fever and the role of a rheumatic fever registry, and imply a need for reevaluation of these programs. (Am J Public Health 69:767-771, 1979).

Rice, M J; Kaplan, E L



Dengue fever and dengue haemorrhagic fever in adolescents and adults  

PubMed Central

Dengue fever (DF) is endemic in tropical and subtropical zones and the prevalence is increasing across South-east Asia, Africa, the Western Pacific and the Americas. In recent years, the spread of unplanned urbanisation, with associated substandard housing, overcrowding and deterioration in water, sewage and waste management systems, has created ideal conditions for increased transmission of the dengue virus in tropical urban centres. While dengue infection has traditionally been considered a paediatric disease, the age distribution of dengue has been rising and more cases have been observed in adolescents and adults. Furthermore, the development of tourism in the tropics has led to an increase in the number of tourists who become infected, most of whom are adults. Symptoms and risk factors for dengue haemorrhagic fever (DHF) and severe dengue differ between children and adults, with co-morbidities and incidence in more elderly patients associated with greater risk of mortality. Treatment options for DF and DHF in adults, as for children, centre round fluid replacement (either orally or intravenously, depending on severity) and antipyretics. Further data are needed on the optimal treatment of adult patients.

Tantawichien, Terapong



African Swine Fever.  

National Technical Information Service (NTIS)

African swine fever (ASF) has become one of the major threats to pig farming, particularly since its spread to the Caribbean and South America and to most countries of the Western hemisphere. Epidemiological aspects of the situation were presented for Sar...

P. J. Wilkinson



Korean Hemorrhagic Fever.  

National Technical Information Service (NTIS)

The causative agent of Korean hemorrhagic fever was first isolated in 1976 from the rodent Apodemus agrarius coreae and it is registered as Hantaan virus. This report presents the results on (1) the first visualization of Hantaan virus by EM and (2) intra...

H. W. Lee



Korean Hemorrhagic Fever.  

National Technical Information Service (NTIS)

This report presents the results on (1) isolation of Korean hemorrhagic fever (KHF) virus from patients (2) antibody responses in animals (3) the ratio of clinical and subclinical infection (4) cultivation of the virus in a tissue culture cells and (5) ve...

H. W. Lee



"Trap" the diagnosis: a man with recurrent episodes of febrile peritonitis, not just familial Mediterranean fever.  


Monogenic periodic fever syndromes are characterized by recurrent episodes of fever, accompanied by localized inflammatory manifestations. Among them, familial Mediterranean fever (FMF) is the most studied and is by far the most prevalent periodic fever syndrome in Israel. We present a diagnostic workup of a patient suffering from a periodic fever syndrome, initially thought to be FMF and characterized by attacks of fever, severe abdominal pain, a migratory erythematous rash and conjunctivitis. The development of periorbital edema presenting as diplopia led to consideration of tumor necrosis factor receptor-1-associated periodic syndrome (TRAPS). Genetic tests confirmed the diagnosis. This case should alert us that even in Israel, a patient with periodic fever not fully consistent with the typical features of FMF, should be evaluated for other periodic fever syndromes. PMID:22675839

Arad, Uri; Niv, Eva; Caspi, Dan; Elkayam, Ori



[Scarlet fever in Poland in 2008].  


The 2008 was another year when the scarlet fever incidence in Poland increased. In total there were 11,179 cases registered and the incidence was 29,3 per 100,000 population ranging from 11.5 in podkarpackie voievodeship to 53.0 in opolskie voievodeship. Cases among children and adolescents of less then 15 years of age accounted for 93.1% of all cases. The incidence peaked among 5 years old children (435.9). Incidence in men (33.9) markedly exceeded the incidence in women (25.1) and incidence in urban areas (32.5) that in rural areas (24.4). Approximately 1.7% of all cases were hospitalized and there were no deaths due to scarlet fever in Poland in 2008. PMID:20731219

Czarkowski, Miros?aw P; Kondej, Barbara



[Scarlet fever in Poland in 2007].  


The 2007 was another year when the scarlet fever incidence in Poland increased. In total there were 10,740 cases registered and the incidence was 28.2 per 100,000 population ranging from 11.4 in zachodniopomorskie voivodeship to 54.1 in lubelskie voivodeship. Cases among children and adolescents of less then 15 years of age accounted for 92.1% of all cases. The incidence peaked among 5 years old children (433.4). Incidence in men (32.7) markedly exceeded the incidence in women (24.0) and incidence in urban areas (31.3) that in rural areas (23.2). Approximately 1.6% of all cases were hospitalized and there were no deaths due to scarlet fever in Poland in 2007. PMID:19799244

Czarkowski, Miros?aw P; Kondej, Barbara



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

PubMed Central

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

Deepak, Desh; Garg, Rakesh; Pawar, Mridula; Banerjee, Neerja; Solanki, Rakesh; Maurya, Indubala



Relapsing fever--a forgotten disease revealed.  


Borrelial relapsing fever was once a major worldwide epidemic disease that made a significant impact on Livingstone during his epic travels through Africa and throughout Europe. Indeed, the term 'relapsing fever' was first used to describe clinical cases of this disease in Edinburgh. During the last century, we have witnessed the demise of the louse-borne infection, largely through improving standards of living resulting in a reduction in body lice, the vector for Borrelia recurrentis [louse-borne relapsing fever (LBRF)]. The tick-borne zoonotic form of the disease persists in endemic foci around the world [tick-borne relapsing fever (TBRF)]. Indeed, TBRF is reportedly the most common bacterial infection from Senegal and listed within the top ten causes of mortality in children under five in Tanzania. In Ethiopia, LBRF is again within the top ten causes of hospital admission, associated with significant morbidity and mortality. Despite these figures, many now regard relapsing fever as an unusual tropical disease. Certainly, recent cases have been imported following travel from endemic zones. More surprisingly, cases have been reported following family reunions in Colorado, USA. A further case was reported from the Mt Wilson observatory in Los Angeles, USA. In many regions, the infection is zoonotic with natural reservoirs in several vertebrate species. In West Africa, infection is again primarily zoonotic. Whether those species found predominantly in East Africa are zoonoses or are infections of humans alone is still debated, however, the life cycle may be determined by the feeding preferences of their arthropod vectors. PMID:19886891

Cutler, S J



Vaccine Platforms to Control Arenaviral Hemorrhagic Fevers.  


