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Sample records for yellow fever cases

  1. Yellow Fever

    MedlinePlus

    ... tropical and subtropical areas in South America and Africa. The virus is transmitted to people by the ... fever Maps of Yellow fever endemic areas in Africa and South America Yellow fever vaccination Prevention Vaccine ...

  2. [A case of Yellow fever in 1887].

    PubMed

    Hansen, Sven Erik

    2015-01-01

    A young Danish sailor died from yellow fever in Barbados in 1887. The Shipmaster's letter to the family with a description of the course of the disease, which has been preserved, is presented here together with a photo of the sailor and a painting of the Danish sailing-ship. PMID:27086445

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

    PubMed

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

    2016-07-01

    There is currently an emerging outbreak of yellow fever in Angola. Cases in infected travellers have been reported in a number of other African countries, as well as in China, representing the first ever documented cases of yellow fever in Asia. There is a large Chinese workforce in Angola, many of whom may be unvaccinated, increasing the risk of ongoing importation of yellow fever into Asia via busy commercial airline routes. Large parts of the region are hyperendemic for the related Flavivirus dengue and are widely infested by Aedes aegypti, the primary mosquito vector of urban yellow fever transmission. The combination of sustained introduction of viraemic travellers, an ecology conducive to local transmission, and an unimmunized population raises the possibility of a yellow fever epidemic in Asia. This represents a major global health threat, particularly in the context of a depleted emergency vaccine stockpile and untested surveillance systems in the region. In this review, the potential for a yellow fever outbreak in Asia is discussed with reference to the ecological and historical forces that have shaped global yellow fever epidemiology. The limitations of surveillance and vector control in the region are highlighted, and priorities for outbreak preparedness and response are suggested. PMID:27156836

  4. Yellow Fever Vaccine

    MedlinePlus

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

  5. Yellow Fever Vaccine

    MedlinePlus

    What is yellow fever?Yellow fever is a serious disease caused by the yellow fever virus. It is found in certain parts of Africa ... How can I prevent yellow fever?Yellow fever vaccine can prevent yellow fever. ... only at designated vaccination centers. After getting the vaccine, you ...

  6. Narcolepsy Following Yellow Fever Vaccination: A Case Report.

    PubMed

    Rosch, Richard E; Farquhar, Michael; Gringras, Paul; Pal, Deb K

    2016-01-01

    Narcolepsy with cataplexy is a rare, but important differential diagnosis for daytime sleepiness and atonic paroxysms in an adolescent. A recent increase in incidence in the pediatric age group probably linked to the use of the Pandemrix influenza vaccine in 2009, has increased awareness that different environmental factors can "trigger" narcolepsy with cataplexy in a genetically susceptible population. Here, we describe the case of a 13-year-old boy with narcolepsy following yellow fever vaccination. He carries the HLA DQB1*0602 haplotype strongly associated with narcolepsy and cataplexy. Polysomnography showed rapid sleep onset with rapid eye movement (REM) latency of 47 min, significant sleep fragmentation and a mean sleep latency of 1.6 min with sleep onset REM in four out of four nap periods. Together with the clinical history, these findings are diagnostic of narcolepsy type 1. The envelope protein E of the yellow fever vaccine strain 17D has significant amino acid sequence overlap with both hypocretin and the hypocretin receptor 2 receptors in protein regions that are predicted to act as epitopes for antibody production. These findings raise the question whether the yellow fever vaccine strain may, through a potential molecular mimicry mechanism, be another infectious trigger for this neuro-immunological disorder. PMID:27559330

  7. Narcolepsy Following Yellow Fever Vaccination: A Case Report

    PubMed Central

    Rosch, Richard E.; Farquhar, Michael; Gringras, Paul; Pal, Deb K.

    2016-01-01

    Narcolepsy with cataplexy is a rare, but important differential diagnosis for daytime sleepiness and atonic paroxysms in an adolescent. A recent increase in incidence in the pediatric age group probably linked to the use of the Pandemrix influenza vaccine in 2009, has increased awareness that different environmental factors can “trigger” narcolepsy with cataplexy in a genetically susceptible population. Here, we describe the case of a 13-year-old boy with narcolepsy following yellow fever vaccination. He carries the HLA DQB1*0602 haplotype strongly associated with narcolepsy and cataplexy. Polysomnography showed rapid sleep onset with rapid eye movement (REM) latency of 47 min, significant sleep fragmentation and a mean sleep latency of 1.6 min with sleep onset REM in four out of four nap periods. Together with the clinical history, these findings are diagnostic of narcolepsy type 1. The envelope protein E of the yellow fever vaccine strain 17D has significant amino acid sequence overlap with both hypocretin and the hypocretin receptor 2 receptors in protein regions that are predicted to act as epitopes for antibody production. These findings raise the question whether the yellow fever vaccine strain may, through a potential molecular mimicry mechanism, be another infectious trigger for this neuro-immunological disorder. PMID:27559330

  8. First case of yellow fever vaccine-associated viscerotropic disease (YEL-AVD) in Hong Kong.

    PubMed

    Leung, Wai Shing; Chan, Man Chun; Chik, Shiu Hong; Tsang, Tak Yin

    2016-04-01

    Yellow fever is an important and potentially fatal infection in tropical regions of Africa, South America, eastern Panama in Central America and Trinidad in the Caribbean. Yellow fever vaccination is not only crucial to reduce the disease risk and mortality in individuals travelling to these areas, but also an important public health measure to prevent the spread of the disease. Despite generally considered as a safe vaccine, yellow fever vaccine can rarely be associated with severe adverse reactions including yellow fever vaccine-associated viscerotropic disease (YEL-AVD). Here, we report the first case of YEL-AVD in Hong Kong. Clinicians should alert to the possibility of YEL-AVD in vaccinees presenting with compatible symptoms after yellow fever vaccination, particularly in people at higher risk of adverse events. PMID:27087559

  9. Yellow fever vaccination during treatment with infliximab in a patient with ulcerative colitis: A case report.

    PubMed

    Rüddel, J; Schleenvoigt, B T; Schüler, E; Schmidt, C; Pletz, M W; Stallmach, A

    2016-09-01

    We report the case of a 59-year-old patient who accidentally underwent live vaccination against yellow fever during continuous treatment with the TNF-α-antibody (AB) infliximab for ulcerative colitis. The clinical course showed fever of short duration and elevation of liver enzymes without further clinical complications. Yellow fever viremia was not detectable and protective antibodies were developed. A primary vaccination against yellow fever under infliximab has not been reported in the literature before, although vaccination is an important topic in IBD. Live vaccinations, like Stamaril(®) against yellow fever, are contraindicated during TNF-α-AB treatment. Treatment regimens containing TNF-α-AB are of growing importance, not only in gastroenterology, but also in rheumatology and dermatology. We discuss this topic by presenting our case and reviewing the current literature. PMID:27612222

  10. Yellow fever: an update.

    PubMed

    Monath, T P

    2001-08-01

    Yellow fever, the original viral haemorrhagic fever, was one of the most feared lethal diseases before the development of an effective vaccine. Today the disease still affects as many as 200,000 persons annually in tropical regions of Africa and South America, and poses a significant hazard to unvaccinated travellers to these areas. Yellow fever is transmitted in a cycle involving monkeys and mosquitoes, but human beings can also serve as the viraemic host for mosquito infection. Recent increases in the density and distribution of the urban mosquito vector, Aedes aegypti, as well as the rise in air travel increase the risk of introduction and spread of yellow fever to North and Central America, the Caribbean and Asia. Here I review the clinical features of the disease, its pathogenesis and pathophysiology. The disease mechanisms are poorly understood and have not been the subject of modern clinical research. Since there is no specific treatment, and management of patients with the disease is extremely problematic, the emphasis is on preventative vaccination. As a zoonosis, yellow fever cannot be eradicated, but reduction of the human disease burden is achievable through routine childhood vaccination in endemic countries, with a low cost for the benefits obtained. The biological characteristics, safety, and efficacy of live attenuated, yellow fever 17D vaccine are reviewed. New applications of yellow fever 17D virus as a vector for foreign genes hold considerable promise as a means of developing new vaccines against other viruses, and possibly against cancers. PMID:11871403

  11. Yellow fever vaccine

    PubMed Central

    Verma, Ramesh; Khanna, Pardeep; Chawla, Suraj

    2014-01-01

    Yellow fever (YF) is an acute viral communicable disease transmitted by an arbovirus of the Flavivirus genus. It is primarily a zoonotic disease, especially the monkeys. Worldwide, an estimated 200 000 cases of yellow fever occurred each year, and the case-fatality rate is ~15%. Forty-five endemic countries in Africa and Latin America, with a population of close to 1 billion, are at risk. Up to 50% of severely affected persons from YF die without treatment. During 2009, 55 cases and 18 deaths were reported from Brazil, Colombia, and Peru. Brazil reported the maximum number of cases and death, i.e., 42 cases with 11 deaths. From January 2010 to March 2011, outbreaks of YF were reported to the WHO by Cameroon, Democratic Republic of Congo, Cote d’Ivoire, Guinea, Sierra Leone, Senegal, and Uganda. Cases were also reported in three northern districts of Abim, Agago, and Kitugun near the border with South Sudan. YF usually causes fever, muscle pain with prominent backache, headache, shivers, loss of appetite, and nausea or vomiting. Most patients improve, and their symptoms disappear after 3 to 4 d. Half of the patients who enter the toxic phase die within 10–14 d, while the rest recover without significant organ damage. Vaccination has been the single most important measure for preventing YF. The 17D-204 YF vaccine is a freeze-dried, live attenuated, highly effective vaccine. It is available in single-dose or multi-dose vials and should be stored at 2–8 °C. It is reconstituted with normal saline and should be used within 1 h of reconstitution. The 0.5 mL dose is delivered subcutaneously. Revaccination is recommended every 10 y for people at continued risk of exposure to yellow fever virus (YFV). This vaccine is available worldwide. Travelers, especially to Africa or Latin America from Asia, must have a certificate documenting YF vaccination, which is required by certain countries for entry under the International Health Regulations (IHR) of the WHO. PMID

  12. A case suspected for yellow fever vaccine-associated viscerotropic disease in the Netherlands.

    PubMed

    van de Pol, Eva M; Gisolf, Elizabeth H; Richter, Clemens

    2014-01-01

    Yellow fever (YF) 17D vaccine is one of the most successful vaccines ever developed. Since 2001, 56 cases of yellow fever vaccine-associated viscerotropic disease (YEL-AVD) have been published in the peer-reviewed literature. Here, we report a new case suspected for YEL-AVD in the Netherlands. Further research is needed to determine the true incidence of YEL-AVD and to clarify host and vaccine-associated factors in the pathogenesis of YEL-AVD. Because of the potential adverse events, healthcare providers should carefully consider vaccination only in people who are truly at risk for YF infection, especially in primary vaccine recipients. PMID:24920138

  13. [Several yellow fever cases in an endemic area in Ivory Coast: serological and epidemiological evidence (author's transl)].

    PubMed

    Chippaux, A; Chippaux-Hyppolite, C l; Monteny-Vandervorst, N; Souloumiac-Deprez, D

    1981-01-01

    1 - More than hundred febrile haemorrhagic jaundice cases with an unexpectedly high number of death happened in the north-west of the Ivory Coast between October 1977 and December 1977. It was the end of the rainy season and in this area, yellow fever is a dreadful eventuality. 2 - Epidemiological and serological survey was immediately carried out. Presence of numerous yellow fever potential vectors was well known and has been noticed in September 1977; there were some left in December 1977. Therefore no virus was isolated either in September or further. 3 - Haemagglutination-inhibition, complement-fixation and neutralization tests were performed with six flavivirus antigens, i.e. yellow fever, Wesselsbron, West Nile, Ntaya, Uganda S and Zika. 2 or 3 sera from 29 patients and 49 school children who have recent jaundice history, sometimes with haemorrhagic symptoms, were available. Single sera from 52 young rural workers and 402 inhabitants of surrounding villages were examined too. 4 - By the way of clinical, epidemiological, serological evidence, authors concluded 21 cases were certainly yellow fever. Evidence of 2 other cases was demonstrated by specific micropathological features. Furthermore, by serological results, 20 were probably yellow fever, 15 were inconclusive and 476 certainly not. 5 - Authors discussed some specific difficulties of yellow fever retrospective diagnosis in flavivirus endemic area. PMID:6268925

  14. Experimental therapies for yellow fever.

    PubMed

    Julander, Justin G

    2013-02-01

    A number of viruses in the family Flaviviridae are the focus of efforts to develop effective antiviral therapies. Success has been achieved with inhibitors for the treatment of hepatitis C, and there is interest in clinical trials of drugs against dengue fever. Antiviral therapies have also been evaluated in patients with Japanese encephalitis and West Nile encephalitis. However, no treatment has been developed against the prototype flavivirus, yellow fever virus (YFV). Despite the availability of the live, attenuated 17D vaccine, thousands of cases of YF continue to occur each year in Africa and South America, with a significant mortality rate. In addition, a small number of vaccinees develop severe systemic infections with the 17D virus. This paper reviews current efforts to develop antiviral therapies, either directly targeting the virus or blocking detrimental host responses to infection. PMID:23237991

  15. Yellow Fever Virus Infection

    PubMed Central

    David-West, Tam. S.; Smith, J. A.

    1971-01-01

    A sequential and quantitative survey of brain and liver of suckling mice for infective virus and complement-fixing antigen, after infection with yellow fever virus, showed that while there was progressive increase of infective virus content in both organs, only the brain showed a corresponding rise in CF antigen. Histopathological examination revealed that the liver was not significantly involved. The target organ was the brain, where the progressive pathological changes culminated in an acute encephalitis by the 3rd day of experiment. Organ destruction began with the molecular layer of the grey matter. But by the 4th day after infection the entire cerebral cortex was involved. At the initial stages the hippocampus was particularly affected. Tissue damage did not appear to be entirely due to the differential quantitative localization of infective virus. It was hypothesized that the CF antigen acting singly or in conjunction with some hypothetical proteins may be principally involved in the pathological outcome of the disease. ImagesFigs. 7-9Figs. 3-6 PMID:5582071

  16. [Yellow fever epidemiology in Brazil].

    PubMed

    Mondet, B

    2001-08-01

    We have carried out a meticulous time-space-analysis of the incidence of yellow fever in humans in Brazil from 1954 to 1972 and especially from 1973 to 1999. This study has added to our knowledge of the epidemiology of yellow fever and enabled us to redefine epidemiological zones and determine their geographical limits. The endemic area is located within the Amazon basin; here cases are scattered and generally limited in number. However, there are also "foci of endemic emergence" within this area, where cases are less rare, although occurrence remains irregular. The epidemic area is for the most part situated outside the Amazon basin, to the north east and particularly to the south. It has been divided into two parts according to whether the occurrence of yellow fever is cyclic or sporadic. The epidemics, which are all sylvatic, follow either a circular path (in the forest area) or a linear path (in forest-galleries of the savannah area). The study of the development of the 3 main epidemics (1972-74; 1979-82; 1986-92) in the cyclic emergence area showed that, on each occasion, the yellow fever virus appeared at a particularly active outbreak site located in the "serra dos Carajás", and from there, it followed the courses of the Tocantins and Araguaia rivers upstream, moving southwards during the "pre-epidemic phase" which may be visible due to the occurrence of a few cases, or may remain invisible. Subsequently the virus reached the emergence area, where it appeared in the form of epidemics. In this zone, it also followed privileged south-western pathways, moving from one hydraulic basin to another along the upstream courses of the rivers. Almost exactly the same pathways have been identified for each of the 3 epidemics studied. The distances travelled by the virus over a period of one year--when it goes rapidly--can reach several hundred kilometers. On the other hand, it may be stationary for a period of one or two consecutive years, occasionally three, remaining

  17. Urbanisation of yellow fever in Santa Cruz, Bolivia.

    PubMed

    Van der Stuyft, P; Gianella, A; Pirard, M; Cespedes, J; Lora, J; Peredo, C; Pelegrino, J L; Vorndam, V; Boelaert, M

    1999-05-01

    Until recently, urban yellow fever had not been reported from the Americas since 1954, but jungle yellow fever increasingly affects forest dwellers in Bolivia, Brazil, Colombia, Ecuador, and Peru. The reinvasion by Aedes aegypti of cities in the Americas now threatens to urbanize yellow fever. After yellow fever infection was identified in a resident of Santa Cruz, Bolivia, in December 1997, all subsequent suspected cases were investigated. Active surveillance of yellow fever was introduced in the Santa Cruz area, with hospitals and selected urban and rural health centers reporting all suspected cases. Patients were serologically screened for yellow fever, dengue, hepatitis A and B, and leptospirosis; clinical and epidemiological data were collected from patients' records and through interviews; and a population-based serosurvey was conducted in the neighborhood of one case. Between December 1997 and June 1998, symptomatic yellow fever infection was confirmed in 6 residents of Santa Cruz, of whom 5 died. 5 lived in the southern sector of the city. 2 cases did not leave the city during their incubation period, and 1 had visited only an area in which sylvatic transmission was deemed impossible. Of the 281 people covered in the serosurvey, 16 (6%) were positive for IgM antibody to yellow fever. Among 5 people for whom that result could not be explained by recent vaccination, there were 2 pairs of neighbors. This instance of urban yellow fever transmission was limited in both time and space. PMID:10334253

  18. Yellow fever in China is still an imported disease.

    PubMed

    Chen, Jun; Lu, Hongzhou

    2016-05-23

    Yellow fever is a vector-borne disease endemic to tropical regions of Africa and South America. A recent outbreak in Angola caused hundreds of deaths. Six cases of yellow fever imported from Angola were reported recently in China. This raised the question of whether it will spread in China and how it can be prevented. This article discusses the possibility of yellow fever transmission in China and the strategies to counter it. PMID:27052094

  19. [Yellow fever: study of an outbreak].

    PubMed

    Ribeiro, Mirtes; Antunes, Carlos Maurício de Figueiredo

    2009-01-01

    This study had the aim of describing an outbreak of yellow fever that occurred in the municipalities under the jurisdiction of the Regional Healthcare Administration of Diamantina, Minas Gerais, between 2002 and 2003, in which 36 cases were notified. This was an autochthonous outbreak of wild-type yellow fever. Failure of vaccinal coverage and low levels of detection of mild cases were found. Among the cases, 33 (91.7%) were male and the age range was from 16 to 67 years. Nineteen (52.8%) of the cases were classified as severe and 12 men (33.3%) died of the disease. All of the cases came from rural areas and presented fever, headache, vomiting, jaundice, myalgia, oliguria and signs of hemorrhage. Surveillance through laboratory tests was the determining factor in diagnosing the outbreak. By describing the epidemiological and clinic findings, this study contributes towards diagnosing and classifying this disease. It was deduced that there is a relationship between deforestation, and outbreaks, and that there is a potential regional risk of yellow fever because of the local development of tourism. PMID:19967234

  20. Yellow Fever Outbreak, Southern Sudan, 2003

    PubMed Central

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

    2004-01-01

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

  1. Epidemiological aspects of the 1969 yellow fever epidemic in Nigeria

    PubMed Central

    Carey, D. E.; Kemp, G. E.; Troup, J. M.; White, H. A.; Smith, E. A.; Addy, R. F.; Fom, A. L. M. D.; Pifer, J.; Jones, E. M.; Brès, P.; Shope, R. E.

    1972-01-01

    The Virus Research Laboratory of the University of Ibadan, Nigeria, was notified on 23 October 1969 that cases of suspected yellow fever had occurred in the Jos area. The diagnosis was confirmed by virus isolation and the existence of a widespread outbreak on the Jos Plateau and adjacent areas was established. This was the first recognized epidemic of yellow fever in Nigeria since 1953. Between September and the end of December 1969, an estimated total of 252 patients with yellow fever were hospitalized. The case—fatality ratio for hospitalized patients was approximately 40%. The diagnosis of yellow fever was confirmed by virus isolation, serology, or pathology in 55 patients. It is estimated that up to 100 000 cases of yellow fever may have occurred during the epidemic. PMID:4538037

  2. Assessing Yellow Fever Risk in the Ecuadorian Amazon

    PubMed Central

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

    2009-01-01

    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. PMID:20300380

  3. Marylanders defeat Philadelphia: yellow fever updated.

    PubMed Central

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

    1976-01-01

    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 PMID:822563

  4. History of Epidemiological Aspects of Yellow Fever

    PubMed Central

    Downs, Wilbur G.

    1982-01-01

    This review attempts to follow the trail of the development of epidemiological aspects and concepts of yellow fever and yellow fever transmission (vectors, vertebrate hosts, spacing of epidemic outbreaks) with less emphasis on well-documented early history and more emphasis on epidemiological problems still remaining, plus discussion of possible means of resolving certain of these problems. PMID:6758368

  5. A clinicopathological study of human yellow fever*

    PubMed Central

    Francis, T. I.; Moore, D. L.; Edington, G. M.; Smith, J. A.

    1972-01-01

    During an epidemic of yellow fever in the Jos Plateau area of Nigeria, 9 adult males with clinically diagnosed yellow fever were studied by haematological, biochemical, virological, serological, and liver biopsy methods. The ages of the patients ranged from 20 to 55 years and the duration of illness was 3-62 days. No virus was isolated from any patient but all patients should biochemical evidence of severe hepatocellular damage. Leucopenia was a feature of the late acute stage of the disease. Five sera had antibodies to yellow fever at titres greater than 1: 32, 3 of them being monospecific for yellow fever. The classical histological features of yellow fever were present only in the acute or late acute stages, when complement-fixation tests may be negative. With convalescence and the production of complement-fixing antibodies in high titres, the histological features resembled those of a persisting nonspecific hepatitis. In an endemic area, the histological features of yellow fever will depend on the stage of the disease and a picture of nonspecific hepatitis would not exclude yellow fever in the absence of confirmation from serological tests. ImagesFig. 1Fig. 2AFig. 2BFig. 3Fig. 4Fig. 5Fig. 6 PMID:4538039

  6. Present status of yellow fever: Memorandum from a PAHO Meeting*

    PubMed Central

    1986-01-01

    An international seminar on the treatment and laboratory diagnosis of yellow fever, sponsored by the Pan American Health Organization (PAHO) and held in 1984, differed from previous meetings on yellow fever because of its emphasis on the care and management of patients and because the participants included specialists from several branches of medicine, such as hepatology, haematology, cardiology, infectious diseases, pathology and nephrology. The meeting reviewed the current status of yellow fever and problems associated with case-finding and notification; features of yellow fever in individual countries of Latin America; health services and facilities for medical care as they relate to diagnosis and management of cases; prevention strategies for and current status of immunization programmes; clinical and pathological aspects of yellow fever in humans; pathogenesis and pathophysiology of yellow fever in experimental animal models; clinical and specific laboratory diagnosis; treatment of the disease and of complications in the functioning of individual organ systems; prognosis and prognostic indicators; and directions for future clinical and experimental research on pathophysiology and treatment. PMID:3490922

  7. Lost Trust: A Yellow Fever Patient Response

    PubMed Central

    Runge, John S.