Arenaviruses are rodent-borne emerging human pathogens. Diseases caused by these viruses, e.g., Lassa fever (LF) in West Africa and South American hemorrhagic fevers (HFs), are serious public health problems in endemic areas. We have employed replication-competent and replication-deficient strategies to design vaccine candidates potentially targeting different groups "at risk". Our leader LF vaccine candidate, the live reassortant vaccine ML29, is safe and efficacious in all tested animal models including non-human primates. In this study we showed that treatment of fatally infected animals with ML29 two days after Lassa virus (LASV) challenge protected 80% of the treated animals. In endemic areas, where most of the target population is poor and many live far from health care facilities, a single-dose vaccination with ML29 would be ideal solution. Once there is an outbreak, a fast-acting vaccine or post-exposure prophylaxis would be best. The 2(nd) vaccine technology is based on Yellow Fever (YF) 17D vaccine. We designed YF17D-based recombinant viruses expressing LASV glycoproteins (GP) and showed protective efficacy of these recombinants. In the current study we developed a novel technology to clone LASV nucleocapsid within YF17D C gene. Low immunogenicity and stability of foreign inserts must be addressed to design successful LASV/YFV bivalent vaccines to control LF and YF in overlapping endemic areas of West Africa. The 3(rd) platform is based on the new generation of alphavirus replicon virus-like-particle vectors (VLPV). Using this technology we designed VLPV expressing LASV GP with enhanced immunogenicity and bivalent VLPV expressing cross-reactive GP of Junin virus (JUNV) and Machupo virus (MACV), causative agents of Argentinian and Bolivian HF, respectively. A prime-boost regimen required for VLPV immunization might be practical for medical providers, military, lab personnel, and visitors in endemic areas. PMID:23420494

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



Influence of chloroplastic photo-oxidative stress on mitochondrial alternative oxidase capacity and respiratory properties: a case study with Arabidopsis yellow variegated 2.  


Mitochondrial alternative oxidase (AOX), the unique respiratory terminal oxidase in plants, catalyzes the energy-wasteful cyanide (CN)-resistant respiration. Although it has been demonstrated that leaf AOX is up-regulated under high-light (HL) conditions, the in vivo mechanism of AOX up-regulation by light is still unknown. In the present study, we examined whether the photo-oxidative stress in the chloroplast modulates mitochondrial respiratory properties, especially the AOX capacity, using Arabidopsis leaf-variegated mutant yellow variegated 2 (var2) and exposing plants to HL. var2 mutants lack FtsH2 metalloprotease required for the repair of damaged PSII. Indeed, var2-1 suffered from photo-oxidative stress even before the HL treatments. While the activities of tricarboxylic acid cycle enzymes and cytochrome c oxidase in var2-1 were almost identical to those in the wild type, the amount of AOX protein and the CN-resistant respiration rate were higher in var2-1. Real-time PCR analysis revealed that HL treatment induced the expression of some energy-dissipating respiratory genes, including AOX1a, NDB2 and UCP5, more strongly in var2-1. Western blotting using var2-1 leaf extracts specific to green or white sectors, containing functional or non-functional photosynthetic apparatus, respectively, revealed that more AOX protein was induced in the green sectors by the HL treatment. These results indicate that photo-oxidative stress by excess light is involved in the regulation of respiratory gene expression and the modulation of respiratory properties, especially the AOX up-regulation. PMID:18296449

Yoshida, Keisuke; Watanabe, Chihiro; Kato, Yusuke; Sakamoto, Wataru; Noguchi, Ko



Fever of unknown origin: an evidence-based review.  


Fever is a common problem for which patients seek medical advice. Fortunately, in most cases, fever is self-limiting or the etiology of fever is promptly established. Sustained, unexplained fever despite a comprehensive work up is recognized as fever of unknown origin (FUO), which frequently poses a clinical challenge. For a methodical approach, FUO is recently categorized into classic FUO, nosocomial FUO, neutropenic FUO and HIV-associated FUO based on the clinical setting and patient's underlying immune status. This review focuses on the key factors of classic FUO. The etiologic clues obtainable from the history, bedside physical examination findings and pertinent laboratory tests are discussed. Also, FUO in older patients and tuberculosis as a cause of FUO are briefly discussed. PMID:22475734

Hayakawa, Kayoko; Ramasamy, Balaji; Chandrasekar, Pranatharthi H



Diagnosis of enteric fever in the emergency department: a retrospective study from Pakistan  

PubMed Central

Background Enteric fever is one of the top differential diagnoses of fever in many parts of the world. Generally, the diagnosis is suspected and treatment is initiated based on clinical and basic laboratory parameters. Aims The present study identifies the clinical and laboratory parameters predicting enteric fever in patients visiting the emergency department of a tertiary care hospital in Pakistan. Methods This is a retrospective chart review of all adult patients with clinically suspected enteric fever admitted to the hospital through the emergency department during a 5-year period (2000–2005). Results A total of 421 emergency department patients were admitted to the hospital with suspected enteric fever. There were 53 cases of blood culture-positive enteric fever and 296 disease-negative cases on culture. The mean age in the blood culture-positive group was 27 years (SD: 10) and in the group with negative blood culture for enteric fever, 35 years (SD: 15) with a male to female ratio of 1:0.6 in both groups. Less than half (48%) of all patients admitted with suspected enteric fever had the discharge diagnosis of enteric fever, of which only 13% of the patients had blood culture/serologically confirmed enteric fever. None of the common clinical and laboratory parameters differed between enteric fever-positive patients and those without it. Conclusion Commonly cited clinical and laboratory parameters were not able to predict enteric fever.