    2013-01-01

    In the 19th century, yellow fever thrived in the tropical, urban trade centers along the American Gulf Coast. Industrializing and populated, New Orleans and Memphis made excellent habitats for the yellow fever-carrying Aedes aegypti mosquitoes and the virulence they imparted on their victims. Known for its jaundice and black, blood-filled vomit, the malady terrorized the region for decades, sometimes claiming tens of thousands of lives during the near annual summertime outbreaks. In response to the failing medical community, a small, pronounced population of sick and healthy laypeople openly criticized the efforts to rid the Gulf region of yellow jack. Utilizing newspapers and cartoons to vocalize their opinions, these critics doubted and mocked the medical community, contributing to the regional and seasonal dilemma yellow fever posed for the American South. These sentient expressions prove to be an early example of patient distrust toward caregivers, a current problem in clinical heath care. PMID:24348220

  8. Yellow fever vaccination in the Americas.

    PubMed

    1984-01-01

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

  9. Enzootic Transmission of Yellow Fever Virus, Venezuela

    PubMed Central

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

    2015-01-01

    Phylogenetic analysis of yellow fever virus (YFV) strains isolated from Venezuela strongly supports YFV maintenance in situ in Venezuela, with evidence of regionally independent evolution within the country. However, there is considerable YFV movement from Brazil to Venezuela and between Trinidad and Venezuela. PMID:25531105

  10. Investigation of a possible yellow fever epidemic and serosurvey for flavivirus infections in northern Cameroon, 1984

    PubMed Central

    Tsai, T. F.; Lazuick, J. S.; Ngah, R. W.; Mafiamba, P. C.; Quincke, G.; Monath, T. P.

    1987-01-01

    A cluster of fatal hepatitis cases in northern Cameroon in 1984 stimulated a field investigation to rule out an epidemic of yellow fever. A serosurvey of villages in the extreme north of the country, in a Sudan savanna (SS) phytogeographical zone, disclosed no evidence of recent yellow fever infection. However, further south, in a Guinea savanna (GS) phytogeographical zone, serological evidence was found of endemic yellow fever virus transmission. The results indicate a potential for epidemic spread of yellow fever virus from the southern GS zone to the nothern SS zone of Cameroon, where immunity in the population was low. PMID:3501739

  11. Yellow fever in Africa: public health impact and prospects for control in the 21st century.

    PubMed

    Tomori, Oyewale

    2002-06-01

    In the last two decades, yellow fever re-emerged with vehemence to constitute a major public health problem in Africa. The disease has brought untold hardship and indescribable misery among different populations in Africa. It is one of Africa's stumbling blocks to economic and social development. Despite landmark achievements made in the understanding of the epidemiology of yellow fever disease and the availability of a safe and efficacious vaccine, yellow fever remains a major public health problem in both Africa and America where the disease affects annually an estimated 200,000 persons causing an estimated 30,000 deaths. Africa contributes more than 90% of global yellow fever morbidity and mortality. Apart from the severity in morbidity and mortality, which are grossly under reported, successive outbreaks of yellow fever and control measures have disrupted existing health care delivery services, overstretched scarce internal resources, fatigued donor assistance and resulted in gross wastage of vaccines. Recent epidemics of yellow fever in Africa have affected predominantly children under the age of fifteen years. Yellow fever disease can be easily controlled. Two examples from Africa suffice to illustrate this point. Between 1939 and 1952, yellow fever virtually disappeared in parts of Africa, where a systematic mass vaccination programme was in place. More recently, following the 1978-1979 yellow fever epidemic in the Gambia, a mass yellow fever vaccination programme was carried out, with a 97% coverage of the population over 6 months of age. Subsequently, yellow fever vaccination was added to the EPI Programme. The Gambia has since then maintained a coverage of over 80%, without a reported case of yellow fever, despite being surrounded by Senegal which experienced yellow fever outbreaks in 1995 and 1996. The resurgence of yellow fever in Africa and failure to control the disease has resulted from a combination of several factors, including: 1) collapse of

  12. Yellow Fever Outbreak, Imatong, Southern Sudan

    PubMed Central

    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.

    2004-01-01

    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

  13. Persistent seropositivity for yellow fever in a previously vaccinated autologous hematopoietic stem cell transplantation recipient.

    PubMed

    Hayakawa, Kayoko; Takasaki, Tomohiko; Tsunemine, Hiroko; Kanagawa, Shuzo; Kutsuna, Satoshi; Takeshita, Nozomi; Mawatari, Momoko; Fujiya, Yoshihiro; Yamamoto, Kei; Ohmagari, Norio; Kato, Yasuyuki

    2015-08-01

    The duration of a protective level of yellow fever antibodies after autologous hematopoietic stem cell transplantation in a previously vaccinated person is unclear. The case of a patient who had previously been vaccinated for yellow fever and who remained seropositive for 22 months after autologous peripheral blood stem cell transplantation for malignant lymphoma is described herein. PMID:26068870

  14. Yellow Fever Remains a Potential Threat to Public Health.

    PubMed

    Vasconcelos, Pedro F C; Monath, Thomas P

    2016-08-01

    Yellow fever (YF) remains a serious public health threat in endemic countries. The recent re-emergence in Africa, initiating in Angola and spreading to Democratic Republic of Congo and Uganda, with imported cases in China and Kenya is of concern. There is such a shortage of YF vaccine in the world that the World Health Organization has proposed the use of reduced doses (1/5) during emergencies. In this short communication, we discuss these and other problems including the risk of spread of YF to areas free of YF for decades or never before affected by this arbovirus disease. PMID:27400066

  15. 42 CFR 71.3 - Designation of yellow fever vaccination centers; Validation stamps.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Designation of yellow fever vaccination centers... Designation of yellow fever vaccination centers; Validation stamps. (a) Designation of yellow fever vaccination centers. (1) The Director is responsible for the designation of yellow fever vaccination...

  16. 42 CFR 71.3 - Designation of yellow fever vaccination centers; Validation stamps.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Designation of yellow fever vaccination centers... Designation of yellow fever vaccination centers; Validation stamps. (a) Designation of yellow fever vaccination centers. (1) The Director is responsible for the designation of yellow fever vaccination...

  17. 42 CFR 71.3 - Designation of yellow fever vaccination centers; Validation stamps.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Designation of yellow fever vaccination centers... Designation of yellow fever vaccination centers; Validation stamps. (a) Designation of yellow fever vaccination centers. (1) The Director is responsible for the designation of yellow fever vaccination...

  18. Advances and controversies in yellow fever vaccination.

    PubMed

    Jonker, Emile F F; Visser, Leonardus G; Roukens, Anna H

    2013-11-01

    Ever since its development in 1937, the live-attenuated 17D yellow fever (YF) vaccine has been one of the most effective vaccines available to man. In this review we highlight the major steps in the development of 17D YF vaccine. We discuss the use of neutralizing antibodies as a surrogate marker for protection, and explore the strengths and weaknesses of the current plaque reduction neutralization test (PRNT), a technique developed in the 1960s that continues to be superior to every modern test in both sensitivity and specificity. The neutralizing antibodies demonstrated by the PRNT can be detected for several decades after vaccination, possibly even for the remainder of the recipient's natural life. We review the available evidence on the duration of protection after primary vaccination, a topic that has been the subject of controversy over the last few months. For persons who are immunocompromised due to disease, medication or advancing age, the duration of protection may be shorter: they should always have their vaccine response checked by PRNT. Due to the higher risk of severe adverse events after vaccination with 17D YF in this group, the development of a new, inactivated vaccine will have substantial benefits in this population. PMID:24757521

  19. Yellow fever, Asia and the East African slave trade.

    PubMed

    Cathey, John T; Marr, John S

    2014-05-01

    Yellow fever is endemic in parts of sub-Saharan Africa and South America, yet its principal vectors--species of mosquito of the genus Aedes--are found throughout tropical and subtropical latitudes. Phylogenetic analyses indicate that yellow fever originated in Africa and that its spread to the New World coincided with the slave trade, but why yellow fever has never appeared in Asia remains a mystery. None of several previously proposed explanations for its absence there is considered satisfactory. We contrast the trans-Atlantic slave trade, and trade across the Sahara and to the Arabian Peninsula and Mesopotamia, with that to Far East and Southeast Asian ports before abolition of the African slave trade, and before the scientific community understood the transmission vector of yellow fever and the viral life cycle, and the need for shipboard mosquito control. We propose that these differences in slave trading had a primary role in the avoidance of yellow fever transmission into Asia in the centuries before the 20(th) century. The relatively small volume of the Black African slave trade between Africa and East and Southeast Asia has heretofore been largely ignored. Although focal epidemics may have occurred, the volume was insufficient to reach the threshold for endemicity. PMID:24743951

  20. The Global Distribution of Yellow Fever and Dengue

    PubMed Central

    Rogers, D.J.; Wilson, A.J.; Hay, S.I.; Graham, A.J.

    2011-01-01

    Yellow fever has been subjected to partial control for decades, but there are signs that case numbers are now increasing globally, with the risk of local epidemic outbreaks. Dengue case numbers have also increased dramatically during the past 40 years and different serotypes have invaded new geographical areas. Despite the temporal changes in these closely related diseases, and their enormous public health impact, few attempts have been made to collect a comprehensive dataset of their spatial and temporal distributions. For this review, records of the occurrence of both diseases during the 20th century have been collected together and are used to define their climatic limits using remotely sensed satellite data within a discriminant analytical model framework. The resulting risk maps for these two diseases identify their different environmental requirements, and throw some light on their potential for co-occurrence in Africa and South East Asia. PMID:16647971

  1. Current status and future prospects of yellow fever vaccines.

    PubMed

    Beck, Andrew S; Barrett, Alan D T

    2015-11-01

    Yellow fever 17D vaccine is one of the oldest live-attenuated vaccines in current use that is recognized historically for its immunogenic and safe properties. These unique properties of 17D are presently exploited in rationally designed recombinant vaccines targeting not only flaviviral antigens but also other pathogens of public health concern. Several candidate vaccines based on 17D have advanced to human trials, and a chimeric recombinant Japanese encephalitis vaccine utilizing the 17D backbone has been licensed. The mechanism(s) of attenuation for 17D are poorly understood; however, recent insights from large in silico studies have indicated particular host genetic determinants contributing to the immune response to the vaccine, which presumably influences the considerable durability of protection, now in many cases considered to be lifelong. The very rare occurrence of severe adverse events for 17D is discussed, including a recent fatal case of vaccine-associated viscerotropic disease. PMID:26366673

  2. Genomic and Phylogenetic Characterization of Brazilian Yellow Fever Virus Strains

    PubMed Central

    Palacios, Gustavo; Cardoso, Jedson F.; Martins, Livia C.; Sousa, Edivaldo C.; de Lima, Clayton P. S.; Medeiros, Daniele B. A.; Savji, Nazir; Desai, Aaloki; Rodrigues, Sueli G.; Carvalho, Valeria L.; Lipkin, W. Ian

    2012-01-01

    Globally, yellow fever virus infects nearly 200,000 people, leading to 30,000 deaths annually. Although the virus is endemic to Latin America, only a single genome from this region has been sequenced. Here, we report 12 Brazilian yellow fever virus complete genomes, their genetic traits, phylogenetic characterization, and phylogeographic dynamics. Variable 3′ noncoding region (3′NCR) patterns and specific mutations throughout the open reading frame altered predicted secondary structures. Our findings suggest that whereas the introduction of yellow fever virus in Brazil led to genotype I-predominant dispersal throughout South and Central Americas, genotype II remained confined to Bolivia, Peru, and the western Brazilian Amazon. PMID:23015713

  3. Yellow fever vaccine: worthy friend or stealthy foe?

    PubMed

    Seligman, Stephen J; Casanova, Jean-Laurent

    2016-06-01

    Recognition that the live yellow fever vaccine may rarely be associated with viscerotropic disease (YEL-AVD) has diminished its safety status. However, the vaccine remains the principal tool for limiting the occurrence of yellow fever, making large portions of Africa and South America more habitable. The subject has previously been exhaustively reviewed. Novel concepts in the current report include the description of a systematic method for deciding whom to vaccinate, recommendations for obtaining data helpful in making that decision, and suggestions for additional study. The vaccine is indeed a worthy friend, but its adverse reactions need to be recognized. PMID:27087465

  4. 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

  5. Serious adverse events associated with yellow fever vaccine

    PubMed Central

    de Menezes Martins, Reinaldo; da Luz Fernandes Leal, Maria; Homma, Akira

    2015-01-01

    Yellow fever vaccine was considered one of the safest vaccines, but in recent years it was found that it could rarely cause invasive and disseminated disease in some otherwise healthy individuals, with high lethality. After extensive studies, although some risk factors have been identified, the real cause of causes of this serious adverse event are largely unknown, but findings point to individual host factors. Meningoencephalitis, once considered to happen only in children less than 6 months of age, has also been identified in older children and adults, but with good prognosis. Efforts are being made to develop a safer yellow fever vaccine, and an inactivated vaccine or a vaccine prepared with the vaccine virus envelope produced in plants are being tested. Even with serious and rare adverse events, yellow fever vaccine is the best way to avoid yellow fever, a disease of high lethality and should be used routinely in endemic areas, and on people from non-endemic areas that could be exposed, according to a careful risk-benefit analysis. PMID:26090855

  6. Suspected YF-AND after yellow fever vaccination in Finland.

    PubMed

    Jääskeläinen, Anne J; Huhtamo, Eili; Kivioja, Reetta; Domingo, Cristina; Vene, Sirkka; Kallio-Kokko, Hannimari; Niedrig, Matthias; Tienari, Pentti J; Vapalahti, Olli

    2014-11-01

    Yellow fever (YF) vaccine is considered safe but vaccine-associated complications have also been encountered. We report neurological symptoms after YF-vaccination in a previously healthy Finnish male. Other concomitant infections or causes for the symptoms could not be identified. PMID:25223921

  7. [Cycles of German yellow fever research in the first half of the 20th century: protagonists and interests].

    PubMed

    Hinz-Wessels, Annette

    2008-01-01

    This article examines for the case of yellow fever research in Germany in the first half of the 20th century how political and military conditions affected the interests of scientific research. As a tropical disease, yellow fever was unknown in Germany and very rare in the German colonies and thus of little scientific or political interest. But this changed once the National Socialists began pursuing their wars of conquest. In preparation for a new colonial empire and a military mission in Africa, yellow fever research became increasingly important. The chief beneficiary of this development was the Robert Koch-Institute in Berlin, where Eugen Haagen worked after his time as a researcher in the Yellow Fever Laboratory in New York. In collaboration with the army and the industry, he used human experiments in his efforts to develop a vaccine for mass production. Ultimately, the vaccine's application was prevented by the German surrender in North Africa. PMID:19137979

  8. Yellow fever risk assessment in the Central African Republic

    PubMed Central

    Staples, J. Erin; Diallo, Mawlouth; Janusz, Kristen B.; Manengu, Casimir; Lewis, Rosamund F.; Perea, William; Yactayo, Sergio; Sall, Amadou A.

    2015-01-01

    Background Starting in 2008, the Central African Republic (CAR) experienced an unprecedented number of reported yellow fever (YF) cases. A risk assessment of YF virus (YFV) activity was conducted to estimate potential disease risk and vaccine needs. Methods A multistage cluster sampling design was used to sample humans, non-human primates, and mosquitoes in distinct ecologic zones. Humans and non-human primates were tested for YFV-specific antibodies; mosquitoes were tested for YFV RNA. Results Overall, 13.3% (125/938) of humans were found to have naturally-acquired YFV antibodies. Antibody levels were higher in zones in the southern and south central regions of CAR. All sampled non-human primates (n=56) were known YFV reservoirs; one tested positive for YFV antibodies. Several known YF vectors were identified including Aedes africanus, Ae. aegypti, Ae. luteocephalus, and Ae. simpsoni. Several more urban locations were found to have elevated Breateau and Container indices for Ae. aegypti. Conclusions A country-wide assessment of YF risk found YFV to be endemic in CAR. The potential for future YF cases and outbreaks, however, varied by ecologic zone. Improved vaccination coverage through mass campaign and childhood immunization was recommended to mitigate the YF risk. PMID:24947520

  9. A regional reconnaissance on yellow fever in the Sudan

    PubMed Central

    Taylor, R. M.; Haseeb, M. A.; Work, T. H.

    1955-01-01

    Neutralization-tests with yellow fever virus performed on 666 human sera collected in the southern Sudan imply that yellow fever is still endemic south of the 10th parallel, in the south-west border of the Nuba Mountains, and in the plains west of the Nuba Mountains as far north as El Muglad. Similar tests on bloods from 110 primates revealed a high rate of immunity among both baboons (Papio sp.) (94%) and grivet monkeys (Cercopithecus aethiops) (77%), and a very low rate (1 in 56) among galagos (Galago senegalensis). It would therefore appear that, in contrast to the baboon and the grivet monkey, the galago is not significantly involved in the cycle of the virus. The epidemiological implications of these findings are discussed. PMID:14379007

  10. Protective and immunological behavior of chimeric yellow fever dengue vaccine.

    PubMed

    Halstead, Scott B; Russell, Philip K

    2016-03-29

    Clinical observations from the third year of the Sanofi Pasteur chimeric yellow fever dengue tetravalent vaccine (CYD) trials document both protection and vaccination-enhanced dengue disease among vaccine recipients. Children who were 5 years-old or younger when vaccinated experienced a DENV disease resulting in hospitalization at 5 times the rate of controls. On closer inspection, hospitalized cases among vaccinated seropositives, those at highest risk to hospitalized disease accompanying a dengue virus (DENV) infection, were greatly reduced by vaccination. But, seronegative individuals of all ages after being vaccinated were only modestly protected from mild to moderate disease throughout the entire observation period despite developing neutralizing antibodies at high rates. Applying a simple epidemiological model to the data, vaccinated seronegative individuals of all ages were at increased risk of developing hospitalized disease during a subsequent wild type DENV infection. The etiology of disease in placebo and vaccinated children resulting in hospitalization during a DENV infection, while clinically similar are of different origin. The implications of the observed mixture of DENV protection and enhanced disease in CYD vaccinees are discussed. PMID:26873054

  11. Yellow Fever Vaccine Booster Doses: Recommendations of the Advisory Committee on Immunization Practices, 2015.

    PubMed

    Staples, J Erin; Bocchini, Joseph A; Rubin, Lorry; Fischer, Marc

    2015-06-19

    On February 26, 2015, the Advisory Committee on Immunization Practices (ACIP) voted that a single primary dose of yellow fever vaccine provides long-lasting protection and is adequate for most travelers. ACIP also approved recommendations for at-risk laboratory personnel and certain travelers to receive additional doses of yellow fever vaccine (Box). The ACIP Japanese Encephalitis and Yellow Fever Vaccines Workgroup evaluated published and unpublished data on yellow fever vaccine immunogenicity and safety. The evidence for benefits and risks associated with yellow fever vaccine booster doses was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. This report summarizes the evidence considered by ACIP and provides the updated recommendations for yellow fever vaccine booster doses. PMID:26086636

  12. 42 CFR 71.3 - Designation of yellow fever vaccination centers; Validation stamps.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...; Validation stamps. 71.3 Section 71.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... Designation of yellow fever vaccination centers; Validation stamps. (a) Designation of yellow fever... health department, may revoke designation. (b) Validation stamps. International Certificates...

  13. 42 CFR 71.3 - Designation of yellow fever vaccination centers; Validation stamps.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...; Validation stamps. 71.3 Section 71.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... Designation of yellow fever vaccination centers; Validation stamps. (a) Designation of yellow fever... health department, may revoke designation. (b) Validation stamps. International Certificates...

  14. Yellow Fever in Africa: Estimating the Burden of Disease and Impact of Mass Vaccination from Outbreak and Serological Data

    PubMed Central

    Garske, Tini; Van Kerkhove, Maria D.; Yactayo, Sergio; Ronveaux, Olivier; Lewis, Rosamund F.; Staples, J. Erin; Perea, William; Ferguson, Neil M.

    2014-01-01

    Background Yellow fever is a vector-borne disease affecting humans and non-human primates in tropical areas of Africa and South America. While eradication is not feasible due to the wildlife reservoir, large scale vaccination activities in Africa during the 1940s to 1960s reduced yellow fever incidence for several decades. However, after a period of low vaccination coverage, yellow fever has resurged in the continent. Since 2006 there has been substantial funding for large preventive mass vaccination campaigns in the most affected countries in Africa to curb the rising burden of disease and control future outbreaks. Contemporary estimates of the yellow fever disease burden are lacking, and the present study aimed to update the previous estimates on the basis of more recent yellow fever occurrence data and improved estimation methods. Methods and Findings Generalised linear regression models were fitted to a dataset of the locations of yellow fever outbreaks within the last 25 years to estimate the probability of outbreak reports across the endemic zone. Environmental variables and indicators for the surveillance quality in the affected countries were used as covariates. By comparing probabilities of outbreak reports estimated in the regression with the force of infection estimated for a limited set of locations for which serological surveys were available, the detection probability per case and the force of infection were estimated across the endemic zone. The yellow fever burden in Africa was estimated for the year 2013 as 130,000 (95% CI 51,000–380,000) cases with fever and jaundice or haemorrhage including 78,000 (95% CI 19,000–180,000) deaths, taking into account the current level of vaccination coverage. The impact of the recent mass vaccination campaigns was assessed by evaluating the difference between the estimates obtained for the current vaccination coverage and for a hypothetical scenario excluding these vaccination campaigns. Vaccination campaigns

  15. Nucleotide sequence variation of the envelope protein gene identifies two distinct genotypes of yellow fever virus.

    PubMed Central

    Chang, G J; Cropp, B C; Kinney, R M; Trent, D W; Gubler, D J

    1995-01-01

    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 and Central Africa. E genotype II viruses were divided into two sublineages: IIA viruses from West Africa and IIB viruses from America, except for a 1979 virus isolated from Trinidad (TRINID79A). Unique signature patterns were identified at 111 nucleotide and 12 amino acid positions within the yellow fever virus E gene by signature pattern analysis. Yellow fever viruses from East and Central Africa contained unique signatures at 60 nucleotide and five amino acid positions, those from West Africa contained unique signatures at 25 nucleotide and two amino acid positions, and viruses from America contained such signatures at 30 nucleotide and five amino acid positions in the E gene. The dissemination of yellow fever viruses from Africa to the Americas is supported by the close genetic relatedness of genotype IIA and IIB viruses and genetic evidence of a possible second introduction of yellow fever virus from West Africa, as illustrated by the TRINID79A virus isolate. The E protein genes of American IIB yellow fever viruses had higher frequencies of amino acid substitutions than did genes of yellow fever viruses of genotypes I and IIA on the basis of comparisons with a consensus amino acid sequence for the yellow fever E gene. The great variation in the E proteins of American yellow fever virus probably results from positive selection imposed by virus interaction with different species of mosquitoes or nonhuman primates in the Americas. PMID:7637022

  16. Structure of Yellow Fever Virus Envelope Protein Domain III

    PubMed Central

    Volk, David E.; May, Fiona J.; Gandham, Sai H. A.; Anderson, Anjenique; Von Lindern, Jana J.; Beasley, David W. C.; Barrett, Alan D. T.; Gorenstein, David G.

    2009-01-01

    The structure of recombinant domain III of the envelope protein (rED3) of yellow fever virus (YFV), containing the major neutralization site, was determined using NMR spectroscopy. The amino acid sequence and structure of the YFV-rED3 shows differences from ED3s of other mosquito-borne flaviviruses; in particular, the partially surface-exposed BC loop where methionine-304 and valine-324 were identified as being critical for the structure of the loop. Variations in the structure and surface chemistry of ED3 between flaviviruses affect neutralization sites and may affect host cell receptor interactions and play a role in the observed variations in viral pathogenesis and tissue tropism. PMID:19818466

  17. Seroprevalence of yellow fever virus in selected health facilities in Western Kenya from 2010 to 2012.

    PubMed

    Kwallah, Allan ole; Inoue, Shingo; Thairu-Muigai, Anne Wangari; Kuttoh, Nancy; Morita, Kouichi; Mwau, Matilu

    2015-01-01

    Yellow fever (YF), which is caused by a mosquito-borne virus, is an important viral hemorrhagic fever endemic in equatorial Africa and South America. Yellow fever virus (YFV) is the prototype of the family Flaviviridae and genus Flavivirus. The aim of this study was to determine the seroprevalence of YFV in selected health facilities in Western Kenya during the period 2010-2012. A total of 469 serum samples from febrile patients were tested for YFV antibodies using in-house IgM-capture ELISA, in-house indirect IgG ELISA, and 50% focus reduction neutralization test (FRNT50). The present study did not identify any IgM ELISA-positive cases, indicating absence of recent YFV infection in the area. Twenty-eight samples (6%) tested positive for YFV IgG, because of either YFV vaccination or past exposure to various flaviviruses including YFV. Five cases were confirmed by FRNT50; of these, 4 were either vaccination or natural infection during the YF outbreak in 1992-1993 or another period and 1 case was confirmed as a West Nile virus infection. Domestication and routine performance of arboviral differential diagnosis will help to address the phenomenon of pyrexia of unknown origin, contribute to arboviral research in developing countries, and enhance regular surveillance. PMID:25672346

  18. [Yellow fever vaccination in non-immunocompetent patients].

    PubMed

    Bruyand, M; Receveur, M C; Pistone, T; Verdière, C H; Thiebaut, R; Malvy, D

    2008-10-01

    Any person travelling in countries where yellow fever (YF) is endemic and without presenting contra-indication for the vaccination against YF may be vaccinated. This vaccination can very rarely induce a potentially lethal neurotropic or viscerotropic disease. In severely immunodeficient patients, the vaccination is contra-indicated because postvaccinal encephalitis may occur after the vaccination, due to vaccine strain pathogenecity. It is important to evaluate the general health status in elderly individuals before vaccinating because of the increased risk of viscerotropic disease in people of 60 years of age and over. Pregnant women should not be vaccinated, except if departure to an endemic zone is unavoidable. YF vaccinatio is contra-indicated for newborns under six months of age. Solid organ grafts, congenital immunodeficiency, leukemia, lymphoma, cancer, and immunosuppressive treatments are contra-indications for this vaccination. Nevertheless, YF immunization is possible after a bone marrow graft and a two-year period without graft-versus-host disease or immunosuppressive treatment. There is no data to support that immunization of the dono prior to the graft could confer protection against yellow fever to the recipient. Low doses, short courses of corticosteroids either as systemic treatment or intra-articular injections are not contra-indications for YF vaccination. Patients infected with HIV with stable clinical status and T CD4-cel count above 200 cells per millimetre cube may be vaccinated. Thymic diseases, including thymoma and thymectomy, are contra-indications for YF vaccination. Finally, a substantial residual level of antibodies beyond 10 years after the latest vaccination could confer protection, thus avoiding a new vaccination when it is an issue. PMID:18715730

  19. Risk groups for yellow fever vaccine-associated viscerotropic disease (YEL-AVD).

    PubMed

    Seligman, Stephen J

    2014-10-01

    Although previously considered as the safest of the live virus vaccines, reports published since 2001 indicate that live yellow fever virus vaccine can cause a severe, often fatal, multisystemic illness, yellow fever vaccine-associated viscerotropic disease (YEL-AVD), that resembles the disease it was designed to prevent. This review was prompted by the availability of a listing of the cumulative cases of YEL-AVD, insights from a statistical method for analyzing risk factors and re-evaluation of previously published data. The purpose of this review is to identify and analyze risk groups based on gender, age, outcome and predisposing illnesses. Using a passive surveillance system in the US, the incidence was reported as 0.3 to 0.4 cases per 100,000. However, other estimates range from 0 to 12 per 100,000. Identified and potential risk groups for YEL-AVD include elderly males, women between the ages of 19 and 34, people with a variety of autoimmune diseases, individuals who have been thymectomized because of thymoma, and infants and children ≤11 years old. All but the last group are supported by statistical analysis. The confirmed risk groups account for 77% (49/64) of known cases and 76% (32/42) of the deaths. The overall case fatality rate is 66% (42/64) with a rate of 80% (12/15) in young women, in contrast to 50% (13/26) in men ≥56 years old. Recognition of YEL-AVD raises the possibility that similar reactions to live chimeric flavivirus vaccines that contain a yellow fever virus vaccine backbone could occur in susceptible individuals. Delineation of risk groups focuses the search for genetic mutations resulting in immune defects associated with a given risk group. Lastly, identification of risk groups encourages concentration on measures to decrease both the incidence and the severity of YEL-AVD. PMID:25192973

  20. Occurrence of Autoimmune Diseases Related to the Vaccine against Yellow Fever

    PubMed Central

    Oliveira, Ana Cristina Vanderley; Maria Henrique da Mota, Licia; dos Santos-Neto, Leopoldo Luiz; De Carvalho, Jozélio Freire; Caldas, Iramaya Rodrigues; Martins Filho, Olindo Assis; Tauil, Pedro Luis

    2014-01-01

    Yellow fever is an infectious disease, endemic in South America and Africa. This is a potentially serious illness, with lethality between 5 and 40% of cases. The most effective preventive vaccine is constituted by the attenuated virus strain 17D, developed in 1937. It is considered safe and effective, conferring protection in more than 90% in 10 years. Adverse effects are known as mild reactions (allergies, transaminases transient elevation, fever, headache) and severe (visceral and neurotropic disease related to vaccine). However, little is known about its potential to induce autoimmune responses. This systematic review aims to identify the occurrence of autoinflammatory diseases related to 17D vaccine administration. Six studies were identified describing 13 possible cases. The diseases were Guillain-Barré syndrome, multiple sclerosis, multiple points evanescent syndrome, acute disseminated encephalomyelitis, autoimmune hepatitis, and Kawasaki disease. The data suggest that 17D vaccination may play a role in the mechanism of loss of self-tolerance. PMID:25405025

  1. Occurrence of Autoimmune Diseases Related to the Vaccine against Yellow Fever.

    PubMed

    Oliveira, Ana Cristina Vanderley; Maria Henrique da Mota, Licia; Dos Santos-Neto, Leopoldo Luiz; De Carvalho, Jozélio Freire; Caldas, Iramaya Rodrigues; Martins Filho, Olindo Assis; Tauil, Pedro Luis

    2014-01-01

    Yellow fever is an infectious disease, endemic in South America and Africa. This is a potentially serious illness, with lethality between 5 and 40% of cases. The most effective preventive vaccine is constituted by the attenuated virus strain 17D, developed in 1937. It is considered safe and effective, conferring protection in more than 90% in 10 years. Adverse effects are known as mild reactions (allergies, transaminases transient elevation, fever, headache) and severe (visceral and neurotropic disease related to vaccine). However, little is known about its potential to induce autoimmune responses. This systematic review aims to identify the occurrence of autoinflammatory diseases related to 17D vaccine administration. Six studies were identified describing 13 possible cases. The diseases were Guillain-Barré syndrome, multiple sclerosis, multiple points evanescent syndrome, acute disseminated encephalomyelitis, autoimmune hepatitis, and Kawasaki disease. The data suggest that 17D vaccination may play a role in the mechanism of loss of self-tolerance. PMID:25405025

  2. Persistence of Yellow Fever vaccine-induced antibodies after cord blood stem cell transplant.

    PubMed

    Avelino-Silva, Vivian Iida; Freire, Marcos da Silva; Rocha, Vanderson; Rodrigues, Celso Arrais; Novis, Yana Sarkis; Sabino, Ester C; Kallas, Esper Georges

    2016-04-01

    We report the case of a cord blood haematopoietic stem cell transplant recipient who was vaccinated for Yellow Fever (YF) 7 days before initiating chemotherapy and had persistent YF antibodies more than 3 years after vaccination. Since the stem cell donor was never exposed to wild YF or to the YF vaccine, and our patient was not exposed to YF or revaccinated, this finding strongly suggests the persistence of recipient immunity. We briefly discuss potential consequences of incomplete elimination of recipient's leukocytes following existing haematopoietic cancer treatments. PMID:26618995

  3. Using Local History To Understand National Themes: The Yellow Fever Epidemic in Philadelphia in 1793.

    ERIC Educational Resources Information Center

    Westbury, Susan

    2003-01-01

    Provides background information for a local history project about the 1793 Philadelphia (Pennsylvania) yellow fever outbreak. Offers potential project topics to help students learn about local history and understand life in the eighteenth century United States. (CMK)

  4. Intriguing olfactory proteins from the yellow fever mosquito, Aedes aegypti

    NASA Astrophysics Data System (ADS)

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

    2004-09-01

    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 α2-helix. As indicated by circular dichroism (CD) spectra, the extra rigidity seems to prevent the predicted formation of a C-terminal α-helix at low pH.

  5. Equilibrium Analysis of a Yellow Fever Dynamical Model with Vaccination

    PubMed Central

    Martorano Raimundo, Silvia

    2015-01-01

    We propose an equilibrium analysis of a dynamical model of yellow fever transmission in the presence of a vaccine. The model considers both human and vector populations. We found thresholds parameters that affect the development of the disease and the infectious status of the human population in the presence of a vaccine whose protection may wane over time. In particular, we derived a threshold vaccination rate, above which the disease would be eradicated from the human population. We show that if the mortality rate of the mosquitoes is greater than a given threshold, then the disease is naturally (without intervention) eradicated from the population. In contrast, if the mortality rate of the mosquitoes is less than that threshold, then the disease is eradicated from the populations only when the growing rate of humans is less than another threshold; otherwise, the disease is eradicated only if the reproduction number of the infection after vaccination is less than 1. When this reproduction number is greater than 1, the disease will be eradicated from the human population if the vaccination rate is greater than a given threshold; otherwise, the disease will establish itself among humans, reaching a stable endemic equilibrium. The analysis presented in this paper can be useful, both to the better understanding of the disease dynamics and also for the planning of vaccination strategies. PMID:25834634

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

    PubMed Central

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

    2001-01-01

    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. PMID:11731813

  7. Yellow fever vaccination coverage following massive emergency immunization campaigns in rural Uganda, May 2011: a community cluster survey

    PubMed Central

    2013-01-01

    desired minimum threshold coverage of 80% according to World Health Organization. Massive emergency vaccination done following an outbreak of Yellow fever achieved high population coverage in Pader district. Active surveillance is necessary for early detection of yellow fever cases. PMID:23497254

  8. Animal models of yellow fever and their application in clinical research.

    PubMed

    Julander, Justin G

    2016-06-01

    Yellow fever virus (YFV) is an arbovirus that causes significant human morbidity and mortality. This virus has been studied intensively over the past century, although there are still no treatment options for those who become infected. Periodic and unpredictable yellow fever (YF) outbreaks in Africa and South America continue to occur and underscore the ongoing need to further understand this viral disease and to develop additional countermeasures to prevent or treat cases of illness. The use of animal models of YF is critical to accomplishing this goal. There are several animal models of YF that replicate various aspects of clinical disease and have provided insight into pathogenic mechanisms of the virus. These typically include mice, hamsters and non-human primates (NHP). The utilities and shortcomings of the available animal models of YF are discussed. Information on recent discoveries that have been made in the field of YFV research is also included as well as important future directions in further ameliorating the morbidity and mortality that occur as a result of YFV infection. It is anticipated that these model systems will help facilitate further improvements in the understanding of this virus and in furthering countermeasures to prevent or treat infections. PMID:27093699

  9. The 1802 Saint-Domingue yellow fever epidemic and the Louisiana Purchase.

    PubMed

    Marr, John S; Cathey, John T

    2013-01-01

    Epidemics have been pivotal in the history of the world as exemplified by a yellow fever epidemic in the Caribbean that clearly altered New World geopolitics. By the end of the 18th century, yellow fever--then an "emerging disease"--was widespread throughout the Caribbean and particularly lethal in Saint-Domingue (present day Haiti). From 1793 to 1798, case fatality rates among British troops in the West Indies (including Saint-Domingue) were as high as 70%. A worse fate befell newly arrived French armed forces in 1802, ostensibly sent by Napoleon to suppress a rebellion and to reestablish slavery. Historians have disagreed on why Napoleon initially dispatched nearly 30,000 soldiers and sailors to the island. Evidence suggests the troops were actually an expeditionary force with intensions to invade North America through New Orleans and to establish a major holding in the Mississippi valley. However, lacking knowledge of basic prevention and control measures, mortality from the disease left only a small and shattered fraction of his troops alive, thwarting his secret ambition to colonize and hold French-held lands, which later became better known as the Louisiana Purchase. If an event of the magnitude of France's experience were to occur in the 21st century, it might also have profound unanticipated consequences. PMID:23169407

  10. Functional characterization of aquaporins and aquaglyceroporins of the yellow fever mosquito, Aedes aegypti

    PubMed Central

    Drake, Lisa L.; Rodriguez, Stacy D.; Hansen, Immo A.

    2015-01-01

    After taking vertebrate blood, female mosquitoes quickly shed excess water and ions while retaining and concentrating the mostly proteinaceous nutrients. Aquaporins (AQPs) are an evolutionary conserved family of membrane transporter proteins that regulate the flow of water and in some cases glycerol and other small molecules across cellular membranes. In a previous study, we found six putative AQP genes in the genome of the yellow fever mosquito, Ae. aegypti, and demonstrated the involvement of three of them in the blood meal-induced diuresis. Here we characterized AQP expression in different tissues before and after a blood meal, explored the substrate specificity of AQPs expressed in the Malpighian tubules and performed RNAi-mediated knockdown and tested for changes in mosquito desiccation resistance. We found that AQPs are generally down-regulated 24 hrs after a blood meal. Ae. aegypti AQP 1 strictly transports water, AQP 2 and 5 demonstrate limited solute transport, but primarily function as water transporters. AQP 4 is an aquaglyceroporin with multiple substrates. Knockdown of AQPs expressed in the MTs increased survival of Ae. aegypti under dry conditions. We conclude that Malpighian tubules of adult female yellow fever mosquitoes utilize three distinct AQPs and one aquaglyceroporin in their osmoregulatory functions. PMID:25589229

  11. Advanced Yellow Fever Virus Genome Detection in Point-of-Care Facilities and Reference Laboratories

    PubMed Central

    Patel, Pranav; Yillah, Jasmin; Weidmann, Manfred; Méndez, Jairo A.; Nakouné, Emmanuel Rivalyn; Niedrig, Matthias

    2012-01-01

    Reported methods for the detection of the yellow fever viral genome are beset by limitations in sensitivity, specificity, strain detection spectra, and suitability to laboratories with simple infrastructure in areas of endemicity. We describe the development of two different approaches affording sensitive and specific detection of the yellow fever genome: a real-time reverse transcription-quantitative PCR (RT-qPCR) and an isothermal protocol employing the same primer-probe set but based on helicase-dependent amplification technology (RT-tHDA). Both assays were evaluated using yellow fever cell culture supernatants as well as spiked and clinical samples. We demonstrate reliable detection by both assays of different strains of yellow fever virus with improved sensitivity and specificity. The RT-qPCR assay is a powerful tool for reference or diagnostic laboratories with real-time PCR capability, while the isothermal RT-tHDA assay represents a useful alternative to earlier amplification techniques for the molecular diagnosis of yellow fever by field or point-of-care laboratories. PMID:23052311

  12. Inadvertent yellow fever vaccination of a patient with Crohn's disease treated with infliximab and methotrexate.

    PubMed

    Ekenberg, Christina; Friis-Møller, Nina; Ulstrup, Thomas; Aalykke, Claus

    2016-01-01

    We present a case of a 56-year-old woman with Crohn's disease, treated with methotrexate and infliximab, who inadvertently received yellow fever vaccination (YFV) prior to a journey to Tanzania. She was not previously vaccinated against YF. YFV contains live-attenuated virus, and is contraindicated in patients treated with immunosuppressive drugs. Following vaccination, the patient fell ill with influenza-like illness. Elevated transaminase levels and YF viremia were detected. Despite being immunocompromised, the patient did not develop more severe adverse effects. Neutralising antibodies to YF virus were detected on day 14 following vaccination and remained protective at least 10 months after vaccination. Limited data is available on outcomes of YFV in patients receiving immunosuppressive therapy, including biologics, and we report this case as a reminder of vigilance of vaccine recommendations in this population. PMID:27571912

  13. [The epidemiology of yellow fever in Western Africa].

    PubMed

    Cordellier, R

    1991-01-01

    Observations made during the epidemics in Côte d'Ivoire (1982), Burkina Faso (1983), Nigeria (1986 and 1987) and Mali (1987), together with studies conducted in the last 10 years, particularly in Côte d'Ivoire, now make it possible, without calling into question the dynamics of yellow fever virus circulation in space and time, to redefine some features of the pattern suggested in 1977 and refined on a number of occasions up to 1983. The endemicity area is still the region of epizootic and enzootic sylvatic circulation, and contains the natural focus and the endemic emergence zone. --The natural focus is no longer confined to the forest alone, now that transovarial transmission has been demonstrated. --The endemic emergence zone is tending to become conterminous with the endemicity area on account of increasing deforestation. Emergence in forest regions, due to Aedes africanus, is still few and isolated, unlike that observed in savanna regions where A. furcifer is the major vector. The different behaviour of these two vectors and their population dynamics determine the quality of the man-vector contact and are responsible for these two patterns of emergence. --The emergence front limits the endemicity area in the north. Its position varies and depends on annual rainfall patterns. The epidemicity area, where the virus does not circulate before an epidemic and where the immunity status of unvaccinated populations is low, is geographically heterogeneous. It consists of regions to the north of the emergence front and of towns anywhere. It is characterized by high potentials for the development of A. aegypti populations. Only man can introduce the virus into this area. Three types of epidemic are distinguished, depending on the vectors: --Urban epidemics resulting from transmission by a domestic vector. These epidemics always occur within the epidemicity area, either in dry savanna (rural subtype) or in towns (urban subtype). The virus is introduced into the ecosystem

  14. International collaborative assay of the International Reference Preparation of Anti-Yellow-Fever Serum

    PubMed Central

    Krag, P.; MacNamara, F. N.; Lyng, J.; Bentzon, M. Weis; Larsen, S. Olesen

    1965-01-01

    A yellow fever immune serum was established in 1962 by the WHO Expert Committee on Biological Standardization as the International Reference Preparation of Anti-Yellow-Fever Serum, intended to serve as an immune reference serum in the mouse protection test used in the control of yellow fever vaccines. Before its establishment as the International Reference Preparation, the proposed material was assayed in eleven laboratories in ten countries against a number of other immune and non-immune sera, and was found stable. Neutralization test results were consistent and the relative potency was sufficiently high. This paper not only reports on the collaborative assay, but also discusses errors in the testing method and problems connected with the distribution of mouse deaths during the observation period and with the preparation of dilutions. PMID:5294595

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

    PubMed

    Patterson, K D

    1992-04-01

    Yellow fever epidemics struck the United States repeatedly in the 18th and 19th centuries. The disease was not indigenous; 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 the Mississippi River system in the 1800s. New Orleans, Mobile, Savannah, and Charleston were major targets; Memphis suffered terribly in 1878. Yellow fever epidemics caused terror, economic disruption, and some 100,000-150,000 deaths. Recent white immigrants to southern port cities were the most vulnerable; local whites and blacks enjoyed considerable resistance. PMID:1604377

  16. "In the interest of humanity and the cause of science": the yellow fever volunteers.

    PubMed

    Pierce, John R

    2003-11-01

    The scientific discoveries of the U.S. Army Yellow Fever Board of 1900 are well known as are the Army physicians who led the board. Walter Reed, of course, is the best known, but James Carroll, Aristides Agramonte, and Jesse Lazear are also known, if not nationally, to their local communities. This article deals not with the known but with the unknown, meaning the volunteers who subjected themselves to the ravages of yellow fever and the real possibility of death. The year 1900 was known as a "yellow fever year" among the locals in Cuba because in the preceding year the epidemics had been relatively mild. Beginning its work in June 1900 in the midst of a deadly epidemic, the board conducted a truly remarkable set of experiments that set a benchmark for controlled clinical trials and informed consent. Because no animal model was known to be susceptible to yellow fever, they used human volunteers for their experiments. These volunteers were recruited from among Spanish immigrants and were accepted from soldiers and two civilians who volunteered. Over 30 men participated in the experiments, and 22 developed yellow fever. With expected death rates of 20% to 40%, it is incredible that none of these volunteers died. In 1929, the U.S. government honored the Americans who volunteered by placing their names on a Roll of Honor published annually in the Army Register. The successes of the 1900 U.S. Army Yellow Fever Board were truly remarkable, and many of the successes were made possible by the men who volunteered, some repeatedly, to risk their lives "in the interest of humanity and the cause of science." PMID:14680037

  17. [Control discourses and power relations of yellow fever: Philadelphia in 1793].