Rahim Khan, Uzma; Saleem, Ali Faisal; Ahmed, Adnan; Jalal, Sabeena




PubMed Central

Six human beings were inoculated with dengue and developed typical disease. Two of these were reinoculated and proved immune. The remaining four were later inoculated with Colorado tick fever. Three developed typical disease. The fourth, who remained well, has previously lived in an endemic area (Colorado). One patient was inoculated with Colorado tick fever first and later with dengue. He developed both diseases. Colorado tick fever and dengue do not give a cross-immunity. Hamsters can be infected with Colorado tick fever but not with dengue. Colorado tick fever and dengue appear to be distinct disease entities.

Florio, Lloyd; Hammon, William McD.; Laurent, Angela; Stewart, Mabel O.




PubMed Central

With a view to determining the mode of infection in Carrion's disease, a study of the blood-sucking insects found in the districts of Peru where the disease prevails has been carried out, through the cooperation of The Rockefeller Institute and the Rockefeller Foundation. The material studied included ticks, mites, midges, lice, fleas, bedbugs, mosquitoes, buffalo gnats, horse-flies, "sheep ticks," 3 species of Streblidae, and 3 species of Phlebotomus, including Phlebotomus verrucarum Townsend and two new species which have been named Phlebotomus noguchii and Phlebotomus peruensis. The insects were collected without the use of chemicals, were prepared for transportation in such a manner as to prevent drying, and were shipped under conditions of refrigeration to New York, where they were inoculated into monkeys. The plan followed was to inject saline suspensions of the crushed insects intradermally into rhesus monkeys and to make cultures of the blood of the animals at intervals of 1 to 6 weeks after inoculation. The only class of insects in which the presence of Bartonella bacilliformis could be detected were phlebotomi. No cutaneous lesions were induced in monkeys injected with the crushed insects, but in the case of four different lots of phlebotomi the blood of the animals so injected yielded cultures of Bartonella bacilliformis which produced typical verrucous lesions on inoculation into other monkeys. The morphology and cultural characteristics of the Bartonella strains obtained from phlebotomi proved identical with those of strains isolated from human blood and skin lesions. Monkeys which had recovered from infection with the phlebotomus strains resisted inoculation with a human strain of Bartonella bacilliformis, and, conversely, monkeys which had passed through an infection induced by the human strain resisted inoculation with the strains obtained from phlebotomi. The experimental observations described in this paper lead us to conclude that certain phlebotomi act as insect vectors of Oroya fever and verruga peruana. The phlebotomi which have been shown quite certainly to carry the Bartonella bacilliformis are those of the species Phlebotomus noguchii. Phlebotomus verrucarum is also probably a vector, while Phlebotomus peruensis remains doubtful in this respect.

Noguchi, Hideyo; Shannon, Raymond C.; Tilden, Evelyn B.; Tyler, Joseph R.



[Cutaneous polymorph manifestations of familial Mediterranean fever in a child].  


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. PMID:23453719

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



Familial Mediterranean fever.  


Familial Mediterranean fever (FMF) is the most frequent periodic syndrome characterized by recurrent attacks of polyserositis. Fever, abdominal pain, chest pain, and arthritis/arthralgia are the leading symptoms. It is an autosomal recessive disorder, which primarily affects Jewish, Armenian, Turkish, and Arab populations. The FMF gene ( MEFV) has recently been cloned to chromosome 16p, which encodes pyrin. Genotype-phenotype correlation is not well established. Amyloidosis is the most severe complication of FMF. The SAA1-alpha/alpha genotype was associated with an increased risk of amyloidosis. Colchicine treatment not only decreases the frequency and severity of attacks, but also prevents amyloidosis. Certain vasculitides, namely Henoch-Schonlein purpura and polyarteritis nodosa, are more frequent among FMF patients. PMID:12836090

Bakkaloglu, Aysin



Rift Valley fever  

Microsoft Academic Search

Summary Rift Valley fever (RVF) is an arthropod-borne viral disease of ruminants, camels and humans. It is also a significant zoonosis which may be encountered as an uncomplicated influenza-like illness, but may also present as a haemorrhagic disease with liver involvement; there may also be ocular or neurological lesions. In animals, RVF may be inapparent in non-pregnant adults, but outbreaks

G. H. Gerdes



Prevention of Typhoid Fever  

Microsoft Academic Search

Typhoid fever, the generalized infection of the reticuloendothelial system (spleen, liver, and bone marrow), gut-associated\\u000a lymphoid tissue, and gall bladder caused by the highly human host restricted pathogen Salmonella enterica serovar Typhi (S. Typhi), is the quintessential infectious disease associated with inadequate sanitation and lack of protected drinking water.\\u000a The pediatric (school-age) and young adult populations in endemic areas bear

Myron M. Levine; Philippe Lepage


A rare cause of ascites: Familial Mediterranean fever.  