    PubMed

    Kim, Seohyung

    2014-12-01

    1793 Yellow fever in Philadelphia was the most severe epidemics in the late 18th century in the United States. More than 10% of the population in the city died and many people fled to other cities. The cause of yellow fever in the United States had close relationship with slaves and sugar in Philadelphia. Sugarcane plantation had needed many labors to produce sugar and lots of Africans had to move to America as slaves. In this process, Aëdes aegypti, the vector of yellow fever had migrated to America and the circumstances of ships or cities provided appropriate conditions for its breeding. In this period, the cause of yellow fever could not be established exactly, so suggestions of doctors became entangled in political and intellectual discourses in American society. There was a critical conflict between Jeffersonian Republicanism and Federalism about the origin and treatment of yellow fever. Benjamin Rush, a Jeffersonian Republican, suggested urban sanitation reform and bloodletting. He believed the infectious disease happened because of unsanitary city condition, so he thought the United States could be a healthy nation by improvement of the public health and sanitation. He would like to cope with national crisis and develop American society on the basis of republicanism. While Rush suggested the improvement of public health and sanitation, the city government of Philadelphia suggested isolation of yellow fever patients and quarantine. City government isolated the patients from healthy people and it reconstructed space of hospital. Also, it built orphanages to take care of children who lost their parents during the epidemic and implemented power to control people put in the state of exception. Of course, city government tried to protect the city and nation by quarantine of every ship to Philadelphia. Control policies of yellow fever in 1793 showed different conflicts and interactions. Through the yellow fever, Jeffersonian Republicanism and Federalism had

  18. An inactivated yellow fever 17DD vaccine cultivated in Vero cell cultures.

    PubMed

    Pereira, Renata C; Silva, Andrea N M R; Souza, Marta Cristina O; Silva, Marlon V; Neves, Patrícia P C C; Silva, Andrea A M V; Matos, Denise D C S; Herrera, Miguel A O; Yamamura, Anna M Y; Freire, Marcos S; Gaspar, Luciane P; Caride, Elena

    2015-08-20

    Yellow fever is an acute infectious disease caused by prototype virus of the genus Flavivirus. It is endemic in Africa and South America where it represents a serious public health problem causing epidemics of hemorrhagic fever with mortality rates ranging from 20% to 50%. There is no available antiviral therapy and vaccination is the primary method of disease control. Although the attenuated vaccines for yellow fever show safety and efficacy it became necessary to develop a new yellow fever vaccine due to the occurrence of rare serious adverse events, which include visceral and neurotropic diseases. The new inactivated vaccine should be safer and effective as the existing attenuated one. In the present study, the immunogenicity of an inactivated 17DD vaccine in C57BL/6 mice was evaluated. The yellow fever virus was produced by cultivation of Vero cells in bioreactors, inactivated with β-propiolactone, and adsorbed to aluminum hydroxide (alum). Mice were inoculated with inactivated 17DD vaccine containing alum adjuvant and followed by intracerebral challenge with 17DD virus. The results showed that animals receiving 3 doses of the inactivated vaccine (2 μg/dose) with alum adjuvant had neutralizing antibody titers above the cut-off of PRNT50 (Plaque Reduction Neutralization Test). In addition, animals immunized with inactivated vaccine showed survival rate of 100% after the challenge as well as animals immunized with commercial attenuated 17DD vaccine. PMID:25862300

  19. A fatal yellow fever virus infection in China: description and lessons.

    PubMed

    Chen, Zhihai; Liu, Lin; Lv, Yanning; Zhang, Wei; Li, Jiandong; Zhang, Yi; Di, Tian; Zhang, Shuo; Liu, Jingyuan; Li, Jie; Qu, Jing; Hua, Wenhao; Li, Chuan; Wang, Peng; Zhang, Quanfu; Xu, Yanli; Jiang, Rongmeng; Wang, Qin; Chen, Lijuan; Wang, Shiwen; Pang, Xinghuo; Liang, Mifang; Ma, Xuejun; Li, Xingwang; Wang, Quanyi; Zhang, Fujie; Li, Dexin

    2016-01-01

    Yellow fever (YF) is a viral disease endemic to the tropical regions of Africa and South America. An outbreak of YF has been occurring in Angola, since the beginning of 2016. In March 2016, a 32-year-old Chinese man who returned from Angola was hospitalized and diagnosed with the first case of imported YF in China. Clinical observations, blood viral RNA detection, serological testing and treatments for the patient were performed daily. The virus was isolated in Vero cells, and the complete viral genome was sequenced and analyzed using the next-generation genomic sequencing platform. The patient presented with hemorrhagic fever, jaundice and oliguria at day 3 after onset, which rapidly progressed to multisystem organ failure with extremely elevated liver, pancreatic and myocardial enzymes. The patient died despite the intensive supportive treatments that were performed. A liver biopsy showed severe and multilobular necrosis. Viral RNA was detectable throughout the clinical course of the disease. Whole-genomic sequence analysis revealed that the virus belongs to the Angola71 genotype. Although the virus has been circulating in Angola for 45 years, only 14 amino-acid substitutions and no amino-acid changes were observed in the membrane and envelope proteins compared with the virus collected in 1971. The presence of this imported YF case in China indicated that with the increase in business travel among countries, YF outbreaks in Africa can lead to the international spread of the disease. The production and use of YF vaccines is, therefore, an urgent issue. PMID:27406389

  20. Risk Assessment for Yellow Fever in Western and North-Western Provinces of Zambia

    PubMed Central

    Babaniyi, Olusegun A.; Mwaba, Peter; Mulenga, David; Monze, Mwaka; Songolo, Peter; Mazaba-Liwewe, Mazyanga L.; Mweene-Ndumba, Idah; Masaninga, Freddie; Chizema, Elizabeth; Eshetu-Shibeshi, Messeret; Malama, Costantine; Rudatsikira, Emmanuel; Siziya, Seter

    2015-01-01

    Background: North-Western and Western provinces of Zambia were reclassified as low-risk areas for yellow fever (YF). However, the current potential for YF transmission in these areas is unclear. Aims: To determine the current potential risk of YF infection. Setting and Design: A cross sectional study was conducted in North-Western and Western provinces of Zambia. Materials and Methods: Samples were tested for both YF virus-specific IgG and IgM antibodies by the ELISA and YF virus confirmation was done using Plaque Reduction Neutralization Test. The samples were also tested for IgG and IgM antibodies against other flaviviruses. Results: Out of the 3625 respondents who participated in the survey, 46.7% were males and 9.4% were aged less than 5 years. Overall, 58.1% of the participants slept under an impregnated insecticide-treated net and 20.6% reported indoor residual spraying of insecticides. A total of 616 (17.0%) samples were presumptive YF positive. The prevalence for YF was 0.3% for long-term infection and 0.2% for recent YF infection. None of the YF confirmed cases had received YF vaccine. Prevalence rates for other flaviviruses were 149 (4.1%) for Dengue, 370 (10.2%) for West Nile and 217 (6.0%) for Zika. Conclusion: There is evidence of past and recent infection of YF in both provinces. Hence, they are at a low risk for YF infection. Yellow fever vaccination should be included in the EPI program in the two provinces and strengthen surveillance with laboratory confirmation. PMID:25722614

  1. Entomological profile of yellow fever epidemics in the Central African Republic, 2006–2010

    PubMed Central

    2012-01-01

    Background The causative agent of yellow fever is an arbovirus of the Flaviviridae family transmitted by infected Aedes mosquitoes, particularly in Africa. In the Central African Republic since 2006, cases have been notified in the provinces of Ombella-Mpoko, Ouham-Pende, Basse-Kotto, Haute-Kotto and in Bangui the capital. As the presence of a vector of yellow fever virus (YFV) represents a risk for spread of the disease, we undertook entomological investigations at these sites to identify potential vectors of YFV and their abundance. Findings Between 2006 and 2010, 5066 mosquitoes belonging to six genera and 43 species were identified. The 20 species of the Aedes genus identified included Ae. aegypti, the main vector of YFV in urban settings, and species found in tropical forests, such as Ae. africanus, Ae. simpsoni, Ae. luteocephalus, Ae. vittatus and Ae. opok. These species were not distributed uniformly in the various sites studied. Thus, the predominant Aedes species was Ae. aegypti in Bangui (90.7 %) and Basse-Kotto (42.2 %), Ae. africanus in Ombella-Mpoko (67.4 %) and Haute-Kotto (77.8 %) and Ae. vittatus in Ouham-Pende (62.2 %). Ae. albopictus was also found in Bangui. The distribution of these dominant species differed significantly according to study site (P < 0.0001). None of the pooled homogenates of Aedes mosquitoes analysed by polymerase chain reaction contained the YFV genome. Conclusion The results indicate a wide diversity of vector species for YFV in the Central African Republic. The establishment of surveillance and vector control programs should take into account the ecological specificity of each species. PMID:22897918

  2. Notes from the field: fatal yellow fever vaccine-associated viscerotropic disease--Oregon, September 2014.

    PubMed

    DeSilva, Malini; Sharma, Arun; Staples, Erin; Arndt, Byron; Shieh, Wun-Ju; Shames, Jim; Cieslak, Paul

    2015-03-20

    In September 2014, a previously healthy Oregon woman in her 60s went to a hospital emergency department with malaise, dyspnea, vomiting, and diarrhea of 3-5 days' duration. She reported no recent travel, ill contacts, or dietary changes. Six days earlier, she had received a single dose of yellow fever vaccine and typhoid vaccine before planned travel to South America. PMID:25789744

  3. Yellow Fever Vaccine: What You Need to Know

    MedlinePlus

    ... a risk of transmitting the vaccine virus through blood products during that period. 4 Wfevheorsvhaocuclidnen?ot get yellow • Anyone with a severe (life-threatening) allergy to any component of the vaccine, including eggs, chicken proteins, or gelatin, or who has had a ...

  4. Yellow fever and Max Theiler: the only Nobel Prize for a virus vaccine

    PubMed Central

    Norrby, Erling

    2007-01-01

    In 1951, Max Theiler of the Rockefeller Foundation received the Nobel Prize in Physiology or Medicine for his discovery of an effective vaccine against yellow fever—a discovery first reported in the JEM 70 years ago. This was the first, and so far the only, Nobel Prize given for the development of a virus vaccine. Recently released Nobel archives now reveal how the advances in the yellow fever vaccine field were evaluated more than 50 years ago, and how this led to a prize for Max Theiler. PMID:18039952

  5. Evidence of recent jungle yellow-fever activity in eastern Panama*

    PubMed Central

    Galindo, Pedro; Srihongse, Sunthorn

    1967-01-01

    Outbreaks of jungle yellow fever in man have been recorded twice from eastern Panama of recent years, first in 1948 and again in 1956. Since then, a close surveillance has been maintained on virus activity in eastern Panama. Recent field observations and serological tests on 402 monkey sera indicate that there was an outbreak of yellow fever among monkeys of southern Darién Province some time between 1963 and 1965. It does not appear that the outbreak has spread as yet to other areas. Virus transmission may have been permanently disrupted during the drought which affected the region in 1965. However, if the virus had managed to survive this unfavourable period, an epizootic wave might have evolved, invading forested areas immediately east of the Panama Canal, now inhabited by a dense non-immune human population. PMID:4962725

  6. Yellow fever disease: density equalizing mapping and gender analysis of international research output

    PubMed Central

    2013-01-01

    Background A number of scientific papers on yellow fever have been published but no broad scientometric analysis on the published research of yellow fever has been reported. The aim of the article based study was to provide an in-depth evaluation of the yellow fever field using large-scale data analysis and employment of bibliometric indicators of production and quantity. Methods Data were retrieved from the Web of Science database (WoS) and analyzed as part of the NewQis platform. Then data were extracted from each file, transferred to databases and visualized as diagrams. Partially by means of density-equalizing mapping makes the findings clear and emphasizes the output of the analysis. Results In the study period from 1900 to 2012 a total of 5,053 yellow fever-associated items were published by 79 countries. The United States (USA) having the highest publication rate at 42% (n = 751) followed by far from Brazil (n = 203), France (n = 149) and the United Kingdom (n = 113). The most productive journals are the “Public Health Reports”, the “American Journal of Tropical Medicine and Hygiene” and the “Journal of Virology”. The gender analysis showed an overall steady increase of female authorship from 1950 to 2011. Brazil is the only country of the five most productive countries with a higher proportion of female scientists. Conclusions The present data shows an increase in research productivity over the entire study period, in particular an increase of female scientists. Brazil shows a majority of female authors, a fact that is confirmed by other studies. PMID:24245856

  7. Survey of the relative prevalence of potential yellow fever vectors in north-west Nigeria

    PubMed Central

    Service, M. W.

    1974-01-01

    The yellow fever epidemic in Nigeria in 1969-70 emphasized the lack of data concerning the possible importance of Aedes aegypti and other Stegomyia mosquitos as vectors. An entomological survey was therefore undertaken in September 1973 in 6 areas in the north-west of Nigeria to determine the prevalence of Stegomyia populations in the villages. An examination of over 6 700 water pots showed that 11-53% contained A. aegypti larvae, and in some areas larvae of A. vittatus were found in up to 18% of pots. In villages in the relatively dry Sudan savanna neither leaf axils nor tree-holes were important Stegomyia larval habitats, but in the more southern Kontagora area of the wetter northern Guinea savanna, these habitats were probably important breeding sites. In the early evening the most abundant man-biting mosquito in the villages was A. aegypti. A. vittatus was also caught at bait in some villages. It was concluded that the only potential yellow fever vectors in the area were A. aegypti and A. vittatus. There were large populations of A. aegypti, closely associated with man, in all the areas surveyed, but they should not present a risk of yellow fever transmission unless the disease were to be introduced into the area by man, or unless virus reservoirs, such as monkeys, were also present. Although monkeys were common in the Kontagora area they were rare in the Sudan savanna. PMID:4156499

  8. SATELLITE-BASED RIFT VALLEY FEVER FORECASTS PREDICT A LARGE YELLOW FEVER EPIDEMIC IN SUDAN, 2005

    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 ...

  9. Mariner transposition and transformation of the yellow fever mosquito, Aedes aegypti.

    PubMed

    Coates, C J; Jasinskiene, N; Miyashiro, L; James, A A

    1998-03-31

    The mariner transposable element is capable of interplasmid transposition in the embryonic soma of the yellow fever mosquito, Aedes aegypti. To determine if this demonstrated mobility could be utilized to genetically transform the mosquito, a modified mariner element marked with a wild-type allele of the Drosophila melanogaster cinnabar gene was microinjected into embryos of a kynurenine hydroxylase-deficient, white-eyed recipient strain. Three of 69 fertile male founders resulting from the microinjected embryos produced families with colored-eyed progeny individuals, a transformation rate of 4%. The transgene-mediated complementation of eye color was observed to segregate in a Mendelian manner, although one insertion segregates with the recessive allele (female-determining) of the sex-determining locus, and a separate insertion is homozygous lethal. Molecular analysis of selected transformed families demonstrated that a single complete copy of the construct had integrated independently in each case and that it had done so in a transposase-mediated manner. The availability of a mariner transformation system greatly enhances our ability to study and manipulate this important vector species. PMID:9520438

  10. Methodology for Definition of Yellow Fever Priority Areas, Based on Environmental Variables and Multiple Correspondence Analyses

    PubMed Central

    Moreno, Eduardo Stramandinoli; Barata, Rita de Cássia Barradas

    2012-01-01

    Yellow fever (YF) is endemic in much of Brazil, where cases of the disease are reported every year. Since 2008, outbreaks of the disease have occurred in regions of the country where no reports had been registered for decades, which has obligated public health authorities to redefine risk areas for the disease. The aim of the present study was to propose a methodology of environmental risk analysis for defining priority municipalities for YF vaccination, using as example, the State of São Paulo, Brazil. The municipalities were divided into two groups (affected and unaffected by YF) and compared based on environmental parameters related to the disease's eco-epidemiology. Bivariate analysis was used to identify statistically significant associations between the variables and virus circulation. Multiple correspondence analysis (MCA) was used to evaluate the relationship among the variables and their contribution to the dynamics of YF in Sao Paulo. The MCA generated a factor that was able to differentiate between affected and unaffected municipalities and was used to determine risk levels. This methodology can be replicated in other regions, standardized, and adapted to each context. PMID:22802971

  11. Sadfly fever: two case reports

    PubMed Central

    Özkale, Yasemin; Özkale, Murat; Kiper, Pinar; Çetinkaya, Bilin; Erol, İlknur

    2016-01-01

    Sandfly fever, also known as ‘three-day fever’ or ‘pappataci fever’ or ‘Phlebotomus fever’ is a viral infection that causes self-limited influenza-like symptoms and characterized by a rapid onset. The disease occurs commonly in endemic areas in summer months and especially in August during which sandflies are active. In this article, two siblings who presented with high fever, redness in the eyes, headache, weakness, malaise and inability to walk, who were found to have increased liver function tests and creatine kinase levels and who were diagnosed with sadfly fever with positive sadfly IgM and IgG antibodies are reported because of the rarity of this disease. PMID:27489469

  12. [Epidemic of yellow fever in the southeastern region of Upper Volta (October-December, 1983). Epidemiological study. Preliminary results].

    PubMed

    Roux, J; Baudon, D; Robert, V; Stanghellini, A; Gazin, P; Lhuillier, M; Saluzzo, J F; Cornet, M; Sarthou, J L; Molez, J F

    1984-01-01

    An epidemic of yellow fever raged during the last three months of 1983 in South East of Upper Volta. It spread on about ten thousand square kilometers, in a bushy savanna area, affecting only populations living in contact with forest galleries, belonging especially to the peul ethnical group. The transmission of the virus was effected by sylvatic vectors, essentially Aedes furcifer. Serological tests showed that about 50 % of the population living in contact with forest galleries was affected, that is to say 15.000 to 17.500 people. The average death rate on the whole area was 4 % (800 to 1.700 deaths); the lethality rate was estimated between 6 and 10 % of affected people. On the whole, 54 strains of yellow fever virus were isolated from human blood samples, and 26 strains from batches of mosquitoes. We called this epidemic "intermediate sylvatic epidemic". The epidemic quickly decreased in the sylvatic area, owing to climatic conditions. A mass campaign of vaccinations prevented it from spreading to near urban centres. On this particular case, the thermostability on field of the vaccine 17D provided by the Institute Pasteur of Dakar was proved to be effective. PMID:6542965

  13. A recombinant Yellow Fever 17D vaccine expressing Lassa virus glycoproteins

    PubMed Central

    Bredenbeek, Peter J.; Molenkamp, Richard; Spaan, Willy J.M.; Deubel, Vincent; Marianneau, Phillippe; Salvato, Maria S.; Moshkoff, Dmitry; Zapata, Juan; Tikhonov, Ilia; Patterson, Jean; Carrion, Ricardo; Ticer, Anysha; Brasky, Kathleen; Lukashevich, Igor S.

    2006-01-01

    The Yellow Fever Vaccine 17D (YFV17D) has been used as a vector for the Lassa virus glycoprotein precursor (LASV-GPC) resulting in construction of YFV17D/LASV-GPC recombinant virus. The virus was replication-competent and processed the LASV-GPC in cell cultures. The recombinant replicated poorly in guinea pigs but still elicited specific antibodies against LASV and YFV17D antigens. A single subcutaneous injection of the recombinant vaccine protected strain 13 guinea pigs against fatal Lassa Fever. This study demonstrates the potential to develop an YFV17D-based bivalent vaccine against two viruses that are endemic in the same area of Africa. PMID:16412488

  14. A recombinant Yellow Fever 17D vaccine expressing Lassa virus glycoproteins.

    PubMed

    Bredenbeek, Peter J; Molenkamp, Richard; Spaan, Willy J M; Deubel, Vincent; Marianneau, Phillippe; Salvato, Maria S; Moshkoff, Dmitry; Zapata, Juan; Tikhonov, Ilia; Patterson, Jean; Carrion, Ricardo; Ticer, Anysha; Brasky, Kathleen; Lukashevich, Igor S

    2006-02-20

    The Yellow Fever Vaccine 17D (YFV17D) has been used as a vector for the Lassa virus glycoprotein precursor (LASV-GPC) resulting in construction of YFV17D/LASV-GPC recombinant virus. The virus was replication-competent and processed the LASV-GPC in cell cultures. The recombinant replicated poorly in guinea pigs but still elicited specific antibodies against LASV and YFV17D antigens. A single subcutaneous injection of the recombinant vaccine protected strain 13 guinea pigs against fatal Lassa Fever. This study demonstrates the potential to develop an YFV17D-based bivalent vaccine against two viruses that are endemic in the same area of Africa. PMID:16412488

  15. A yellow fever epizootic in Zika forest, Uganda, during 1972: Part 1: Virus isolation and sentinel monkeys.

    PubMed

    Kirya, B G

    1977-01-01

    The results of the yellow fever immunity survey of Central and East Africa reported by SAWYER & WHITMAN in 1936 prompted scientists to undertake well-planned epidemiological studies on yellow fever in eastern Africa. A Yellow Fever Research Institute (the present East African Virus Research Institute) was established at Entebbe in 1936 for this purpose. One of the areas where much work has been carried out is a strip of typical tropical forest, the Zika Forest, 12 kilometres from the Institute. Routine surveillance work, particularly on the biting activity of the yellow fever vector mosquitoes, has been going on since 1946. It was during one of these studies in 1972 that the first yellow fever virus strain was isolated from Aedes africanus collected from the Zika and Sisa forests and one strain was isolated from Coquillettidia fuscopennata, also from the Zika Forest. Three sentinel rhesus monkeys, nomimmune to YF, which were kept in the Zika Forest during the time of the epizootic died of YF disease. The present observations indicate that YF is still present in Africa, and as such it still remains a potential menace to the human population. The epidemiological implications are discussed. PMID:407675

  16. Yellow fever vector live-virus vaccines: West Nile virus vaccine development.

    PubMed

    Arroyo, J; Miller, C A; Catalan, J; Monath, T P

    2001-08-01

    By combining molecular-biological techniques with our increased understanding of the effect of gene sequence modification on viral function, yellow fever 17D, a positive-strand RNA virus vaccine, has been manipulated to induce a protective immune response against viruses of the same family (e.g. Japanese encephalitis and dengue viruses). Triggered by the emergence of West Nile virus infections in the New World afflicting humans, horses and birds, the success of this recombinant technology has prompted the rapid development of a live-virus attenuated candidate vaccine against West Nile virus. PMID:11516995

  17. Guiding dengue vaccine development using knowledge gained from the success of the yellow fever vaccine

    PubMed Central

    Liang, Huabin; Lee, Min; Jin, Xia

    2016-01-01

    Flaviviruses comprise approximately 70 closely related RNA viruses. These include several mosquito-borne pathogens, such as yellow fever virus (YFV), dengue virus (DENV), and Japanese encephalitis virus (JEV), which can cause significant human diseases and thus are of great medical importance. Vaccines against both YFV and JEV have been used successfully in humans for decades; however, the development of a DENV vaccine has encountered considerable obstacles. Here, we review the protective immune responses elicited by the vaccine against YFV to provide some insights into the development of a protective DENV vaccine. PMID:26435066

  18. Guiding dengue vaccine development using knowledge gained from the success of the yellow fever vaccine.

    PubMed

    Liang, Huabin; Lee, Min; Jin, Xia

    2016-01-01

    Flaviviruses comprise approximately 70 closely related RNA viruses. These include several mosquito-borne pathogens, such as yellow fever virus (YFV), dengue virus (DENV), and Japanese encephalitis virus (JEV), which can cause significant human diseases and thus are of great medical importance. Vaccines against both YFV and JEV have been used successfully in humans for decades; however, the development of a DENV vaccine has encountered considerable obstacles. Here, we review the protective immune responses elicited by the vaccine against YFV to provide some insights into the development of a protective DENV vaccine. PMID:26435066

  19. Isolation of yellow fever virus from nulliparous Haemagogus (Haemagogus) janthinomys in eastern Amazonia.

    PubMed

    Mondet, B; Vasconcelos, P F C; Travassos da Rosa, A P A; Travassos da Rosa, E S; Rodrigues, S G; Travassos Rosa, J F S; Bicout, D J

    2002-01-01

    In 1998, an epizootic of yellow fever (YF) killed many howler monkeys (Alouatta spp.) in eastern Amazonia near the city of Altamira. An infection level with YF virus of approximately 3.6% was determined from analysis of 456 females of Haemagogus janthinomys Dyar, the main enzootic YF vector in South America. One month later, a second study of 164 females captured in the same place led to infection levels of 0.8% for parous and 2.9% for nulliparous females. These results lead to the conclusion that vertical transmission, one of the key elements in the epidemiology of YF, occurs in South America as it does in Africa. PMID:12656130

  20. Yellow fever

    MedlinePlus

    ... the heart, liver, and kidney. Bleeding disorders, seizures, coma, and delirium may also occur. Symptoms may include: ... heartbeats (arrhythmias) Bleeding (may progress to hemorrhage) Seizures Coma

  1. Mortality and Morbidity Among Military Personnel and Civilians During the 1930s and World War II From Transmission of Hepatitis During Yellow Fever Vaccination: Systematic Review

    PubMed Central

    Lorenzetti, Diane L.; Spragins, Wendy

    2013-01-01

    During World War II, nearly all US and Allied troops received yellow fever vaccine. Until May 1942, it was both grown and suspended in human serum. In April 1942, major epidemics of hepatitis occurred in US and Allied troops who had received yellow fever vaccine. A rapid and thorough investigation by the US surgeon general followed, and a directive was issued discontinuing the use of human serum in vaccine production. The large number of cases of hepatitis caused by the administration of this vaccine could have been avoided. Had authorities undertaken a thorough review of the literature, they would have discovered published reports, as early as 1885, of postvaccination epidemics of hepatitis in both men and horses. It would take 4 additional decades of experiments and epidemiological research before viruses of hepatitis A, B, C, D, and E were identified, their modes of transmission understood, and their genomes sequenced. PMID:23327242

  2. Mortality and morbidity among military personnel and civilians during the 1930s and World War II from transmission of hepatitis during yellow fever vaccination: systematic review.