Familial Mediterranean fever is an autosomal recessive disorder characterized by sporadic, paroxysmal attacks of fever and serosal inflammation. In Familial Mediterranean fever, peritoneal effusion during abdominal attacks is usually mild, is not detected by clinical evaluation, and disappears during clinical remission. Chronic ascites has rarely been described in patients with Familial Mediterranean fever. Genetic analysis is highly specific and sensitive for diagnosis of Familial Mediterranean fever. All of the four cases discussed in our study had no benign or malignant pathology that could explain the ascites. They had suffered from repetitive periods of fever and ascites since childhood. Genetic analysis of these four cases revealed that one was M694V/M694V homozygote, one was M694V/? heterozygote, and the other two were M694V/V726A compound heterozygote. Ascites regressed with colchicine therapy. Since Familial Mediterranean fever is common our country, it should be kept in mind in the differential diagnosis in patients with ascites of unknown etiology. PMID:18386244

Bekta?, Mehmet; Soykan, Irfan; Gören, Deniz; Altan, Mehmet; Korkut, Esin; Cetinkaya, Hülya; Ozden, Ali



Rat bite fever: a misnomer?  

PubMed Central

We report a case of rat bite fever (Streptobacillus moniliformis) in a young man who presented generally unwell with pyrexia, vomiting, arthralgia and deranged liver function. Two weeks before his illness he had disposed of a dead rat but was not bitten by it. This zoonotic infection was treated with broad spectrum antibiotics and he made a complete recovery. It is a rarely diagnosed but likely common infection given the frequent contact between humans and rodents. In the past, confirmation of the organism has been difficult due its dislike of culture mediums, but the advent of polymerase chain reaction (PCR) testing has allowed reliable isolation. Appropriate treatment is important because there is an associated mortality from secondary endocarditis.

Glasman, Peter James; Thuraisingam, Adrian



Microbiological challenges in the diagnosis of chronic Q fever.  


Diagnosis of chronic Q fever is difficult. PCR and culture lack sensitivity; hence, diagnosis relies mainly on serologic tests using an immunofluorescence assay (IFA). Optimal phase I IgG cutoff titers are debated but are estimated to be between 1:800 and 1:1,600. In patients with proven, probable, or possible chronic Q fever, we studied phase I IgG antibody titers at the time of positive blood PCR, at diagnosis, and at peak levels during chronic Q fever. We evaluated 200 patients, of whom 93 (46.5%) had proven, 51 (25.5%) had probable, and 56 (28.0%) had possible chronic Q fever. Sixty-five percent of proven cases had positive Coxiella burnetii PCR results for blood, which was associated with high phase I IgG. Median phase I IgG titers at diagnosis and peak titers in patients with proven chronic Q fever were significantly higher than those for patients with probable and possible chronic Q fever. The positive predictive values for proven chronic Q fever, compared to possible chronic Q fever, at titers 1:1,024, 1:2,048, 1:4,096, and ?1:8,192 were 62.2%, 66.7%, 76.5%, and ?86.2%, respectively. However, sensitivity dropped to <60% when cutoff titers of ?1:8,192 were used. Although our study demonstrated a strong association between high phase I IgG titers and proven chronic Q fever, increasing the current diagnostic phase I IgG cutoff to >1:1,024 is not recommended due to increased false-negative findings (sensitivity < 60%) and the high morbidity and mortality of untreated chronic Q fever. Our study emphasizes that serologic results are not diagnostic on their own but should always be interpreted in combination with clinical parameters. PMID:22441385

Kampschreur, Linda M; Oosterheert, Jan Jelrik; Koop, Annemarie M C; Wegdam-Blans, Marjolijn C A; Delsing, Corine E; Bleeker-Rovers, Chantal P; De Jager-Leclercq, Monique G L; Groot, Cornelis A R; Sprong, Tom; Nabuurs-Franssen, Marrigje H; Renders, Nicole H M; van Kasteren, Marjo E; Soethoudt, Yvonne; Blank, Sybrandus N; Pronk, Marjolijn J H; Groenwold, Rolf H H; Hoepelman, Andy I M; Wever, Peter C



Rat bite fever: fever, arthritis, and rash in a 4-year-old boy.  


Rat bite fever is a rare but potentially fatal Gram-negative infection that predominantly affects populations with exposure to rats, notably children. The clinical presentation is nonspecific and requires a high threshold of suspicion to elicit a history of rat exposure. We report here a case of a child whose diagnosis was made retrospectively but with good outcome. PMID:22066490

Lewis, Bethany K H; Vanderhooft, Sheryll



Agranulocytosis in dengue hemorrhagic fever: a neglected condition.  


A granulocytosis in dengue hemorrhagic fever has not been mentioned, it mayprobably be included under the term of leucopenia. Here is the case of a 14-year Thai boy presenting with fever and diarrhea for 3 days. He was diagnosed as dengue hemorrhagic fever, grade I because he had hemoconcentration, thrombocytopenia without bleeding and positive IgM dengue antibody On the 5th day, he developed agranulocytosis and was treated with G-CSF and empirical antibiotics. His leucocyte count was successfully normalized within 1 day and persistently sustained until discharge. PMID:20462096

Insiripong, Somchai



Management of chemotherapy-induced neutropenic fever.  


Fever occurs at high rates in patients with chemotherapy-induced neutropenia and is considered an oncologic emergency. Numerous algorithms have been developed to guide treatment decisions. Prompt care and the initiation of empiric antibiotic therapy are critically important universal aspects of these treatment-decision schemata. Fever may be the only sign of infection, as in patients with cancer who are undergoing chemotherapy, the immune response is attenuated. In the majority of cases, no etiology for neutropenic fever is uncovered; nonetheless, a thorough workup is essential. The workup allows practitioners to risk stratify patients as being at low or high risk for infectious complications so that appropriate care can be administered. Although it is important to note that there are management algorithms to follow, every patient may present and respond differently. We generally start with broad-spectrum monotherapy for Gram-negative bacteria and then consider whether Gram-positive or antifungal coverage is necessary based on the clinical picture, including factors such as duration and degree of neutropenia. It is important for all practitioners to understand how to care for patients with neutropenic fever because it is a common and treatable condition. PMID:23466972

Bhardwaj, Aarti S; Navada, Shyamala C



[Scarlet fever in Poland in 2009].  


After the last outbreak of scarlet fever, when the peak was recorded in 1985, now is observed the visible extension of disease epidemic period and the weakness of the dynamics of the annual changes of incidence. In 2009, as in previous years, the scarlet fever incidence in Poland increased. There were 13,968 cases registered in total and the incidence was 36.6 per 100,000 population ranging from 18.4 in podkarpackie voivodeship to 62.1 in opolskie voivodeship. Cases among children and adolescents of less than 15 years of age accounted for 95.3% of all cases. The highest incidence was observed among 4 years old children (566.5) and 6 years old children (564.70). Incidence in men (41.5) markedly exceeded the incidence in women (32.1) and incidence in urban areas (40.5) and in rural areas (30.6). Approximately 1.1% of all cases were hospitalized. Due to scarlet fever there were no deaths in Poland in 2009. PMID:21913461

Czarkowski, Miros?aw P; Kondej, Barbara; Staszewska, Ewa



Q Fever with Unusual Exposure History: A Classic Presentation of a Commonly Misdiagnosed Disease  

PubMed Central

We describe the case of a man presumptively diagnosed and treated for Rocky Mountain spotted fever following exposure to multiple ticks while riding horses. The laboratory testing of acute and convalescent serum specimens led to laboratory confirmation of acute Q fever as the etiology. This case represents a potential tickborne transmission of Coxiella burnetii and highlights the importance of considering Q fever as a possible diagnosis following tick exposures.

Nett, Randall J.; Book, Earl; Anderson, Alicia D.



[Laboratory diagnosis of viral hemorrhagic fevers].  


Viral hemorrhagic fevers (VHFs) refer to a group of acute infections with high case fatality rates that are caused by four distinct families of RNA viruses belonging to the families Bunyaviridae, Flaviviridae, Filoviridae and Arenaviridae, the main clinical symptoms of these diseases are accompanied by fever and bleeding. For the reason that these infections have similar primary clinical symptoms, it is difficult to diagnose and distinguish them; rapid and reliable laboratory diagnostic tests are required in suspected cases for epidemiological investigation and controlling the spread of VHFs. This review addresses the laboratory diagnostics of VHFs, covering etiological classification and different diagnostic techniques, such as virus isolation, nucleic acid detection, as well as antigen and antibody assays. Prospects for novel diagnostic tools are also discussed. PMID:23905482

Pang, Zheng; Li, De-Xin



Effect of a yellow filter on brightness evaluated by asymmetric matching: measurements and predictions  

NASA Astrophysics Data System (ADS)

We found that yellow filters reduce the mean brightness of a set of coloured samples significantly less with blue surrounds than with black, achromatic or yellow ones, in comparison with the naked eye and less than a yellow surround in comparison with a luminance-matched grey filter. The predictions of Hunt's model and Guth's ATD95 agree with these results. The yellow filter is actually capable of significantly increasing the brightness with the blue surround both in comparison with the naked eye (although only for our younger observer) and with the neutral filter. We show that in some samples the yellow filter causes global response increments in the chromatic mechanisms that compensate the response reduction in the achromatic mechanism, resulting in increased brightness. Although global chromatic response increments may arise from any chromatic mechanism, the blue-yellow mechanism determines in most cases the final result, even when the response of the red-green mechanism decreases.

Luque, M. J.; Capilla, P.; Díez, M. A.; Felipe, A.



Temporomandibular joint involvement in familial mediterranean fever  

Microsoft Academic Search

Case 2. A 15-year-old girl of Jewish Sephardi origin had a history of recurrent cellulitis on the medial aspect of the ankles since 7 years of age. At age 12, she had recurrent episodes of chest pain and\\/or abdominal pain with fever. At age 14 years she underwent laparotomy and appendectomy because of signs of peritonitis. Histologically her appendix was

M. Mukamel; M. Mimouni



Familial Mediterranean Fever and Seronegative Arthritis  

Microsoft Academic Search

Familial Mediterranean fever (FMF) is characterized by recurrent, self-limited episodes of polyserositis, with articular involvement\\u000a also being a common manifestation. The pattern and joint predilection of arthritis show many similarities to those of spondyloarthritis.\\u000a Moreover, case series suggest an increased prevalence of ankylosing spondylitis or spondyloarthritis among FMF patients. FMF\\u000a is caused by mutations in the MEFV gene encoding pyrin,

Nurullah Akkoc; Ahmet Gul


Yellow nail syndrome as a cause of unexplained edema.  


Yellow nail syndrome is a rare cause of edema due to a disordered lymphatic drainage. We recently observed two cases of long-standing, chronic edema, whose nature could not be understood despite innumerable diagnostic procedures. The diagnosis was suspected based on an attentive clinical exam and confirmed by radionuclide lymph scan. Yellow nail syndrome has to be considered in the differential diagnosis in cases of systemic edema, as well as long standing pleural effusions, particularly in patients with bronchiectasis or sinusitis. Clues to diagnosis are the presence of dystrophic, yellowish nails, peripheral lymphedema and relapsing pleural effusions and/or ascites. Long-term control of symptoms is difficult to achieve and may benefit from the judicious use of diuretics and intravenous albumin and by topical alpha-tocopherol. Pleurodesis may be needed. Other pathologic conditions are often associated to yellow nail syndrome and should be ruled out. PMID:20440922

Cimini, C; Giunta, R; Utili, R; Durante-Mangoni, E




Microsoft Academic Search

Dengue fever and dengue hemorrhagic fever constitute a substantial health burden on the population in Thailand. In this study, the impact of symptomatic dengue virus infection on the families of patients hospitalized at the Kamphaeng Phet Provincial Hospital with laboratory-confirmed dengue in 2001 was assessed, and the disability-adjusted life years (DALYs) lost for fatal and non-fatal cases of dengue were




Childbed Fever A Nineteenth-Century Mystery  

NSDL National Science Digital Library

This case describes the pioneering work of Ignaz Semmelweis and his efforts to remedy the problem of childbed fever in mid-19th century Europe.  Its purpose is to teach students about the scientific method by “dissecting” the various steps involved in this important, historical medical breakthrough. The case is an interrupted case, that is, students receive only one piece of information at a time, followed by discussion, before moving on to the next piece of information to solve the mystery.