    PubMed

    Thomas, Roger E; Lorenzetti, Diane L; Spragins, Wendy

    2013-03-01

    During World War II, nearly all US and Allied troops received yellow fever vaccine. Until May 1942, it was both grown and suspended in human serum. In April 1942, major epidemics of hepatitis occurred in US and Allied troops who had received yellow fever vaccine. A rapid and thorough investigation by the US surgeon general followed, and a directive was issued discontinuing the use of human serum in vaccine production. The large number of cases of hepatitis caused by the administration of this vaccine could have been avoided. Had authorities undertaken a thorough review of the literature, they would have discovered published reports, as early as 1885, of postvaccination epidemics of hepatitis in both men and horses. It would take 4 additional decades of experiments and epidemiological research before viruses of hepatitis A, B, C, D, and E were identified, their modes of transmission understood, and their genomes sequenced. PMID:23327242

  3. Synthetic strategy and antiviral evaluation of diamide containing heterocycles targeting dengue and yellow fever virus.

    PubMed

    Saudi, Milind; Zmurko, Joanna; Kaptein, Suzanne; Rozenski, Jef; Gadakh, Bharat; Chaltin, Patrick; Marchand, Arnaud; Neyts, Johan; Van Aerschot, Arthur

    2016-10-01

    High-throughput screening of a subset of the CD3 chemical library (Centre for Drug Design and Discovery; KU Leuven) provided us with a lead compound 1, displaying low micromolar potency against dengue virus and yellow fever virus. Within a project aimed at discovering new inhibitors of flaviviruses, substitution of its central imidazole ring led to synthesis of variably substituted pyrazine dicarboxylamides and phthalic diamides, which were evaluated in cell-based assays for cytotoxicity and antiviral activity against the dengue virus (DENV) and yellow fever virus (YFV). Fourteen compounds inhibited DENV replication (EC50 ranging between 0.5 and 3.4 μM), with compounds 6b and 6d being the most potent inhibitors (EC50 0.5 μM) with selectivity indices (SI) > 235. Compound 7a likewise exhibited anti-DENV activity with an EC50 of 0.5 μM and an SI of >235. In addition, good antiviral activity of seven compounds in the series was also noted against the YFV with EC50 values ranging between 0.4 and 3.3 μM, with compound 6n being the most potent for this series with an EC50 0.4 μM and a selectivity index of >34. Finally, reversal of one of the central amide bonds as in series 13 proved deleterious to the inhibitory activity. PMID:27240271

  4. Docking studies towards exploring antiviral compounds against envelope protein of yellow fever virus.

    PubMed

    Umamaheswari, Amineni; Kumar, Manne Muni; Pradhan, Dibyabhaba; Marisetty, Hemanthkumar

    2011-03-01

    Yellow fever is among one of the most lethal viral diseases for which approved antiviral therapies were yet to be discovered. Herein, functional assignment of complete YFV proteome was done through support vector machine. Major envelope (E) protein that mediates entry of YFV into host cell was selected as a potent molecular target. Three dimensional structure of the molecular target was predicted using Modeller9v7. The model was optimized in Maestro9.0 applying OPLS AA force field and was evaluated using PROCHECK, ProSA, ProQ and Profile 3D. The BOG pocket residues Val48, Glu197, Thr200, Ile204, Thr265, Thr268 and Gly278 were located in YFV E protein using SiteMap2.3. More than one million compounds of Ligandinfo Meta database were explored using a computational virtual screening protocol targeting BOG pocket of the E protein. Finally, ten top ranked lead molecules with strong binding affinity to BOG pocket of YFV E protein were identified based on XP Gscore. Drug likeliness and comparative bioactivity analysis for these leads using QikProp3.2 had shown that these molecules would have the potential to act as better drug. Thus, the 10 lead molecules suggested in the present study would be of interest as promising starting point for designing antiviral compound against yellow fever. PMID:21369890

  5. Infection of Mosquito Cells (C6/36) by Dengue-2 Virus Interferes with Subsequent Infection by Yellow Fever Virus.

    PubMed

    Abrao, Emiliana Pereira; da Fonseca, Benedito Antônio Lopes

    2016-02-01

    Dengue is one of the most important diseases caused by arboviruses in the world. Yellow fever is another arthropod-borne disease of great importance to public health that is endemic to tropical regions of Africa and the Americas. Both yellow fever and dengue viruses are flaviviruses transmitted by Aedes aegypti mosquitoes, and then, it is reasonable to consider that in a given moment, mosquito cells could be coinfected by both viruses. Therefore, we decided to evaluate if sequential infections of dengue and yellow fever viruses (and vice-versa) in mosquito cells could affect the virus replication patterns. Using immunofluorescence and real-time PCR-based replication assays in Aedes albopictus C6/36 cells with single or sequential infections with both viruses, we demonstrated the occurrence of viral interference, also called superinfection exclusion, between these two viruses. Our results show that this interference pattern is particularly evident when cells were first infected with dengue virus and subsequently with yellow fever virus (YFV). Reduction in dengue virus replication, although to a lower extent, was also observed when C6/36 cells were initially infected with YFV followed by dengue virus infection. Although the importance that these findings have on nature is unknown, this study provides evidence, at the cellular level, of the occurrence of replication interference between dengue and yellow fever viruses and raises the question if superinfection exclusion could be a possible explanation, at least partially, for the reported lack of urban yellow fever occurrence in regions where a high level of dengue transmission occurs. PMID:26808727

  6. Synthesis and structure-activity relationships of 1-undec-10-enoyl-piperidines as adulticides against the yellow fever mosquito Aedes aegypti (Diptera: Culicidae)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The yellow fever mosquito, Aedes aegypti (L.), is considered the primary vector for both dengue and yellow fever. Using insecticide is one of the major ways to control this medically important insect pest. However, few new insecticides have been developed for mosquito control. As part of our collabo...

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

    PubMed

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

    2013-05-01

    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

  8. Travel Characteristics and Yellow Fever Vaccine Usage Among US Global TravEpiNet Travelers Visiting Countries with Risk of Yellow Fever Virus Transmission, 2009–2011

    PubMed Central

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

    2013-01-01

    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

  9. Rapid Detection and Quantification of RNA of Ebola and Marburg Viruses, Lassa Virus, Crimean-Congo Hemorrhagic Fever Virus, Rift Valley Fever Virus, Dengue Virus, and Yellow Fever Virus by Real-Time Reverse Transcription-PCR

    PubMed Central

    Drosten, Christian; Göttig, Stephan; Schilling, Stefan; Asper, Marcel; Panning, Marcus; Schmitz, Herbert; Günther, Stephan

    2002-01-01

    Viral hemorrhagic fevers (VHFs) are acute infections with high case fatality rates. Important VHF agents are Ebola and Marburg viruses (MBGV/EBOV), Lassa virus (LASV), Crimean-Congo hemorrhagic fever virus (CCHFV), Rift Valley fever virus (RVFV), dengue virus (DENV), and yellow fever virus (YFV). VHFs are clinically difficult to diagnose and to distinguish; a rapid and reliable laboratory diagnosis is required in suspected cases. We have established six one-step, real-time reverse transcription-PCR assays for these pathogens based on the Superscript reverse transcriptase-Platinum Taq polymerase enzyme mixture. Novel primers and/or 5′-nuclease detection probes were designed for RVFV, DENV, YFV, and CCHFV by using the latest DNA database entries. PCR products were detected in real time on a LightCycler instrument by using 5′-nuclease technology (RVFV, DENV, and YFV) or SybrGreen dye intercalation (MBGV/EBOV, LASV, and CCHFV). The inhibitory effect of SybrGreen on reverse transcription was overcome by initial immobilization of the dye in the reaction capillaries. Universal cycling conditions for SybrGreen and 5′-nuclease probe detection were established. Thus, up to three assays could be performed in parallel, facilitating rapid testing for several pathogens. All assays were thoroughly optimized and validated in terms of analytical sensitivity by using in vitro-transcribed RNA. The ≥95% detection limits as determined by probit regression analysis ranged from 1,545 to 2,835 viral genome equivalents/ml of serum (8.6 to 16 RNA copies per assay). The suitability of the assays was exemplified by detection and quantification of viral RNA in serum samples of VHF patients. PMID:12089242

  10. [Construction of recombinant yellow fever virus 17D containing 2A fragment as a vaccine vector].

    PubMed

    Xiaowu, Pang; Fu, Wen-Chuan; Guo, Yin-Han; Zhang, Li-Shu; Xie, Tian-Pei; Xinbin, Gu

    2006-05-01

    The Yellow Fever (YF) vaccine, an attenuated yellow fever 17D (YF-17D) live vaccine, is one of the most effective and safest vaccines in the world and is regarded as one of the best candidates for viral expression vector. We here first reported in China the construction and characterization of the recombinant expression vector of yellow fever 17D which contained the proteinase 2A fragment of foot-and-mouth disease virus (FMDV). Three cDNA fragments representing the full-length YF-17D genome, named 5'-end cDNA (A), 3'-end cDNA (B) and middle cDNA (C), were obtained by reverse transcription polymerase chain reaction (RT-PCR), together with the introduction of SP6 enhancer, necessary restriction sites and overlaps for homologous recombination in yeast. Fragment A and B were then introduced into pRS424 in turn by DNA recombination, followed by transfection of fragment C and the recombinant pRS424 containing A and B (pRS-A-B) into yeast. A recombinant vector containing full length cDNA of YF-17D (pRS-YF) was obtained by screening on medium lack of tryptophan and uracil. A recombinant YF-17D expression vector containing FMDV-2A gene fragment (pRS-YF-2A1) was then constructed by methods of DNA recombination and homologous recombination in yeast described above. In vitro transcription of the recombinant vector pRS-YF-2A1 was then carried out and introduced into BHK-21 cells by electroporation. Results of indirect immunofluorescence assay (IFA) and titer determination showed a stable infectious recombinant virus was gotten, whose features such as growth curve were similar to those of the parental YF-17D. The results suggest that the recombinant vector pRS-YF-2A1, by introduction of heterogenous genes via 2A region, is potential to be an effective live vaccine expression vector. PMID:16755933

  11. Gustatory receptor neuron responds to DEET and other insect repellents in the yellow fever mosquito, aedes aegypti

    Technology Transfer Automated Retrieval System (TEKTRAN)

    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 DEET and other insect repellents. Two other ...

  12. The single kinin receptor signals to separate and independent physiological pathways in Malpighian tubules of the yellow fever mosquito

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In the past we have used the leucokinins, the kinins of the cockroach Leucophaea, to evaluate the mechanism of diuretic action of kinin peptides in Malpighian tubules of the yellow fever mosquito Aedes aegypti. Now using aedeskinins, the kinins of Aedes, are available, we find that in isolated Aede...

  13. Efficient, trans-complementing packaging systems for chimeric, pseudoinfectious dengue 2/yellow fever viruses

    SciTech Connect

    Shustov, Alexandr V.

    2010-04-25

    In our previous studies, we have stated to build a new strategy for developing defective, pseudoinfectious flaviviruses (PIVs) and applying them as a new type of vaccine candidates. PIVs combined the efficiency of live vaccines with the safety of inactivated or subunit vaccines. The results of the present work demonstrate further development of chimeric PIVs encoding dengue virus 2 (DEN2V) glycoproteins and yellow fever virus (YFV)-derived replicative machinery as potential vaccine candidates. The newly designed PIVs have synergistically functioning mutations in the prM and NS2A proteins, which abolish processing of the latter proteins and make the defective viruses capable of producing either only noninfectious, immature and/or subviral DEN2V particles. The PIV genomes can be packaged to high titers into infectious virions in vitro using the NS1-deficient YFV helper RNAs, and both PIVs and helpers can then be passaged as two-component genome viruses at an escalating scale.

  14. The yellow fever 17D virus as a platform for new live attenuated vaccines

    PubMed Central

    Bonaldo, Myrna C; Sequeira, Patrícia C; Galler, Ricardo

    2014-01-01

    The live-attenuated yellow fever 17D virus is one of the most outstanding human vaccines ever developed. It induces efficacious immune responses at a low production cost with a well-established manufacture process. These advantages make the YF17D virus attractive as a vector for the development of new vaccines. At the beginning of vector development studies, YF17D was genetically manipulated to express other flavivirus prM and E proteins, components of the viral envelope. While these 17D recombinants are based on the substitution of equivalent YF17D genes, other antigens from unrelated pathogens have also been successfully expressed and delivered by recombinant YF17D viruses employing alternative strategies for genetic manipulation of the YF17D genome. Herein, we discuss these strategies in terms of possibilities of single epitope or larger sequence expression and the main properties of these replication-competent viral platforms. PMID:24553128

  15. Systems biology approach predicts immunogenicity of the yellow fever vaccine in humans

    PubMed Central

    Lee, Eva K; Cao, Weiping; Nakaya, Helder I; Teuwen, Dirk; Pirani, Ali; Gernert, Kim; Deng, Jiusheng; Marzolf, Bruz; Kennedy, Kathleen; Wu, Haiyan; Bennouna, Soumaya; Oluoch, Herold; Miller, Joseph; Vencio, Ricardo Z; Mulligan, Mark; Aderem, Alan; Ahmed, Rafi; Pulendran, Bali

    2014-01-01

    A major challenge in vaccinology is to prospectively determine vaccine efficacy. Here we have used a systems biology approach to identify early gene ‘signatures’ that predicted immune responses in humans vaccinated with yellow fever vaccine YF-17D. Vaccination induced genes that regulate virus innate sensing and type I interferon production. Computational analyses identified a gene signature, including complement protein C1qB and eukaryotic translation initiation factor 2 alpha kinase 4—an orchestrator of the integrated stress response—that correlated with and predicted YF-17D CD8+ T cell responses with up to 90% accuracy in an independent, blinded trial. A distinct signature, including B cell growth factor TNFRS17, predicted the neutralizing antibody response with up to 100% accuracy. These data highlight the utility of systems biology approaches in predicting vaccine efficacy. PMID:19029902

  16. [The risk of urban yellow fever outbreaks in Brazil by dengue vectors. Aedes aegypti and Aedes albopictus].

    PubMed

    Mondet, B; da Rosa, A P; Vasconcelos, P F

    1996-01-01

    Urban yellow fever (YF) epidemics have disappeared from Brazil since about 50 years, but a selvatic cycle still exist. In many States, cases are more or less numerous each year. Ae. aegypti was eradicated in 1954, re-appeared temporarily in 1967, and then definitively in 1976-1977. Ae. aegypti is a vector of yellow few (YF), but also of dengue, whose first cases were reported in 1982. Today, dengue is endemic in many regions. A second Flavivirus vector, Aedes albopictus is present since about ten years in some States, from which Säo Paulo. The analysis of the YF cases between 1972 and 1994 allowed us to determine the epidemiologic regions. In the first region, the endemic area, the YF virus is circulating "silently" among monkeys, and the emergence of human cases is rare. In the second region, the epidemic area, some epizootics occur in a more or less cyclic way, and human cases can be numerous. Nevertheless, these outbreaks are considered "selvatic" epidemics, as long as Ae. aegypti is not concerned. From the Amazonian region, the virus moves forward along the forest galleries of the Amazone tributaries, from North to South. Actually, dengue epidemics appear in quite all States, and reflect the geographical distribution of Ae. aegypti. Recently, Ae. aegypti was found in the southern part of the Pará State, in the Carajás region considered to be the source of the main YF epidemics. In another hand, Ae. albopictus is now increasing its distribution area, specially in the suburban zones. The ecology of this potential vector, which seems to have a great adaptative capacity, give this vector an intermediate position between the forest galleries, where the YF virus circulates, and the agglomerations infested with Ae. aegypti. Since a few years, the possibility of urban YF is threatening Brazil, it is more and more predictable and we must survey very carefully the epidemiological situation in some regions of the country. PMID:8924767

  17. Rapid Molecular Assays for the Detection of Yellow Fever Virus in Low-Resource Settings

    PubMed Central

    Escadafal, Camille; Faye, Oumar; Sall, Amadou Alpha; Faye, Ousmane; Weidmann, Manfred; Strohmeier, Oliver; von Stetten, Felix; Drexler, Josef; Eberhard, Michael; Niedrig, Matthias; Patel, Pranav

    2014-01-01

    Background Yellow fever (YF) is an acute viral hemorrhagic disease transmitted by Aedes mosquitoes. The causative agent, the yellow fever virus (YFV), is found in tropical and subtropical areas of South America and Africa. Although a vaccine is available since the 1930s, YF still causes thousands of deaths and several outbreaks have recently occurred in Africa. Therefore, rapid and reliable diagnostic methods easy to perform in low-resources settings could have a major impact on early detection of outbreaks and implementation of appropriate response strategies such as vaccination and/or vector control. Methodology The aim of this study was to develop a YFV nucleic acid detection method applicable in outbreak investigations and surveillance studies in low-resource and field settings. The method should be simple, robust, rapid and reliable. Therefore, we adopted an isothermal approach and developed a recombinase polymerase amplification (RPA) assay which can be performed with a small portable instrument and easy-to-use lyophilized reagents. The assay was developed in three different formats (real-time with or without microfluidic semi-automated system and lateral-flow assay) to evaluate their application for different purposes. Analytical specificity and sensitivity were evaluated with a wide panel of viruses and serial dilutions of YFV RNA. Mosquito pools and spiked human plasma samples were also tested for assay validation. Finally, real-time RPA in portable format was tested under field conditions in Senegal. Conclusion/Significance The assay was able to detect 20 different YFV strains and demonstrated no cross-reactions with closely related viruses. The RPA assay proved to be a robust, portable method with a low detection limit (<21 genome equivalent copies per reaction) and rapid processing time (<20 min). Results from real-time RPA field testing were comparable to results obtained in the laboratory, thus confirming our method is suitable for YFV detection in

  18. An Integrated Linkage, Chromosome, and Genome Map for the Yellow Fever Mosquito Aedes aegypti

    PubMed Central

    Timoshevskiy, Vladimir A.; Severson, David W.; deBruyn, Becky S.; Black, William C.; Sharakhov, Igor V.; Sharakhova, Maria V.

    2013-01-01

    Background Aedes aegypti, the yellow fever mosquito, is an efficient vector of arboviruses and a convenient model system for laboratory research. Extensive linkage mapping of morphological and molecular markers localized a number of quantitative trait loci (QTLs) related to the mosquito's ability to transmit various pathogens. However, linking the QTLs to Ae. aegypti chromosomes and genomic sequences has been challenging because of the poor quality of polytene chromosomes and the highly fragmented genome assembly for this species. Methodology/Principal Findings Based on the approach developed in our previous study, we constructed idiograms for mitotic chromosomes of Ae. aegypti based on their banding patterns at early metaphase. These idiograms represent the first cytogenetic map developed for mitotic chromosomes of Ae. aegypti. One hundred bacterial artificial chromosome clones carrying major genetic markers were hybridized to the chromosomes using fluorescent in situ hybridization. As a result, QTLs related to the transmission of the filarioid nematode Brugia malayi, the avian malaria parasite Plasmodium gallinaceum, and the dengue virus, as well as sex determination locus and 183 Mbp of genomic sequences were anchored to the exact positions on Ae. aegypti chromosomes. A linear regression analysis demonstrated a good correlation between positions of the markers on the physical and linkage maps. As a result of the recombination rate variation along the chromosomes, 12 QTLs on the linkage map were combined into five major clusters of QTLs on the chromosome map. Conclusion This study developed an integrated linkage, chromosome, and genome map—iMap—for the yellow fever mosquito. Our discovery of the localization of multiple QTLs in a few major chromosome clusters suggests a possibility that the transmission of various pathogens is controlled by the same genomic loci. Thus, the iMap will facilitate the identification of genomic determinants of traits responsible

  19. Assessment of Yellow Fever Epidemic Risk: An Original Multi-criteria Modeling Approach

    PubMed Central

    Briand, Sylvie; Beresniak, Ariel; Nguyen, Tim; Yonli, Tajoua; Duru, Gerard; Kambire, Chantal; Perea, William

    2009-01-01

    Background Yellow fever (YF) virtually disappeared in francophone West African countries as a result of YF mass vaccination campaigns carried out between 1940 and 1953. However, because of the failure to continue mass vaccination campaigns, a resurgence of the deadly disease in many African countries began in the early 1980s. We developed an original modeling approach to assess YF epidemic risk (vulnerability) and to prioritize the populations to be vaccinated. Methods and Findings We chose a two-step assessment of vulnerability at district level consisting of a quantitative and qualitative assessment per country. Quantitative assessment starts with data collection on six risk factors: five risk factors associated with “exposure” to virus/vector and one with “susceptibility” of a district to YF epidemics. The multiple correspondence analysis (MCA) modeling method was specifically adapted to reduce the five exposure variables to one aggregated exposure indicator. Health districts were then projected onto a two-dimensional graph to define different levels of vulnerability. Districts are presented on risk maps for qualitative analysis in consensus groups, allowing the addition of factors, such as population migrations or vector density, that could not be included in MCA. The example of rural districts in Burkina Faso show five distinct clusters of risk profiles. Based on this assessment, 32 of 55 districts comprising over 7 million people were prioritized for preventive vaccination campaigns. Conclusion This assessment of yellow fever epidemic risk at the district level includes MCA modeling and consensus group modification. MCA provides a standardized way to reduce complexity. It supports an informed public health decision-making process that empowers local stakeholders through the consensus group. This original approach can be applied to any disease with documented risk factors. PMID:19597548

  20. Three-dimensional visualization of cultural clusters in the 1878 yellow fever epidemic of New Orleans

    PubMed Central

    Curtis, Andrew J

    2008-01-01

    Background An epidemic may exhibit different spatial patterns with a change in geographic scale, with each scale having different conduits and impediments to disease spread. Mapping disease at each of these scales often reveals different cluster patterns. This paper will consider this change of geographic scale in an analysis of yellow fever deaths for New Orleans in 1878. Global clustering for the whole city, will be followed by a focus on the French Quarter, then clusters of that area, and finally street-level patterns of a single cluster. The three-dimensional visualization capabilities of a GIS will be used as part of a cluster creation process that incorporates physical buildings in calculating mortality-to-mortality distance. Including nativity of the deceased will also capture cultural connection. Results Twenty-two yellow fever clusters were identified for the French Quarter. These generally mirror the results of other global cluster and density surfaces created for the entire epidemic in New Orleans. However, the addition of building-distance, and disease specific time frame between deaths reveal that disease spread contains a cultural component. Same nativity mortality clusters emerge in a similar time frame irrespective of proximity. Italian nativity mortalities were far more densely grouped than any of the other cohorts. A final examination of mortalities for one of the nativity clusters reveals that further sub-division is present, and that this pattern would only be revealed at this scale (street level) of investigation. Conclusion Disease spread in an epidemic is complex resulting from a combination of geographic distance, geographic distance with specific connection to the built environment, disease-specific time frame between deaths, impediments such as herd immunity, and social or cultural connection. This research has shown that the importance of cultural connection may be more important than simple proximity, which in turn might mean traditional

  1. Unusual manifestation of the yellow nail syndrome - Case report*

    PubMed Central

    Papaiordanou, Francine; Epstein, Marina Gabrielle; Miyaoka, Mariana Yumi; Yang, Jeane Jeong Hoon; Pires, Mario Cezar

    2014-01-01

    The yellow nail syndrome is a rare disorder characterized by the classic triad of yellow and dystrophic nails, lymphedema and pleural effusion. We report in this paper a case of yellow nail syndrome, presenting the classic triad of the disease, associated with an unusual lymph accumulation in the abdomen region. PMID:24937826

  2. A Single 17D Yellow Fever Vaccination Provides Lifelong Immunity; Characterization of Yellow-Fever-Specific Neutralizing Antibody and T-Cell Responses after Vaccination

    PubMed Central

    van Leeuwen, Ester M. M.; Remmerswaal, Ester B. M.; ten Berge, Ineke J. M.; de Visser, Adriëtte W.; van Genderen, Perry J. J.; Goorhuis, Abraham; Visser, Leo G.; Grobusch, Martin P.; de Bree, Godelieve J.