Colyer, Christa



Yellow Poplar Glued-Laminated Timber: Product Development and Use in Timber Bridge Construction  

Microsoft Academic Search

This paper outlines the research efforts involved in incorporating yellow-poplar (Liriodendron tulipifera) as a viable resource for structural glued-laminated timber (glulam). The development of an efficient combination of yellow poplar glulam is presented, along with a description of how this was implemented in the industry standard for hardwood glulam. A case study is then presented that utilized this new technology

Roland Hernandez; Michael A. Ritter; Russell C. Moody; Paula D. Hilbrich Lee


Genetics Home Reference: Familial Mediterranean fever  


... Recent literature OMIM Genetic disorder catalog Conditions > Familial Mediterranean fever On this page: Description Genetic changes Inheritance ... Glossary definitions Reviewed September 2008 What is familial Mediterranean fever? Familial Mediterranean fever is an inherited condition ...


Fever, Sweats, and Hot Flashes (PDQ)  


... Research & Funding News About NCI Fever, Sweats, and Hot Flashes (PDQ®) Patient Version Health Professional Version En ... Last Modified: 06/13/2013 Fever, Sweats, and Hot Flashes (PDQ®) Overview Causes of Fever in Patients ...


Modeling spatio-temporal risk changes in the incidence of Dengue fever in Saudi Arabia: a geographical information system case study.  


The aim of this study was to use geographical information systems to demonstrate the Dengue fever (DF) risk on a monthly basis in Jeddah, Saudi Arabia with the purpose to provide documentation serving to improve surveillance and monitor the Aedes aegypti mosquito vector. Getis-Ord Gi* statistics and a frequency index covering a five-year period (2006-2010) were used to map DF and model the risk spatio-temporally. The results show that monthly hotspots were mainly concentrated in central Jeddah districts and that the pattern changes considerably with time. For example, on a yearly basis, for the month of January, the Burman district was identified as a low risk area in 2006, a high-risk area in 2007, medium risk in 2008, very low risk in 2009 and low risk in 2010. The results demonstrate that it would be useful to follow the monthly DF pattern, based on the average weekly frequency, as this can facilitate the allocation of resources for the treatment of the disease, preventing its prevalence and monitoring its vector. PMID:22109865

Khormi, Hassan M; Kumar, Lalit; Elzahrany, Ramze A



Viral hemorrhagic fevers.  


A taxonomically diverse set of single-stranded ribonucleic acid(ssRNA) viruses from four diverse viral families Arenaviridae,Bunyaviridae, Filoviridae, and Flaviviridae cause an acute systemic febrile syndrome called viral hemorrhagic fever (VHF). The syndrome produces combinations of prostration, malaise, increased vascular permeability, and coagulation maladies. In severe illness,VHF may include generalized bleeding but the bleeding does not typically constitute a life-threatening loss of blood volume. To a certain extent, it is a sign of damage to the vascular endothelium and is an indicator of disease severity in specific target organs. Although the viruses that cause hemorrhagic fever (HF) can productively replicate in endothelial cells, much of the disease pathology including impairment to the vascular system is thought to result primarily from the release of a variety of mediators from virus-infected cells, such as monocytes and macrophages that subsequently alter vascular function and trigger the coagulation disorders that epitomize these infections. While significant progress has been made over the last several years in dissecting out the molecular biology and pathogenesis of the HF viruses, there are currently no vaccines or drugs licensed available for most of the VHFs. PMID:16815457

Marty, Aileen M; Jahrling, Peter B; Geisbert, Thomas W



High fever following postpartum administration of sublingual misoprostol  

PubMed Central

Objective To explore what triggers an elevated body temperature of ?40.0°C in some women given misoprostol, a prostaglandin E1 analogue, for postpartum haemorrhage (PPH). Design Post hoc analysis. Setting One tertiary-level hospital in Quito, Ecuador. Population A cohort of 58 women with a fever of above 40°C following treatment with sublingual misoprostol (800 micrograms) for PPH. Methods Side effects were documented for 163 Ecuadorian women given sublingual misoprostol to treat their PPH. Women’s body temperatures were measured, and if they had a fever of ?40.0°C, measurements were taken hourly until the fever subsided. Temperature trends were analysed, and the possible physiological mechanisms by which postpartum misoprostol produces a high fever were explored. Main outcome measures The onset, duration, peak temperatures, and treatments administered for cases with a high fever. Results Fifty-eight of 163 women (35.6%) treated with misoprostol experienced a fever of ?40.0°C. High fevers followed a predictable pattern, often preceded by moderate/severe shivering within 20 minutes of treatment. Body temperatures peaked 1–2 hours post-treatment, and gradually declined over 3 hours. Fevers were transient and did not lead to any hospitalisation. Baseline characteristics were comparable among women who did and did not develop a high fever, except for known previous PPH and time to placental expulsion. Conclusions An unexpectedly high rate of elevated body temperature of ?40.0°C was documented in Ecuador following sublingually administered misoprostol. It is unclear why temperatures ?40.0°C occurred with a greater frequency in Ecuador than in other study populations using similar treatment regimens for PPH. Pharmacogenetic studies may shed further light on variations in individuals’ responses to misoprostol.