    2016-01-01

    Introduction Prompted by recent amendments of Yellow Fever (YF) vaccination guidelines from boost to single vaccination strategy and the paucity of clinical data to support this adjustment, we used the profile of the YF-specific CD8+ T-cell subset profiles after primary vaccination and neutralizing antibodies as a proxy for potentially longer lasting immunity. Methods and Findings PBMCs and serum were collected in six individuals on days 0, 3, 5, 12, 28 and 180, and in 99 individuals >10 years after YF-vaccination. Phenotypic characteristics of YF- tetramer+ CD8+ T-cells were determined using class I tetramers. Antibody responses were measured using a standardized plaque reduction neutralization test (PRNT). Also, characteristics of YF-tetramer positive CD8+ T-cells were compared between individuals who had received a primary- and a booster vaccination. YF-tetramer+ CD8+ T-cells were detectable on day 12 (median tetramer+ cells as percentage of CD8+ T-cells 0.2%, range 0.07–3.1%). On day 180, these cells were still present (median 0.06%, range 0.02–0.78%). The phenotype of YF-tetramer positive CD8+ T-cells shifted from acute phase effector cells on day 12, to late differentiated or effector memory phenotype (CD45RA-/+CD27-) on day 28. Two subsets of YF-tetramer positive T-cells (CD45RA+CD27- and CD45RA+CD27+) persisted until day 180. Within all phenotypic subsets, the T-bet: Eomes ratio tended to be high on day 28 after vaccination and shifted towards predominant Eomes expression on day 180 (median 6.0 (day 28) vs. 2.2 (day 180) p = 0.0625), suggestive of imprinting compatible with long-lived memory properties. YF-tetramer positive CD8+ T-cells were detectable up to 18 years post vaccination, YF-specific antibodies were detectable up to 40 years after single vaccination. Booster vaccination did not increase titers of YF-specific antibodies (mean 12.5 vs. 13.1, p = 0.583), nor induce frequencies or alter phenotypes of YF-tetramer+ CD8+ T-cells. Conclusion The

  3. The effect of bacterial challenge on ferritin regulation in the yellow fever mosquito, Aedes aegypti.

    PubMed

    Geiser, Dawn L; Zhou, Guoli; Mayo, Jonathan J; Winzerling, Joy J

    2013-10-01

    Secreted ferritin is the major iron storage and transport protein in insects. Here, we characterize the message and protein expression profiles of yellow fever mosquito (Aedes aegypti) ferritin heavy chain homologue (HCH) and light chain homologue (LCH) subunits in response to iron and bacterial challenge. In vivo experiments demonstrated tissue-specific regulation of HCH and LCH expression over time post-blood meal (PBM). Transcriptional regulation of HCH and LCH was treatment specific, with differences in regulation for naïve versus mosquitoes challenged with heat-killed bacteria (HKB). Translational regulation by iron regulatory protein (IRP) binding activity for the iron-responsive element (IRE) was tissue-specific and time-dependent PBM. However, mosquitoes challenged with HKB showed little change in IRP/IRE binding activity compared to naïve animals. The changes in ferritin regulation and expression in vivo were confirmed with in vitro studies. We challenged mosquitoes with HKB followed by a blood meal to determine the effects on ferritin expression, and demonstrate a synergistic, time-dependent regulation of expression for HCH and LCH. PMID:23956079

  4. Patterns of a Sylvatic Yellow Fever Virus Amplification in Southeastern Senegal, 2010

    PubMed Central

    Diallo, Diawo; Sall, Amadou A.; Diagne, Cheikh T.; Faye, Oumar; Hanley, Kathryn A.; Buenemann, Michaela; Ba, Yamar; Faye, Ousmane; Weaver, Scott C.; Diallo, Mawlouth

    2014-01-01

    During the wet season of 2010, yellow fever virus (YFV) was detected in field-collected mosquitoes in the Kédougou region in southeastern Senegal. During this outbreak, we studied the association of the abundance of YFV-infected mosquitoes and land cover features to try and understand the dynamics of YFV transmission within the region. In total, 41,234 mosquito females were collected and tested for virus infection in 5,152 pools. YFV was detected in 67 pools; species including Aedes furcifer (52.2% of the infected pools), Ae. luteocephalus (31.3% of the infected pools), Ae. taylori (6.0% of the infected pools) and six other species (10.4% of the infected pools) captured in September (13.4%), October (70.1%), and November (16.4%). Spatially, YFV was detected from mosquitoes collected in all land cover classes but mainly, forest canopies (49.2%). Human infection is likely mediated by Ae. furcifer, the only species found infected with YFV within villages. Villages containing YFV-infected mosquitoes were significantly closer to large forests (> 2 ha) than villages in which no infected mosquitoes were detected. PMID:24615140

  5. YELLOW FEVER PREVENTION STRATEGIES AWARENESS AMONG HIV-INFECTED PATIENTS IN SÃO PAULO, BRAZIL

    PubMed Central

    Avelino-Silva, Vivian Iida; Francelino, Hilario Sousa; Kallás, Esper Georges

    2014-01-01

    Introduction: Vaccination is the main preventive strategy against Yellow Fever (YF), which is a public health concern in Brazil. However, HIV-infected patients might have insufficient knowledge regarding YF, YF prevention, and vaccines in general. Methods: In this questionnaire-based study, data from 158 HIV-infected individuals were addressed in three distinct outpatient clinics in São Paulo. Information was collected on demographic and clinical characteristics, as well as patients' knowledge of vaccines, YF and YF preventive strategies. In addition, individual YF vaccine recommendations and vaccine status were investigated. Results: Although most participants adequately ascertain the vaccine as the main prevention strategy against YF, few participants were aware of the severity and lack of specific treatment for YF. Discrepancy in YF vaccine (patients who should have taken the vaccine, but did not) was observed in 18.8% of participants. Conclusion: YF is an important and preventable public health concern, and these results demonstrate that more information is necessary for the HIV-infected population. PMID:25229222

  6. Is There a Risk of Yellow Fever Virus Transmission in South Asian Countries with Hyperendemic Dengue?

    PubMed Central

    Agampodi, Suneth B.; Wickramage, Kolitha

    2013-01-01

    The fact that yellow fever (YF) has never occurred in Asia remains an “unsolved mystery” in global health. Most countries in Asia with high Aedes aegypti mosquito density are considered “receptive” for YF transmission. Recently, health officials in Sri Lanka issued a public health alert on the potential spread of YF from a migrant group from West Africa. We performed an extensive review of literature pertaining to the risk of YF in Sri Lanka/South Asian region to understand the probability of actual risk and assist health authorities to form evidence informed public health policies/practices. Published data from epidemiological, historical, biological, molecular, and mathematical models were harnessed to assess the risk of YF in Asia. Using this data we examine a number of theories proposed to explain lack of YF in Asia. Considering the evidence available, we conclude that the probable risk of local transmission of YF is extremely low in Sri Lanka and for other South Asian countries despite a high Aedes aegypti density and associated dengue burden. This does not however exclude the future possibility of transmission in Asia, especially considering the rapid influx travelers from endemic areas, as we report, arriving in Sri Lanka. PMID:24367789

  7. Kinetic Study of Yellow Fever 17DD Viral Infection in Gallus gallus domesticus Embryos.

    PubMed

    Manso, Pedro Paulo de Abreu; E P Dias de Oliveira, Bárbara Cristina; Carvalho de Sequeira, Patrícia; Rodrigues Maia de Souza, Yuli; Dos Santos Ferro, Jessica Maria; da Silva, Igor José; Gonçalves Caputo, Luzia Fátima; Tavares Guedes, Priscila; Araujo Cunha Dos Santos, Alexandre; da Silva Freire, Marcos; Bonaldo, Myrna Cristina; Pelajo Machado, Marcelo

    2016-01-01

    Yellow fever continues to be an important epidemiological problem in Africa and South America even though the disease can be controlled by vaccination. The vaccine has been produced since 1937 and is based on YFV 17DD chicken embryo infection. However, little is known about the histopathological background of virus infection and replication in this model. Here we show by morphological and molecular methods (brightfield and confocal microscopies, immunofluorescence, nested-PCR and sequencing) the kinetics of YFV 17DD infection in chicken embryos with 9 days of development, encompassing 24 to 96 hours post infection. Our principal findings indicate that the main cells involved in virus production are myoblasts with a mesenchymal shape, which also are the first cells to express virus proteins in Gallus gallus embryos at 48 hours after infection. At 72 hours post infection, we observed an increase of infected cells in embryos. Many sites are thus affected in the infection sequence, especially the skeletal muscle. We were also able to confirm an increase of nervous system infection at 96 hours post infection. Our data contribute to the comprehension of the pathogenesis of YF 17DD virus infection in Gallus gallus embryos. PMID:27158977

  8. Development and characterization of polyclonal peptide antibodies for the detection of Yellow fever virus proteins.

    PubMed

    Stock, N K; Escadafal, C; Achazi, K; Cissé, M; Niedrig, M

    2015-09-15

    There is still a considerable need for development of new tools and methods detecting specific viral proteins for the diagnosis and pathogenesis study of the Yellow fever virus (YFV). This study aimed to develop and characterize polyclonal peptide antisera for detection of YFV-C and -NS1 proteins. The antisera were used further to investigate NS1 protein expression during YFV infection in mammalian cells. YFV target proteins were detected by all antisera in western blot and immunofluorescence assays. No cross-reactivity was observed with Dengue virus, West Nile virus, Tick-borne encephalitis virus and Japanese encephalitis virus. Nuclear localization of the YFV-C protein was demonstrated for the first time. Experiments investigating NS1 expression suggested a potential use of the YFV-NS1 antisera for development of diagnostic approaches targeting the secreted form of the NS1 protein. The antisera described in this study offer new possibilities for use in YFV research and for the development of novel diagnostic tests. PMID:26086983

  9. Ecdysis triggering hormone signaling in the yellow fever mosquito Aedes aegypti.

    PubMed

    Dai, Li; Adams, Michael E

    2009-05-15

    At the end of each developmental stage, the yellow fever mosquito Aedes aegypti performs the ecdysis behavioral sequence, a precisely timed series of behaviors that culminates in shedding of the old exoskeleton. Here we describe ecdysis triggering hormone-immunoreactive Inka cells located at branch points of major tracheal trunks and loss of staining coincident with ecdysis. Peptides (AeaETH1, AeaETH2) purified from extracts of pharate 4th instar larvae have--PRXamide C-terminal amino acid sequence motifs similar to ETHs previously identified in moths and flies. Injection of synthetic AeaETHs induced premature ecdysis behavior in pharate larvae, pupae and adults. Two functionally distinct subtypes of ETH receptors (AeaETHR-A, AeaETHR-B) of A. aegypti are identified and show high sensitivity and selectivity to ETHs. Increased ETHR transcript levels and behavioral sensitivity to AeaETHs arising in the hours preceding the 4th instar larva-to-pupa ecdysis are correlated with rising ecdysteroid levels, suggesting steroid regulation of receptor gene expression. Our description of natural and ETH-induced ecdysis in A. aegypti should facilitate future approaches directed toward hormone-based interference strategies for control of mosquitoes as human disease vectors. PMID:19298818

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

    PubMed Central

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

    2011-01-01

    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). PMID:21976581

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

    PubMed Central

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

    1998-01-01

    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. PMID:9520437

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

    PubMed

    Jasinskiene, N; Coates, C J; Benedict, M Q; Cornel, A J; Rafferty, C S; James, A A; Collins, F H

    1998-03-31

    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. PMID:9520437

  13. Structure of hermes integrations in the germline of the yellow fever mosquito, Aedes aegypti.

    PubMed

    Jasinskiene, N; Coates, C J; James, A A

    2000-02-01

    The Hermes transposable element is derived from the house fly, Musca domestica, and can incorporate into the germline of the yellow fever mosquito, Aedes aegypti. Preliminary Southern analyses indicated that Hermes integrated along with the marker gene into the mosquito genomic DNA. Here we show that Hermes integrations are accompanied by the integration of the donor plasmid as well. In addition, breaks in the donor plasmid DNAs do not occur precisely, or at the end of the terminal inverted repeats, and are accompanied by small deletions in the plasmids. Furthermore, integrations do not cause the typical 8-bp duplications of the target site DNA. No integrations are observed in the absence of a source of Hermes transposase. The Hermes transposase clearly did not catalyse precise cut-and-paste transposition in these transformed lines. It may have integrated the transposon through general recombination or through a partial replicative transposition mechanism. The imprecision of Hermes integration may result from interactions of the transposase with an endogenous hAT-like element in the mosquito genome. PMID:10672066

  14. Kinetic Study of Yellow Fever 17DD Viral Infection in Gallus gallus domesticus Embryos

    PubMed Central

    Manso, Pedro Paulo de Abreu; E. P. Dias de Oliveira, Bárbara Cristina; Carvalho de Sequeira, Patrícia; Rodrigues Maia de Souza, Yuli; dos Santos Ferro, Jessica Maria; da Silva, Igor José; Gonçalves Caputo, Luzia Fátima; Tavares Guedes, Priscila; Araujo Cunha dos Santos, Alexandre; da Silva Freire, Marcos; Bonaldo, Myrna Cristina; Pelajo Machado, Marcelo

    2016-01-01

    Yellow fever continues to be an important epidemiological problem in Africa and South America even though the disease can be controlled by vaccination. The vaccine has been produced since 1937 and is based on YFV 17DD chicken embryo infection. However, little is known about the histopathological background of virus infection and replication in this model. Here we show by morphological and molecular methods (brightfield and confocal microscopies, immunofluorescence, nested-PCR and sequencing) the kinetics of YFV 17DD infection in chicken embryos with 9 days of development, encompassing 24 to 96 hours post infection. Our principal findings indicate that the main cells involved in virus production are myoblasts with a mesenchymal shape, which also are the first cells to express virus proteins in Gallus gallus embryos at 48 hours after infection. At 72 hours post infection, we observed an increase of infected cells in embryos. Many sites are thus affected in the infection sequence, especially the skeletal muscle. We were also able to confirm an increase of nervous system infection at 96 hours post infection. Our data contribute to the comprehension of the pathogenesis of YF 17DD virus infection in Gallus gallus embryos. PMID:27158977

  15. Pressure-inactivated yellow fever 17DD virus: implications for vaccine development.

    PubMed

    Gaspar, Luciane P; Mendes, Ygara S; Yamamura, Anna M Y; Almeida, Luiz F C; Caride, Elena; Gonçalves, Rafael B; Silva, Jerson L; Oliveira, Andréa C; Galler, Ricardo; Freire, Marcos S

    2008-06-01

    The successful Yellow Fever (YF) vaccine consists of the live attenuated 17D-204 or 17DD viruses. Despite its excellent record of efficacy and safety, serious adverse events have been recorded and influenced extensive vaccination in endemic areas. Therefore, alternative strategies should be considered, which may include inactivated whole virus. High hydrostatic pressure has been described as a method for viral inactivation and vaccine development. The present study evaluated whether high hydrostatic pressure would inactivate the YF 17DD virus. YF 17DD virus was grown in Vero cells in roller bottle cultures and subjected to 310MPa for 3h at 4 degrees C. This treatment abolished YF infectivity and eliminated the ability of the virus to cause disease in mice. Pressure-inactivated virus elicited low level of neutralizing antibody titers although exhibited complete protection against an otherwise lethal challenge with 17DD virus in the murine model. The data warrant further development of pressure-inactivated vaccine against YF. PMID:18420285

  16. Yellow Fever 17DD Vaccine Virus Infection Causes Detectable Changes in Chicken Embryos

    PubMed Central

    Manso, Pedro Paulo de Abreu; Dias de Oliveira, Barbara C. E. P.; de Sequeira, Patrícia Carvalho; Maia de Souza, Yuli Rodrigues; Ferro, Jessica Maria dos Santos; da Silva, Igor José; Caputo, Luzia Fátima Gonçalves; Guedes, Priscila Tavares; dos Santos, Alexandre Araujo Cunha; Freire, Marcos da Silva; Bonaldo, Myrna Cristina; Pelajo-Machado, Marcelo

    2015-01-01

    The yellow fever (YF) 17D vaccine is one of the most effective human vaccines ever created. The YF vaccine has been produced since 1937 in embryonated chicken eggs inoculated with the YF 17D virus. Yet, little information is available about the infection mechanism of YF 17DD virus in this biological model. To better understand this mechanism, we infected embryos of Gallus gallus domesticus and analyzed their histopathology after 72 hours of YF infection. Some embryos showed few apoptotic bodies in infected tissues, suggesting mild focal infection processes. Confocal and super-resolution microscopic analysis allowed us to identify as targets of viral infection: skeletal muscle cells, cardiomyocytes, nervous system cells, renal tubular epithelium, lung parenchyma, and fibroblasts associated with connective tissue in the perichondrium and dermis. The virus replication was heaviest in muscle tissues. In all of these specimens, RT-PCR methods confirmed the presence of replicative intermediate and genomic YF RNA. This clearer characterization of cell targets in chicken embryos paves the way for future development of a new YF vaccine based on a new cell culture system. PMID:26371874

  17. The first cases of Lassa fever in Ghana.

    PubMed

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

    2012-09-01

    Lassa fever is a zoonotic disease endemic in West Africa but with no previous case reported in Ghana. We describe the first two laboratory confirmed cases of Lassa fever from the Ashanti Region of Ghana detected in October and December, 2011. PMID:23661832

  18. Surveillance for Yellow Fever Virus in Non-Human Primates in Southern Brazil, 2001–2011: A Tool for Prioritizing Human Populations for Vaccination

    PubMed Central

    Almeida, Marco A. B.; Cardoso, Jader da C.; dos Santos, Edmilson; da Fonseca, Daltro F.; Cruz, Laura L.; Faraco, Fernando J. C.; Bercini, Marilina A.; Vettorello, Kátia C.; Porto, Mariana A.; Mohrdieck, Renate; Ranieri, Tani M. S.; Schermann, Maria T.; Sperb, Alethéa F.; Paz, Francisco Z.; Nunes, Zenaida M. A.; Romano, Alessandro P. M.; Costa, Zouraide G.; Gomes, Silvana L.; Flannery, Brendan

    2014-01-01

    In Brazil, epizootics among New World monkey species may indicate circulation of yellow fever (YF) virus and provide early warning of risk to humans. Between 1999 and 2001, the southern Brazilian state of Rio Grande do Sul initiated surveillance for epizootics of YF in non-human primates to inform vaccination of human populations. Following a YF outbreak, we analyzed epizootic surveillance data and assessed YF vaccine coverage, timeliness of implementation of vaccination in unvaccinated human populations. From October 2008 through June 2009, circulation of YF virus was confirmed in 67 municipalities in Rio Grande do Sul State; vaccination was recommended in 23 (34%) prior to the outbreak and in 16 (24%) within two weeks of first epizootic report. In 28 (42%) municipalities, vaccination began more than two weeks after first epizootic report. Eleven (52%) of 21 laboratory-confirmed human YF cases occurred in two municipalities with delayed vaccination. By 2010, municipalities with confirmed YF epizootics reported higher vaccine coverage than other municipalities that began vaccination. In unvaccinated human populations timely response to epizootic events is critical to prevent human yellow fever cases. PMID:24625681

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

    PubMed Central

    2009-01-01

    Introduction Lassa fever is an acute arena viral haemorrhagic fever with varied neurological sequelae. Sensorineural hearing loss is one of the rare complications which occur usually during the convalescent stage of the infection. Case presentation The cases of two female patients aged 19 and 43 years old, respectively, with clinical features suggestive of Lassa fever and confirmed by immunoserological/Lassa-virus-specific reverse transcriptase polymerase chain reaction are presented. Both patients developed severe sensorineural hearing loss at acute phases of the infections. Conclusion Sensorineural hearing loss from Lassa fever infections can occur in both acute and convalescent stages and is probably induced by an immune response. PMID:19178735

  20. Typhoid fever: case report and literature review.

    PubMed

    Sanhueza Palma, Natalia Carolina; Farías Molina, Solange; Calzadilla Riveras, Jeannette; Hermoso, Amalia

    2016-01-01

    Typhoid fever remains a major health problem worldwide, in contrast to Chile, where this disease is an isolated finding. Clinical presentation is varied, mainly presenting with fever, malaise, abdominal discomfort, and nonspecific symptoms often confused with other causes of febrile syndrome. We report a six-year-old, male patient presenting with fever of two weeks associated with gastrointestinal symptoms, malaise, hepatomegaly and elevated liver enzymes. Differential diagnoses were considered and a Widal reaction and two blood cultures were requested; both came back positive, confirming the diagnosis of typhoid fever caused by Salmonella typhi. Prior to diagnosis confirmation, empirical treatment was initiated with ceftriaxone and metronidazole, with partial response; then drug therapy was adjusted according to ciprofloxacin susceptibility testing with a favorable clinical response. We discuss diagnostic methods and treatment of enteric fever with special emphasis on typhoid fever. PMID:27392073

  1. Transcutaneous yellow fever vaccination of subjects with or without atopic dermatitis

    PubMed Central

    Slifka, Mark K.; Leung, Donald Y. M.; Hammarlund, Erika; Raué, Hans-Peter; Simpson, Eric L.; Tofte, Susan; Baig-Lewis, Shahana; David, Gloria; Lynn, Henry; Woolson, Rob; Hata, Tissa; Milgrom, Henry; Hanifin, Jon

    2013-01-01

    Background Atopic dermatitis (AD) is a common inflammatory skin disease with global prevalence ranging from 3% to 20%. AD patients have an increased risk for complications following viral infection (e.g., herpes simplex virus), and vaccination of AD patients with live vaccinia virus is contraindicated due to a heightened risk of eczema vaccinatum, a rare but potentially lethal complication associated with smallpox vaccination. Objective To develop a better understanding of immunity to cutaneous viral infection in AD patients. Methods In a double-blind, randomized study, we investigated the safety and immunogenicity of live attenuated yellow fever virus (YFV) vaccination of non-atopic (NA) subjects and AD patients following standard subcutaneous (SC) inoculation or transcutaneous (TC) vaccination administered with a bifurcated needle. Viremia, neutralizing antibody, and antiviral T cell responses were analyzed for up to 30 days post-vaccination. Results YFV vaccination by either route was well tolerated. SC vaccination resulted in higher seroconversion rates than TC vaccination but elicited similar antiviral antibody levels and T cell responses in both NA and AD groups. Following TC vaccination, both groups mounted similar neutralizing antibody responses, but AD patients demonstrated lower antiviral T cell responses by 30 days after vaccination. Among TC-vaccinated subjects, a significant inverse correlation between baseline IgE levels and the magnitude of antiviral antibody and CD4+ T cell responses was observed. Conclusions YFV vaccination of AD patients by the TC route revealed that high baseline IgE levels provides a potential biomarker for predicting reduced virus-specific immune memory following TC infection with a live virus. PMID:24331381

  2. Fluid absorption in the isolated midgut of adult female yellow fever mosquitoes (Aedes aegypti)

    PubMed Central

    Onken, Horst; Moffett, David F.

    2015-01-01

    ABSTRACT The transepithelial voltage (Vte) and the volume of isolated posterior midguts of adult female yellow fever mosquitoes (Aedes aegypti) were monitored. In all experiments, the initial Vte after filling the midgut was lumen negative, but subsequently became lumen positive at a rate of approximately 1 mV min−1. Simultaneously, the midgut volume decreased, indicating spontaneous fluid absorption. When the midguts were filled and bathed with mosquito saline, the average rate of fluid absorption was 36.5±3.0 nl min−1 (N=4, ±s.e.m.). In the presence of theophylline (10 mmol l−1), Vte reached significantly higher lumen-positive values, but the rate of fluid absorption was not affected (N=6). In the presence of NaCN (5 mmol l−1), Vte remained close to 0 mV (N=4) and fluid absorption was reduced (14.4±1.3 nl min−1, N=3, ±s.e.m.). When midguts were filled with buffered NaCl (154 mmol l−1 plus 1 mmol l−1 HEPES) and bathed in mosquito saline with theophylline, fluid absorption was augmented (50.0±5.8 nl min−1, N=12, ±s.e.m.). Concanamycin A (10 µmol l−1), ouabain (1 mmol l−1), and acetazolamide (1 mmol l−1) affected Vte in different ways, but all reduced fluid absorption by 60–70% of the value before addition of the drugs. PMID:25944920

  3. Molecular and immunological characterization of a DNA-launched yellow fever virus 17D infectious clone.

    PubMed

    Jiang, Xiaohong; Dalebout, Tim J; Lukashevich, Igor S; Bredenbeek, Peter J; Franco, David

    2015-04-01

    Yellow fever virus (YFV)-17D is an empirically developed, highly effective live-attenuated vaccine that has been administered to human beings for almost a century. YFV-17D has stood as a paradigm for a successful viral vaccine, and has been exploited as a potential virus vector for the development of recombinant vaccines against other diseases. In this study, a DNA-launched YFV-17D construct (pBeloBAC-FLYF) was explored as a new modality to the standard vaccine to combine the commendable features of both DNA vaccine and live-attenuated viral vaccine. The DNA-launched YFV-17D construct was characterized extensively both in cell culture and in mice. High titres of YFV-17D were generated upon transfection of the DNA into cells, whereas a mutant with deletion in the capsid-coding region (pBeloBAC-YF/ΔC) was restricted to a single round of infection, with no release of progeny virus. Homologous prime-boost immunization of AAD mice with both pBeloBAC-FLYF and pBeloBAC-YF/ΔC elicited specific dose-dependent cellular immune response against YFV-17D. Vaccination of A129 mice with pBeloBAC-FLYF resulted in the induction of YFV-specific neutralizing antibodies in all vaccinated subjects. These promising results underlined the potential of the DNA-launched YFV both as an alternative to standard YFV-17D vaccination and as a vaccine platform for the development of DNA-based recombinant YFV vaccines. PMID:25516543

  4. Entomological assessment of yellow fever-epidemic risk indices in Benue State, Nigeria, 2010-2011.

    PubMed

    Agwu, Ekenma Julia; Igbinosa, Igho Benjamin; Isaac, Clement

    2016-09-01

    Yellow fever (YF) is a vector-borne disease affecting humans and non-human primates in tropical areas. In the past, there have been pockets of YF outbreaks in Nigeria that resulted in preventable deaths. Surveillance efforts towards avoiding another outbreak have been put in place with the aim of early detection and control. However, risk indices relating to the density of immature YF-mosquito vectors are given little consideration even though it is the first step in curbing a possible outbreak. Immature collections from 1538 houses in Ega, Oju, Otukpoicho and Otukpo in Benue State were carried out in 2010 and 2011. Risk indices such as house index (HI), container index (CI) and Breteau index (BI) were estimated. Molecular detection of YF was carried out on randomly selected Aedes larvae and pupae. Overall, 431,381 mosquitoes were collected in and around house premises. Thirteen species were identified: Ae. aegypti (Linneaus), Ae. africanus (Theobald), Ae. albopictus (Skuse), Ae. cumminsii (Theobald), Ae. luteocephalus (Newstead), Ae. simpsoni s.l. (Theobald), Ae. vittatus (Bigot), Anopheles gambiae Giles, An. nili (Theobald), Cx. nebulosus Theobald, Culex quinquefasciatus Say, Lutzia tigripes (Grandpre and Charmoy) and Toxorhynchites brevipalpis Theobald. The HI, CI and BI for Ae. aegypti were high in all the study locations, but low for Ae. lueteocephalus except in Ega. With 50 immature Aedes mosquitoes screened across locations, only Ae. aegypti from Ega were positive for YF. This study places Ega on a high alert of an impending YF outbreak. Thus, urgent steps to clear this area of potential mosquito sites are highly recommended. PMID:27189925

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

    PubMed Central

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

    1999-01-01

    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. PMID:10074160

  6. Phoenix dactylifera L. spathe essential oil: chemical composition and repellent activity against the yellow fever mosquito.

    PubMed

    Demirci, Betül; Tsikolia, Maia; Bernier, Ulrich R; Agramonte, Natasha M; Alqasoumi, Saleh I; Al-Yahya, Mohammed A; Al-Rehaily, Adnan J; Yusufoglu, Hasan S; Demirci, Fatih; Başer, K Hüsnü Can; Khan, Ikhlas A; Tabanca, Nurhayat

    2013-12-01

    Date palm, Phoenix dactylifera L. (Arecaceae), grows commonly in the Arabian Peninsula and is traditionally used to treat various diseases. The aim of the present study was to identify chemical composition of the essential oil and to investigate the repellent activity. The essential oil of P. dactylifera was obtained by hydrodistillation from the spathe, a specialized leaf structure that surrounds the pollinating organs of the palm. The oil was subsequently analyzed by GC-FID and GC-MS. The oil showed promising repellent activity against yellow fever mosquito - Aedes aegypti. Sixteen components were characterized, constituting 99% of the oil. The main components were 3,4-dimethoxytoluene (73.5%), 2,4-dimethoxytoluene (9.5%), β-caryophyllene (5.5%), p-cresyl methyl ether (3.8%), and caryophyllene oxide (2.4%). The minimum effective dosage (MED) for repellency for the P. dactylifera oil was 0.051mg/cm(2), which had moderately lower potency compared to reference standard N,N-diethyl-3-methylbenzamide, DEET (0.018mg/cm(2)) in the "cloth patch assay". The five major compounds were individually assayed for repellency to determine to what extent each is responsible for repellency from the oil. 3,4-Dimethoxytoluene and 2,4-dimethoxytoluene showed the best repellent activity with the same MED value of 0.063mg/cm(2), respectively. The results indicate that these two constituents which comprise a large proportion of the P. dactylifera oil (83%) are likely responsible for the observed repellent activity. In this aspect, the P. dactylifera spathe oil is a sustainable, promising new source of natural repellents. PMID:23948523

  7. Ovary ecdysteroidogenic hormone functions independently of the insulin receptor in the yellow fever mosquito, Aedes aegypti.

    PubMed

    Dhara, Animesh; Eum, Jai-Hoon; Robertson, Anne; Gulia-Nuss, Monika; Vogel, Kevin J; Clark, Kevin D; Graf, Rolf; Brown, Mark R; Strand, Michael R

    2013-12-01

    Most mosquito species must feed on the blood of a vertebrate host to produce eggs. In the yellow fever mosquito, Aedes aegypti, blood feeding triggers medial neurosecretory cells in the brain to release insulin-like peptides (ILPs) and ovary ecdysteroidogenic hormone (OEH). Theses hormones thereafter directly induce the ovaries to produce ecdysteroid hormone (ECD), which activates the synthesis of yolk proteins in the fat body for uptake by oocytes. ILP3 stimulates ECD production by binding to the mosquito insulin receptor (MIR). In contrast, little is known about the mode of action of OEH, which is a member of a neuropeptide family called neuroparsin. Here we report that OEH is the only neuroparsin family member present in the Ae. aegypti genome and that other mosquitoes also encode only one neuroparsin gene. Immunoblotting experiments suggested that the full-length form of the peptide, which we call long OEH (lOEH), is processed into short OEH (sOEH). The importance of processing, however, remained unclear because a recombinant form of lOEH (rlOEH) and synthetic sOEH exhibited very similar biological activity. A series of experiments indicated that neither rlOEH nor sOEH bound to ILP3 or the MIR. Signaling studies further showed that ILP3 activated the MIR but rlOEH did not, yet both neuropeptides activated Akt, which is a marker for insulin pathway signaling. Our results also indicated that activation of TOR signaling in the ovaries required co-stimulation by amino acids and either ILP3 or rlOEH. Overall, we conclude that OEH activates the insulin signaling pathway independently of the MIR, and that insulin and TOR signaling in the ovaries is coupled. PMID:24076067

  8. AaCAT1 of the Yellow Fever Mosquito, Aedes aegypti

    PubMed Central

    Hansen, Immo A.; Boudko, Dmitri Y.; Shiao, Shin-Hong; Voronov, Dmitri A.; Meleshkevitch, Ella A.; Drake, Lisa L.; Aguirre, Sarah E.; Fox, Jeffrey M.; Attardo, Geoffrey M.; Raikhel, Alexander S.

    2011-01-01

    Insect yolk protein precursor gene expression is regulated by nutritional and endocrine signals. A surge of amino acids in the hemolymph of blood-fed female mosquitoes activates a nutrient signaling system in the fat bodies, which subsequently derepresses yolk protein precursor genes and makes them responsive to activation by steroid hormones. Orphan transporters of the SLC7 family were identified as essential upstream components of the nutrient signaling system in the fat body of fruit flies and the yellow fever mosquito, Aedes aegypti. However, the transport function of these proteins was unknown. We report expression and functional characterization of AaCAT1, cloned from the fat body of A. aegypti. Expression of AaCAT1 transcript and protein undergoes dynamic changes during postembryonic development of the mosquito. Transcript expression was especially high in the third and fourth larval stages; however, the AaCAT1 protein was detected only in pupa and adult stages. Functional expression and analysis of AaCAT1 in Xenopus oocytes revealed that it acts as a sodium-independent cationic amino acid transporter, with unique selectivity to l-histidine at neutral pH (K0.5l-His = 0.34 ± 0.07 mm, pH 7.2). Acidification to pH 6.2 dramatically increases AaCAT1-specific His+-induced current. RNAi-mediated silencing of AaCAT1 reduces egg yield of subsequent ovipositions. Our data show that AaCAT1 has notable differences in its transport mechanism when compared with related mammalian cationic amino acid transporters. It may execute histidine-specific transport and signaling in mosquito tissues. PMID:21262963

  9. ATon, abundant novel nonautonomous mobile genetic elements in yellow fever mosquito (Aedes aegypti)

    PubMed Central

    2012-01-01

    Background Mosquitoes are important pathogen vectors affecting human and other animals. Studies on genetic control of mosquito mediated disease transmission gained traction recently due to mosquito transgenesis technology. Active transposons are considered valuable tools to propagate pathogen resistance transgenes among mosquitoes, rendering the whole population recalcitrant to diseases. A major hurdle in this approach is the inefficient remobilization activity after the integration of heterologous transposon vectors bearing transgenes into chromosomes. Therefore, endogenous active transposons in mosquito genomes are highly desirable. Results Starting with the transposable element database of the yellow fever mosquito Aedes aegypti genome, detailed analyses of the members of each TE family were performed to identify sequences with multiple identical copies, an indicator of their latest or current transposition activity. Among a dozen of potentially active TE families, two DNA elements (TF000728 and TF000742 in TEfam) are short and nonautonomous. Close inspection of the elements revealed that these two families were previously mis-categorized and, unlike other known TEs, insert specifically at dinucleotide “AT”. These two families were therefore designated as ATon-I and ATon-II. ATon-I has a total copy number of 294, among which three elements have more than 10 identical copies (146, 61 and 17). ATon-II has a total copy number of 317, among which three elements have more than 10 identical copies (84, 15 and 12). Genome wide searches revealed additional 24 ATon families in A. aegypti genome with nearly 6500 copies in total. Transposon display analysis of ATon-1 family using different A. aegypti strains suggests that the elements are similarly abundant in the tested mosquito strains. Conclusion ATons are novel mobile genetic elements bearing terminal inverted repeats and insert specifically at dinucleotide “AT”. Five ATon families contain elements existing at

  10. Subdoses of 17DD yellow fever vaccine elicit equivalent virological/immunological kinetics timeline

    PubMed Central

    2014-01-01

    Background The live attenuated 17DD Yellow Fever vaccine is one of the most successful prophylactic interventions for controlling disease expansion ever designed and utilized in larger scale. However, increase on worldwide vaccine demands and manufacturing restrictions urge for more detailed dose sparing studies. The establishment of complementary biomarkers in addition to PRNT and Viremia could support a secure decision-making regarding the use of 17DD YF vaccine subdoses. The present work aimed at comparing the serum chemokine and cytokine kinetics triggered by five subdoses of 17DD YF Vaccine. Methods Neutralizing antibody titers, viremia, cytokines and chemokines were tested on blood samples obtained from eligible primary vaccinees. Results and discussion The results demonstrated that a fifty-fold lower dose of 17DD-YF vaccine (587 IU) is able to trigger similar immunogenicity, as evidenced by significant titers of anti-YF PRNT. However, only subdoses as low as 3,013 IU elicit viremia kinetics with an early peak at five days after primary vaccination equivalent to the current dose (27,476 IU), while other subdoses show a distinct, lower in magnitude and later peak at day 6 post-vaccination. Although the subdose of 587 IU is able to trigger equivalent kinetics of IL-8/CXCL-8 and MCP-1/CCL-2, only the subdose of 3,013 IU is able to trigger similar kinetics of MIG/CXCL-9, pro-inflammatory (TNF, IFN-γ and IL-2) and modulatory cytokines (IL-5 and IL-10). Conclusions The analysis of serum biomarkers IFN-γ and IL-10, in association to PRNT and viremia, support the recommendation of use of a ten-fold lower subdose (3,013 IU) of 17DD-YF vaccine. PMID:25022840

  11. Molecular and immunological characterization of a DNA-launched yellow fever virus 17D infectious clone

    PubMed Central

    Jiang, Xiaohong; Dalebout, Tim J.; Lukashevich, Igor S.; Bredenbeek, Peter J.

    2015-01-01

    Yellow fever virus (YFV)-17D is an empirically developed, highly effective live-attenuated vaccine that has been administered to human beings for almost a century. YFV-17D has stood as a paradigm for a successful viral vaccine, and has been exploited as a potential virus vector for the development of recombinant vaccines against other diseases. In this study, a DNA-launched YFV-17D construct (pBeloBAC-FLYF) was explored as a new modality to the standard vaccine to combine the commendable features of both DNA vaccine and live-attenuated viral vaccine. The DNA-launched YFV-17D construct was characterized extensively both in cell culture and in mice. High titres of YFV-17D were generated upon transfection of the DNA into cells, whereas a mutant with deletion in the capsid-coding region (pBeloBAC-YF/ΔC) was restricted to a single round of infection, with no release of progeny virus. Homologous prime–boost immunization of AAD mice with both pBeloBAC-FLYF and pBeloBAC-YF/ΔC elicited specific dose-dependent cellular immune response against YFV-17D. Vaccination of A129 mice with pBeloBAC-FLYF resulted in the induction of YFV-specific neutralizing antibodies in all vaccinated subjects. These promising results underlined the potential of the DNA-launched YFV both as an alternative to standard YFV-17D vaccination and as a vaccine platform for the development of DNA-based recombinant YFV vaccines. PMID:25516543

  12. Yellow Fever Virus Maintenance in Trinidad and Its Dispersal throughout the Americas▿ †

    PubMed Central

    Auguste, Albert J.; Lemey, Philippe; Pybus, Oliver G.; Suchard, Marc A.; Salas, Rosa Alba; Adesiyun, Abiodun A.; Barrett, Alan D.; Tesh, Robert B.; Weaver, Scott C.; Carrington, Christine V. F.

    2010-01-01

    Trinidad, like many other American regions, experiences repeated epizootics of yellow fever virus (YFV). However, it is unclear whether these result from in situ evolution (enzootic maintenance) or regular reintroduction of YFV from the South American mainland. To discriminate between these hypotheses, we carried out a Bayesian phylogeographic analysis of over 100 prM/E gene sequences sampled from 8 South American countries. These included newly sequenced isolates from the recent 2008-2009 Trinidad epizootic and isolates derived from mainland countries within the last decade. The results indicate that the most recent common ancestor of the 2008-2009 epizootic existed in Trinidad 4.2 years prior to 2009 (95% highest probability density [HPD], 0.5 to 9.0 years). Our data also suggest a Trinidad origin for the progenitor of the 1995 Trinidad epizootic and support in situ evolution of YFV between the 1979 and 1988-1989 Trinidad epizootics. Using the same phylogeographic approach, we also inferred the historical spread of YFV in the Americas. The results suggest a Brazilian origin for YFV in the Americas and an overall dispersal rate of 182 km/year (95% HPD, 52 to 462 km/year), with Brazil as the major source population for surrounding countries. There is also strong statistical support for epidemiological links between four Brazilian regions and other countries. In contrast, while there were well-supported epidemiological links within Peru, the only statistically supported external link was a relatively weak link with neighboring Bolivia. Lastly, we performed a complete analysis of the genome of a newly sequenced Trinidad 2009 isolate, the first complete genome for a genotype I YFV isolate. PMID:20631128

  13. Enrollment in YFV Vaccine Trial: An Evaluation of Recruitment Outcomes Associated with a Randomized Controlled Double-Blind Trial of a Live Attenuated Yellow Fever Vaccine.

    PubMed

    Frew, Paula M; Shapiro, Eve T; Lu, Lu; Edupuganti, Srilatha; Keyserling, Harry L; Mulligan, Mark J

    2013-04-15

    This investigation evaluated several factors associated with diverse participant enrollment of a clinical trial assessing safety, immunogenicity, and comparative viremia associated with administration of 17-D live, attenuated yellow fever vaccine given alone or in combination with human immune globulin. We obtained baseline participant information (e.g., sociodemographic, medical) and followed recruitment outcomes from 2005 to 2007. Of 355 potential Yellow Fever vaccine study participants, 231 cases were analyzed. Strong interest in study participation was observed among racial and ethnically diverse persons with 36.34% eligible following initial study screening, resulting in 18.75% enrollment. The percentage of white participants increased from 63.66% (prescreened sample) to 81.25% (enrollment group). The regression model was significant with white race as a predictor of enrollment (OR=2.744, 95% CI=1.415-5.320, p=0.003).In addition, persons were more likely to enroll via direct outreach and referral mechanisms compared to mass advertising (OR=2.433, 95% CI=1.102-5.369). The findings indicate that racially diverse populations can be recruited to vaccine clinical trials, yet actual enrollment may not reflect that diversity. PMID:25221781

  14. The effect of chloroquine prophylaxis on yellow fever vaccine antibody response: comparison of plaque reduction neutralization test and enzyme-linked immunosorbent assay.

    PubMed

    Barry, M; Patterson, J E; Tirrell, S; Cullen, M R; Shope, R E

    1991-01-01

    Weekly oral chloroquine prophylaxis for malaria has been associated with impaired antibody response to intradermal rabies vaccination. Experimental data indicate that chloroquine may inhibit yellow fever virus in vitro, yet there has been no clinical evidence to suggest that antibody response to yellow fever vaccine is impaired by concomitant oral administration of chloroquine. A prospective trial was undertaken to evaluate the antibody response to yellow fever 17D vaccine (Connaught Laboratories) of volunteers who were randomized to taking either chloroquine or no drug. Of fifty subjects, 28 were randomized to taking chloroquine, 22 were randomized to taking no drug. Yellow fever 17D vaccine was administered on day 0 and blood sampled on days 0, 14, 35 and 210. Chloroquine was administered weekly for four weeks. There was no significant difference in peak antibody titer by plaque reduction neutralization testing (PRNT) between the group that took chloroquine (mean log peak of reciprocal titer 1.43 +/- SD 0.60) with vaccine subcutaneously compared to vaccine-only group (mean log peak of reciprocal titer = 1.21 +/- 0.55). All fifty subjects seroconverted to yellow fever vaccine by day 210. ELISA testing was also performed on all subjects. The two tests showed good correlation (Spearman r = 0.675), although ELISA readings were positive by day 14 in significantly more subjects (p = .01). We conclude that routine anti-malarial doses of chloroquine do not affect antibody response to yellow fever 17D vaccine. ELISA testing, a less complex and less time-consuming test, correlates well with PRNT and is proposed for additional trials to measure yellow fever 17D vaccine response in flavivirus non-immune subjects. PMID:1996743

  15. RISK ANALYSIS: CASE HISTORY OF PUCCINIA JACEAE ON YELLOW STARTHISTLE

    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...