Durocher, J; Bynum, J; Leon, W; Barrera, G; Winikoff, B



Borrelia hispanica Relapsing Fever, Morocco  

PubMed Central

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.

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



Crimean-Congo Hemorrhagic Fever.  

National Technical Information Service (NTIS)

Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease caused by the arbovirus Crimean-Congo hemorrhagic fever virus (CCHFV), which is a member of the Nairovirus genus (family Bunyaviridae). CCHF was first recognized during a large outbreak among ...

C. A. Whitehouse



Mayaro Fever Virus, Brazilian Amazon  

PubMed Central

In February 2008, a Mayaro fever virus (MAYV) outbreak occurred in a settlement in Santa Barbara municipality, northern Brazil. Patients had rash, fever, and severe arthralgia lasting up to 7 days. Immunoglobulin M against MAYV was detected by ELISA in 36 persons; 3 MAYV isolates sequenced were characterized as genotype D.

Azevedo, Raimunda S.S.; Silva, Eliana V.P.; Carvalho, Valeria L.; Rodrigues, Sueli G.; Neto, Joaquim P. Nunes; Monteiro, Hamilton A.O.; Peixoto, Victor S.; Chiang, Jannifer O.; Nunes, Marcio R.T.



Possibilities for Relapsing Fever Reemergence  

PubMed Central

Relapsing fever Borrelia infections have attracted little attention in recent years; however, where endemic, these infections still result in considerable illness and death. Despite the marked antimicrobial drug susceptibility of these organisms, therapy is often delayed through lack of clinical suspicion. With increasing travel, infections may be imported, through exotic relapsing fever infection or through resurgence of infected disease vectors. Although louseborne relapsing fever is now geographically limited, it was once of global importance. The possibility for reemergence was recently highlighted by the probable reemergence of louseborne relapsing fever in homeless persons from France. Host limitations enforced through louseborne transmission are less applicable for the tickborne forms of relapsing fever. Although the latter have reduced potential for epidemic spread, they have the ability to infect diverse hosts, thus establishing reservoirs of infection and presenting greater challenges for their control.



Q Fever in Alberta--Infection in Humans and Animals  

PubMed Central

The presence of Q fever antibodies in the milk of cattle in Alberta is described. The incidence of positive milk samples rose from 0.8% of herds tested in 1959 to 7.7% in 1964. The largest number of infected animals is in the southern part of the province. A case of Q fever in an infant is reported. This occurred on the Duffield Indian Reserve near Edmonton in November 1963. Two of 44 blood samples collected at random from asymptomatic individuals on the Reserve in February 1965 contained complement-fixing antibodies to Q fever antigen. Studies on milk from dairy cattle in the area were negative for Q fever antibodies, and the source of human infection has not yet been determined.

Herbert, F. A.; Morgante, O.; Burchak, E. C.; Kadis, V. W.



Crimean-Congo hemorrhagic Fever in Tajikistan.  


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. PMID:22217164

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



[Genetic fever syndromes. Hereditary recurrent (periodic) fever syndromes].  


Genetic fever syndromes or hereditary recurrent fever syndromes (HRF) are considered to be part of the autoinflammatory diseases (AID) which result from errors in the innate immune system. Patients typically have self-limiting episodes of fever and high levels of inflammation markers. The mode of inheritance is autosomal recessive or autosomal dominant. The diseases of the HRF include familial Mediterranean fever, tumor necrosis factor receptor 1-associated periodic syndrome, hyper-IgD syndrome and cryopyrin-associated periodic fever syndromes. The disease known as deficiency of interleukin 1 (IL1) receptor antagonist does not fully belong to this group because fever is not a typical symptom. The therapy depends on the type and severity of the disease. Effective prophylaxis is possible for FMF. Biologicals, especially IL1 blocking agents are highly effective in very severe fever syndromes. In order to collect more information on AID, to establish a biobank and coordinate research in this field the AID-Net project was founded. Currently 606 patients with AID are registered of whom 381 have HRF. PMID:23552978

Neudorf, U; Lainka, E; Kallinich, T; Holzinger, D; Roth, J; Föll, D; Niehues, T



The Yellow River in transition  

Microsoft Academic Search

Like many parts of the world, the Yellow River basin has problems associated with water scarcity, pollution, and flood risk. Analyses that focus only on the physical characteristics of these problems miss some of their most important social drivers. In this paper we identify some interlocking changes that have occurred as a consequence of economic reforms begun in China in

Michael Webber; Jon Barnett; Mark Wang; Brian Finlayson; Debbie Dickinson




Technology Transfer Automated Retrieval System (TEKTRAN)

Six insects that attack yellow starthistle have become established in California, but only two species are very abundant, and only the seedheads are attacked. Little impact on the weed has occurred except at low elevation sites in Oregon which are not overgrazed or disturbed (e.g., roadsides). Add...


Is immediate postoperative fever related to drop in haemoglobin? A comparative study in simultaneous bilateral total knee arthroplasty patients.  


The purpose of the study was to assess whether fever in the immediate postoperative period after total knee arthroplasty was indeed related to the fall in haemoglobin. Only patients undergoing bilateral simultaneous total knee replacement were included in the study since the fall in haemoglobin is expected to be more as compared to unilateral cases. The mean fall in haemoglobin of 25 patients having immediate postoperative fever ('fever group') was compared with 27 patients having no fever ('no-fever group'). Though the mean fall of haemoglobin in 'fever group' was more compared to 'no-fever group', the difference was not statistically significant. Therefore, this study does not support the view that immediate postoperative fever after total knee arthroplasty is related to drop in haemoglobin. PMID:23412282

Shetty, Vijay; Kasture, Sarang



Overwintering Yellow Perch Fry in Alabama  

Microsoft Academic Search

Wild harvests of yellow perch Perca flavescens have failed to keep up with the strong market demand for the fish. Moreover, yellow perch has many attributes that make it attractive for commercial aquaculture in the USA. One drawback to yellow perch culture in the north-central region of the United States is that low winter water temperatures inhibit somatic growth. In

I. Patrick Saoud; Leonard Rodgers; Jesse Chappell; D. Allen Davis



COMMUNICATIONS Overwintering Yellow Perch Fry in Alabama  

Microsoft Academic Search

Wild harvests of yellow perch Perca fla- vescens have failed to keep up with the strong market demand for the fish. Moreover, yellow perch has many attributes that make it attractive for commercial aqua- culture in the USA. One drawback to yellow perch cul- ture in the north-central region of the United States is that low winter water temperatures inhibit



Akhawayni and the first fever curve.  


By the time of Hippocrates the typical paroxysmal fever patterns of tertian (every 48 hours) and quartan (every 72 hours) fevers caused by malaria were known. Through the ensuing centuries, ancient Greek, Roman, and Persian physicians made additional contributions to the understanding of fevers. By the end of that era, there was a working definition of what constitutes a fever, the distinction between fever as a symptom and fever as a disease, an elaborate classification scheme for multiple types of fever, hypotheses as to the causes of fever, and methods for diagnosing and treating fevers. Based on the definition of fever at that time, the 10th century ce Persian physician Akhawayn? created fever curves hundreds of years before they were routinely used in the clinical setting. In Hid?yat al-Muta'allim?n f? al-Tibb, Akhawayn? describes a system for fever curves and draws fever curves for tertian and quartan Fevers, as well as the double tertian, double quartan, and triple quartan fevers. In this work we examine the history of fevers in the ancient world and the first description of the fever curve. PMID:22820543

Sajadi, Mohammad M; Bonabi, Reza; Sajadi, Mohamad-Reza M; Mackowiak, Philip A




Microsoft Academic Search

A population-based surveillance for typhoid fever was conducted in three rural communes of Dong Thap Province in southern Vietnam (population 28,329) for a 12-month-period starting on December 4, 1995. Cases of typhoid fever were detected by obtaining blood for culture from residents with fever 3 days. Among 658 blood cultures, 56 (8.5%) were positive for Salmonella typhi with an overall



Azithromycin versus Ciprofloxacin for Treatment of Uncomplicated Typhoid Fever in a Randomized Trial in Egypt That Included Patients with Multidrug Resistance  

Microsoft Academic Search

To compare clinical and bacteriological efficacies of azithromycin and ciprofloxacin for typhoid fever, 123 adults with fever and signs of uncomplicated typhoid fever were entered into a randomized trial. Cultures of blood were positive for Salmonella typhi in 59 patients and for S. paratyphi A in 3 cases; stool cultures were positive for S. typhi in 11 cases and for




Fever effects and treatment in critical care: Literature review.  


Considering that the incidence of fever may reach up to 75% among critically ill adults, healthcare professionals employed in the Intensive Care Unit (ICU) are called to evaluate and manage patient temperature elevation on a daily basis. This literature review synthesizes the evidence about the effects of fever and antipyretic treatment in ICU patients. Although the febrile response acts protectively against infections, noxious effects are possible for patients with cerebral damage, neuropsychiatric disorders or limited cardiorespiratory reserve. Observational studies on ICU populations have reported associations between fever magnitude and patient mortality. Especially recent findings indicated that infected patients may significantly benefit from temperature elevation, while high fever may be maladaptive for non-infected ones. Aggressive antipyretic treatment of ICU patients has not been followed by decreased mortality in randomized trials. However, fever suppression and return to normothermia improved outcomes of septic shock patients. Antipyretic treatment should begin with drug administration and proceed with external cooling in case of refractory fever, but adverse effects of both antipyretic methods should always be considered. This article concludes by providing implications for antipyretic treatment of critically ill adults and suggesting areas for future research. PMID:23199670

Kiekkas, Panagiotis; Aretha, Diamanto; Bakalis, Nick; Karpouhtsi, Irini; Marneras, Chris; Baltopoulos, George I



Molecular characterization of the 2011 Hong Kong scarlet fever outbreak.  


A scarlet fever outbreak occurred in Hong Kong in 2011. The majority of cases resulted in the isolation of Streptococcus pyogenes emm12 with multiple antibiotic resistances. Phylogenetic analysis of 22 emm12 scarlet fever outbreak isolates, 7 temporally and geographically matched emm12 non-scarlet fever isolates, and 18 emm12 strains isolated during 2005-2010 indicated the outbreak was multiclonal. Genome sequencing of 2 nonclonal scarlet fever isolates (HKU16 and HKU30), coupled with diagnostic polymerase chain reaction assays, identified 2 mobile genetic elements distributed across the major lineages: a 64.9-kb integrative and conjugative element encoding tetracycline and macrolide resistance and a 46.4-kb prophage encoding superantigens SSA and SpeC and the DNase Spd1. Phenotypic comparison of HKU16 and HKU30 with the S. pyogenes M1T1 strain 5448 revealed that HKU16 displays increased adherence to HEp-2 human epithelial cells, whereas HKU16, HKU30, and 5448 exhibit equivalent resistance to neutrophils and virulence in a humanized plasminogen murine model. However, in contrast to M1T1, the virulence of HKU16 and HKU30 was not associated with covRS mutation. The multiclonal nature of the emm12 scarlet fever isolates suggests that factors such as mobile genetic elements, environmental factors, and host immune status may have contributed to the 2011 scarlet fever