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

    PubMed

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

    2013-01-01

    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. PMID:23597024

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

    PubMed Central

    2013-01-01

    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. PMID:23597024

  18. A Case of Relapsing Polychondritis Initiating with Unexplained Fever

    PubMed Central

    Hirayama, Kosuke; Iwanaga, Nozomi; Izumi, Yasumori; Yoshimura, Satoshi; Kurohama, Kazuhiro; Yamashita, Mai; Takahata, Taichi; Oku, Ryuta; Ito, Masahiro; Kawakami, Atsushi; Migita, Kiyoshi

    2016-01-01

    Relapsing polychondritis (RP) is a rare autoimmune disease affecting the multiple organ system. Here, we describe a case of RP initially presenting with high fever. The patient was referred to our hospital for further examination of fever of unknown origin (FUO). On admission, the patient reported dry cough in addition to fever. On physical examination, her red, swollen ears were noted, attributed on histology to inflammation with auricular perichondritis. She was diagnosed with RP and treated with oral prednisone (50 mg/day); her fever and auricular inflammation resolved. The patient no longer reported cough and body temperature returned to normal and the elevated levels of C-reactive protein (CRP) were normalized. In this case, identification of the origin of fever was a challenge because of unspecific symptoms; however, awareness of the systemic manifestations of RP may lead to the prompt diagnosis and therapeutic intervention. PMID:26981127

  19. Hemorrhagic Fevers

    MedlinePlus

    ... by four families of viruses. These include the Ebola and Marburg, Lassa fever, and yellow fever viruses. ... Some VHFs cause mild disease, but some, like Ebola or Marburg, cause severe disease and death. VHFs ...

  20. Increasing Vero viable cell densities for yellow fever virus production in stirred-tank bioreactors using serum-free medium.

    PubMed

    Mattos, Diogo A; Silva, Marlon V; Gaspar, Luciane P; Castilho, Leda R

    2015-08-20

    In this work, changes in Vero cell cultivation methods have been employed in order to improve cell growth conditions to obtain higher viable cell densities and to increase viral titers. The propagation of the 17DD yellow fever virus (YFV) in Vero cells grown on Cytodex I microcarriers was evaluated in 3-L bioreactor vessels. Prior to the current changes, Vero cells were repeatedly displaying insufficient microcarrier colonization. A modified cultivation process with four changes has resulted in higher cell densities and higher virus titers than previously observed for 17DD YFV. PMID:25930117

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

    NASA Astrophysics Data System (ADS)

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

    2013-03-01

    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.

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

    PubMed

    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

    2012-01-01

    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

  3. Clinical and Immunological Insights on Severe, Adverse Neurotropic and Viscerotropic Disease following 17D Yellow Fever Vaccination▿

    PubMed Central

    Silva, Maria Luiza; Espírito-Santo, Luçandra Ramos; Martins, Marina Angela; Silveira-Lemos, Denise; Peruhype-Magalhães, Vanessa; Caminha, Ricardo Carvalho; de Andrade Maranhão-Filho, Péricles; Auxiliadora-Martins, Maria; de Menezes Martins, Reinaldo; Galler, Ricardo; da Silva Freire, Marcos; Marcovistz, Rugimar; Homma, Akira; Teuwen, Dirk E.; Elói-Santos, Silvana Maria; Andrade, Mariléia Chaves; Teixeira-Carvalho, Andréa; Martins-Filho, Olindo Assis

    2010-01-01

    Yellow fever (YF) vaccines (17D-204 and 17DD) are well tolerated and cause very low rates of severe adverse events (YEL-SAE), such as serious allergic reactions, neurotropic adverse diseases (YEL-AND), and viscerotropic diseases (YEL-AVD). Viral and host factors have been postulated to explain the basis of YEL-SAE. However, the mechanisms underlying the occurrence of YEL-SAE remain unknown. The present report provides a detailed immunological analysis of a 23-year-old female patient. The patient developed a suspected case of severe YEL-AVD with encephalitis, as well as with pancreatitis and myositis, following receipt of a 17D-204 YF vaccination. The patient exhibited a decreased level of expression of Fc-γR in monocytes (CD16, CD32, and CD64), along with increased levels of NK T cells (an increased CD3+ CD16+/− CD56+/−/CD3+ ratio), activated T cells (CD4+ and CD8+ cells), and B lymphocytes. Enhanced levels of plasmatic cytokines (interleukin-6 [IL-6], IL-17, IL-4, IL-5, and IL-10) as well as an exacerbated ex vivo intracytoplasmic cytokine pattern, mainly observed within NK cells (gamma interferon positive [IFN-γ+], tumor necrosis factor alpha positive [TNF-α+], and IL-4 positive [IL-4+]), CD8+ T cells (IL-4+ and IL-5+), and B lymphocytes (TNF-α+, IL-4+, and IL-10+). The analysis of CD4+ T cells revealed a complex profile that consisted of an increased frequency of IL-12+ and IFN-γ+ cells and a decreased percentage of TNF-α+, IL-4+, and IL-5+ cells. Depressed cytokine synthesis was observed in monocytes (TNF-α+) following the provision of antigenic stimuli in vitro. These results support the hypothesis that a strong adaptive response and abnormalities in the innate immune system may be involved in the establishment of YEL-AND and YEL-AVD. PMID:19906894

  4. Pathophysiologic and Transcriptomic Analyses of Viscerotropic Yellow Fever in a Rhesus Macaque Model

    PubMed Central

    Engelmann, Flora; Josset, Laurence; Girke, Thomas; Park, Byung; Barron, Alex; Dewane, Jesse; Hammarlund, Erika; Lewis, Anne; Axthelm, Michael K.; Slifka, Mark K.; Messaoudi, Ilhem

    2014-01-01

    Infection with yellow fever virus (YFV), an explosively replicating flavivirus, results in viral hemorrhagic disease characterized by cardiovascular shock and multi-organ failure. Unvaccinated populations experience 20 to 50% fatality. Few studies have examined the pathophysiological changes that occur in humans during YFV infection due to the sporadic nature and remote locations of outbreaks. Rhesus macaques are highly susceptible to YFV infection, providing a robust animal model to investigate host-pathogen interactions. In this study, we characterized disease progression as well as alterations in immune system homeostasis, cytokine production and gene expression in rhesus macaques infected with the virulent YFV strain DakH1279 (YFV-DakH1279). Following infection, YFV-DakH1279 replicated to high titers resulting in viscerotropic disease with ∼72% mortality. Data presented in this manuscript demonstrate for the first time that lethal YFV infection results in profound lymphopenia that precedes the hallmark changes in liver enzymes and that although tissue damage was noted in liver, kidneys, and lymphoid tissues, viral antigen was only detected in the liver. These observations suggest that additional tissue damage could be due to indirect effects of viral replication. Indeed, circulating levels of several cytokines peaked shortly before euthanasia. Our study also includes the first description of YFV-DakH1279-induced changes in gene expression within peripheral blood mononuclear cells 3 days post-infection prior to any clinical signs. These data show that infection with wild type YFV-DakH1279 or live-attenuated vaccine strain YFV-17D, resulted in 765 and 46 differentially expressed genes (DEGs), respectively. DEGs detected after YFV-17D infection were mostly associated with innate immunity, whereas YFV-DakH1279 infection resulted in dysregulation of genes associated with the development of immune response, ion metabolism, and apoptosis. Therefore, WT-YFV infection

  5. A Mouse Model for Studying Viscerotropic Disease Caused by Yellow Fever Virus Infection

    PubMed Central

    Meier, Kathryn C.; Gardner, Christina L.; Khoretonenko, Mikhail V.; Klimstra, William B.; Ryman, Kate D.

    2009-01-01

    Mosquito-borne yellow fever virus (YFV) causes highly lethal, viscerotropic disease in humans and non-human primates. Despite the availability of efficacious live-attenuated vaccine strains, 17D-204 and 17DD, derived by serial passage of pathogenic YFV strain Asibi, YFV continues to pose a significant threat to human health. Neither the disease caused by wild-type YFV, nor the molecular determinants of vaccine attenuation and immunogenicity, have been well characterized, in large part due to the lack of a small animal model for viscerotropic YFV infection. Here, we describe a small animal model for wild-type YFV that manifests clinical disease representative of that seen in primates without adaptation of the virus to the host, which was required for the current hamster YF model. Investigation of the role of type I interferon (IFN-α/β) in protection of mice from viscerotropic YFV infection revealed that mice deficient in the IFN-α/β receptor (A129) or the STAT1 signaling molecule (STAT129) were highly susceptible to infection and disease, succumbing within 6–7 days. Importantly, these animals developed viscerotropic disease reminiscent of human YF, instead of the encephalitic signs typically observed in mice. Rapid viremic dissemination and extensive replication in visceral organs, spleen and liver, was associated with severe pathologies in these tissues and dramatically elevated MCP-1 and IL-6 levels, suggestive of a cytokine storm. In striking contrast, infection of A129 and STAT129 mice with the 17D-204 vaccine virus was subclinical, similar to immunization in humans. Although, like wild-type YFV, 17D-204 virus amplified within regional lymph nodes and seeded a serum viremia in A129 mice, infection of visceral organs was rarely established and rapidly cleared, possibly by type II IFN-dependent mechanisms. The ability to establish systemic infection and cause viscerotropic disease in A129 mice correlated with infectivity for A129-derived, but not WT129

  6. Kawasaki disease following Rocky Mountain spotted fever: a case report

    PubMed Central

    2009-01-01

    Introduction Kawasaki disease is an idiopathic acute systemic vasculitis of childhood. Although it simulates the clinical features of many infectious diseases, an infectious etiology has not been established. This is the first reported case of Kawasaki disease following Rocky Mountain spotted fever. Case presentation We report the case of a 4-year-old girl who presented with fever and petechial rash. Serology confirmed Rocky Mountain spotted fever. While being treated with intravenous doxycycline, she developed swelling of her hands and feet. She had the clinical features of Kawasaki disease which resolved after therapy with intravenous immune globulin (IVIG) and aspirin. Conclusion This case report suggests that Kawasaki disease can occur concurrently or immediately after a rickettsial illness such as Rocky Mountain spotted fever, hypothesizing an antigen-driven immune response to a rickettsial antigen. PMID:19830185

  7. Limited replication of yellow fever 17DD and 17D-Dengue recombinant viruses in rhesus monkeys.

    PubMed

    Trindade, Gisela F; Marchevsky, Renato S; Fillipis, Ana M B de; Nogueira, Rita M R; Bonaldo, Myrna C; Acero, Pedro C; Caride, Elena; Freire, Marcos S; Galler, Ricardo

    2008-06-01

    For the development of safe live attenuated flavivirus vaccines one of the main properties to be established is viral replication. We have used real-time reverse transcriptase-polymerase chain reaction and virus titration by plaque assay to determine the replication of yellow fever 17DD virus (YFV 17DD) and recombinant yellow fever 17D viruses expressing envelope proteins of dengue virus serotypes 2 and 4 (17D-DENV-2 and 17D-DENV-4). Serum samples from rhesus monkeys inoculated with YFV 17DD and 17D-DENV chimeras by intracerebral or subcutaneous route were used to determine and compare the viremia induced by these viruses. Viral load quantification in samples from monkeys inoculated by either route with YFV 17DD virus suggested a restricted capability of the virus to replicate reaching not more than 2.0 log10 PFU mL(-1) or 3.29 log10 copies mL(-1). Recombinant 17D-dengue viruses were shown by plaquing and real-time PCR to be as attenuated as YF 17DD virus with the highest mean peak titer of 1.97 log10 PFU mL(-1) or 3.53 log10 copies mL(-1). These data serve as a comparative basis for the characterization of other 17D-based live attenuated candidate vaccines against other diseases. PMID:18506257

  8. A public health risk assessment for yellow fever vaccination: a model exemplified by an outbreak in the state of São Paulo, Brazil

    PubMed Central

    Ribeiro, Ana Freitas; Tengan, Ciléa; Sato, Helena Keico; Spinola, Roberta; Mascheretti, Melissa; França, Ana Cecilia Costa; Port-Carvalho, Marcio; Pereira, Mariza; de Souza, Renato Pereira; Amaku, Marcos; Burattini, Marcelo Nascimento; Coutinho, Francisco Antonio Bezerra; Lopez, Luis Fernandez; Massad, Eduardo

    2015-01-01

    We propose a method to analyse the 2009 outbreak in the region of Botucatu in the state of São Paulo (SP), Brazil, when 28 yellow fever (YF) cases were confirmed, including 11 deaths. At the time of the outbreak, the Secretary of Health of the State of São Paulo vaccinated one million people, causing the death of five individuals, an unprecedented number of YF vaccine-induced fatalities. We apply a mathematical model described previously to optimise the proportion of people who should be vaccinated to minimise the total number of deaths. The model was used to calculate the optimum proportion that should be vaccinated in the remaining, vaccine-free regions of SP, considering the risk of vaccine-induced fatalities and the risk of YF outbreaks in these regions. PMID:25946247

  9. Fever

    MedlinePlus

    A fever is a body temperature that is higher than normal. It is not an illness. It is part of your body's defense against infection. Most bacteria ... cause infections do well at the body's normal temperature (98.6 F). A slight fever can make ...

  10. Plasmid DNA initiates replication of yellow fever vaccine in vitro and elicits virus-specific immune response in mice

    SciTech Connect

    Tretyakova, Irina; Nickols, Brian; Hidajat, Rachmat; Jokinen, Jenny; Lukashevich, Igor S.; Pushko, Peter

    2014-11-15

    Yellow fever (YF) causes an acute hemorrhagic fever disease in tropical Africa and Latin America. To develop a novel experimental YF vaccine, we applied iDNA infectious clone technology. The iDNA represents plasmid that encodes the full-length RNA genome of 17D vaccine downstream from a cytomegalovirus (CMV) promoter. The vaccine was designed to transcribe the full-length viral RNA and to launch 17D vaccine virus in vitro and in vivo. Transfection with 10 ng of iDNA plasmid was sufficient to start replication of vaccine virus in vitro. Safety of the parental 17D and iDNA-derived 17D viruses was confirmed in AG129 mice deficient in receptors for IFN-α/β/γ. Finally, direct vaccination of BALB/c mice with a single 20 μg dose of iDNA plasmid resulted in seroconversion and elicitation of virus-specific neutralizing antibodies in animals. We conclude that iDNA immunization approach combines characteristics of DNA and attenuated vaccines and represents a promising vaccination strategy for YF. - Highlights: • The iDNA{sup ®} platform combines advantages of DNA and live attenuated vaccines. • Yellow fever (YF) 17D vaccine was launched from iDNA plasmid in vitro and in vivo. • Safety of iDNA-generated 17D virus was confirmed in AG129 mice. • BALB/c mice seroconverted after a single-dose vaccination with iDNA. • YF virus-neutralizing response was elicited in iDNA-vaccinated mice.

  11. [A case of imported Dengue fever with acute hepatitis].

    PubMed

    Suh, Sang-jun; Seo, Yeon Seok; Ahn, Jae Hong; Park, Eun Bum; Lee, Sun Jae; Sohn, Jang-uk; Um, Soon Ho

    2007-12-01

    Dengue fever is an acute febrile disease caused by the dengue virus, which belongs to the flaviviridae family, and this virus is transmitted by the bite of the mosquito Aedes aegypti. It occurs in the tropical climates of the South Pacific, Southeast Asia, India, Africa and the subtropical zone of America. Imported cases of Dengue fever and Dengue hemorrhagic fever are rapidly increasing as many Koreans are now traveling abroad. Liver injury is usually detected by laboratory investigation according to a surveillance protocol. Although liver injury by dengue virus has been described in Asia and the Pacific islands, the pathogenic mechanisms are not yet fully clarified. It is usually expressed in a self-limiting pattern and the patient has a complete recovery. We report here on a case of a young woman who presented with general weakness, nausea and significant elevation of the aminotransferase levels, and she was diagnosed with dengue fever. PMID:18159153

  12. Fever

    PubMed Central

    Conti, Bruno

    2010-01-01

    Measurement of body temperature remains one of the most common ways to assess health. An increase in temperature above what is considered to be a normal value is inevitably regarded as a sure sign of disease and referred to with one simple word: fever. In this review, we summarize how research on fever allowed the identification of the exogenous and endogenous molecules and pathways mediating the fever response. We also show how temperature elevation is common to different pathologies and how the molecular components of the fever-generation pathway represent drug targets for antipyretics, such as acetylsalicylic acid, the first “blockbuster drug”. We also show how fever research provided new insights into temperature and energy homeostasis, and into treatment of infection and inflammation. PMID:20305990

  13. [Acute Q Fever: 35 cases in Castilla-La Mancha].

    PubMed

    Bartolomé, Joaquín; Marín, Amparo; Lorente, Santiago; Heredero, Eva; Crespo, María Dolores

    2004-05-01

    We report 35 sporadic cases of acute Q fever diagnosed in the area of Castilla-La Mancha (Spain). Diagnosis was based on a fourfold or greater rise in specific antibody titer. The mean age of the patients was 33 years and the male/female ratio was 2.5. Seventeen patients had hepatitis, 9 had pneumonia, 8 had isolated fever and 1 had myocarditis. An underlying disease was more frequent among patients with pneumonia. PMID:15207121

  14. A fatal case of Lassa fever in London, January 2009.

    PubMed

    Kitching, A; Addiman, S; Cathcart, S; Bischop, L; Krahé, D; Nicholas, M; Coakley, J; Lloyd, G; Brooks, T; Morgan, D; Turbitt, D

    2009-02-12

    In January 2009, the eleventh [corrected] case of Lassa fever imported to the United Kingdom was diagnosed in London. Risk assessment of 328 healthcare contacts with potential direct exposure to Lassa virus - through contact with the case or exposure to bodily fluids - was undertaken. No contacts were assessed to be at high risk of infection and no secondary clinical cases identified. PMID:19215723

  15. Travel Pattern and Prescription Analysis at a Single Travel Clinic Specialized for Yellow Fever Vaccination in South Korea

    PubMed Central

    Gianella, Sara

    2016-01-01

    Background Travel-related risks for infectious diseases vary depending on travel patterns such as purpose, destination, and duration. In this study, we describe the patterns of travel and prescription of vaccines as well as malaria prophylaxis medication (MPM) at a travel clinic in South Korea to identify the gaps to fill for the optimization of pre-travel consultation. Materials and Methods A cohort of travel clinic visitors in 2011 was constructed and early one-third of the visitors of each month were reviewed. During the study period, 10,009 visited the travel clinic and a retrospective chart review was performed for 3,332 cases for analysis of travel patterns and prescriptions. Results People receiving yellow fever vaccine (YFV) (n = 2,933) were traveling more frequently for business and tourism and less frequently for providing non-medical service or research/education compared to the 399 people who did not receive the YFV. Overall, most people were traveling to Eastern Africa, South America, and Western Africa, while South-Eastern Asia was the most common destination for the non-YFV group. Besides YFV, the typhoid vaccine was the most commonly prescribed (54.2%), while hepatitis A presented the highest coverage (74.7%) considering the natural immunity, prior and current vaccination history. Additionally, 402 (82.5%) individuals received a prescription for MPM among the 487 individuals travelling to areas with high-risk of malaria infection. Age over 55 was independently associated with receiving MPM prescription, while purpose of providing service and travel duration over 10 days were associated with no MPM prescription, despite travelling to high-risk areas. Conclusion Eastern Africa and South America were common travel destinations among the visitors to a travel clinic for YFV, and most of them were travelling for tourism and business. For the individuals who are traveling to areas with high-risk for malaria, more proactive approach might be required in

  16. Survival and swimming behavior of insecticide-exposed larvae and pupae of the yellow fever mosquito Aedes aegypti

    PubMed Central

    2014-01-01

    Background The yellow fever mosquito Aedes aegypti is essentially a container-inhabiting species that is closely associated with urban areas. This species is a vector of human pathogens, including dengue and yellow fever viruses, and its control is of paramount importance for disease prevention. Insecticide use against mosquito juvenile stages (i.e. larvae and pupae) is growing in importance, particularly due to the ever-growing problems of resistance to adult-targeted insecticides and human safety concerns regarding such use in human dwellings. However, insecticide effects on insects in general and mosquitoes in particular primarily focus on their lethal effects. Thus, sublethal effects of such compounds in mosquito juveniles may have important effects on their environmental prevalence. In this study, we assessed the survival and swimming behavior of A. aegypti 4th instar larvae (L4) and pupae exposed to increasing concentrations of insecticides. We also assessed cell death in the neuromuscular system of juveniles. Methods Third instar larvae of A. aegypti were exposed to different concentrations of azadirachtin, deltamethrin, imidacloprid and spinosad. Insect survival was assessed for 10 days. The distance swam, the resting time and the time spent in slow swimming were assessed in 4th instar larvae (L4) and pupae. Muscular and nervous cells of L4 and pupae exposed to insecticides were marked with the TUNEL reaction. The results from the survival bioassays were subjected to survival analysis while the swimming behavioral data were subjected to analyses of covariance, complemented with a regression analysis. Results All insecticides exhibited concentration-dependent effects on survival of larvae and pupae of the yellow fever mosquito. The pyrethroid deltamethrin was the most toxic insecticide followed by spinosad, imidacloprid, and azadirachtin, which exhibited low potency against the juveniles. All insecticides except azadirachtin reduced L4 swimming speed and

  17. A Curious Case of Inhalation Fever Caused by Synthetic Cannabinoid

    PubMed Central

    Chinnadurai, Thiru; Shrestha, Srijan; Ayinla, Raji

    2016-01-01

    Patient: Male, 29 Final Diagnosis: Inhalation fever induced by synthetic cannabinoid Symptoms: Agitation • smoked synthetic cannabinoid Medication: Ringer’s lactate solution • Ceftriaxone • Azithromycin• Magnesium sulfate • Potassium Phosphate • Levofloxacin • Risperidone Clinical Procedure: Chest radiograph • CBC • urine toxicology Specialty: Pulmonology Objective: Unusual clinical course Background: This case report describes inhalation fever as an uncommon pulmonary adverse effect of synthetic cannabinoids. Case Report: A 29-year-old man was brought in for severe agitation after smoking K2, a synthetic cannabinoid. He required multiple doses of lorazepam and haloperidol for sedation. His vital signs were notable for a mild fever and tachycardia. Otherwise, the rest of his exam was unremarkable. The laboratory test was significant for leucocytosis and diffuse reticular-nodular and interstitial infiltrates on chest radiograph. Urine drug toxicology was negative. Interestingly, his symptoms and pulmonary infiltrates on the chest radiograph resolved spontaneously after 24 hours of observation. Conclusions: This patient developed transient pulmonary infiltrates and fever following the synthetic cannabinoid inhalation, as seen in self-limiting inhalation fever. Inhalation fever as a consequence of synthetic cannabinoid has not been described previously and there is a need for further research in this field. PMID:27262587

  18. Fever

    MedlinePlus

    ... of charts. A fever is defined as a temperature 1° or more above the normal 98.6°. Minor infections may cause mild or short-term temperature elevations. Temperatures of 103° and above are considered ...

  19. Immunogenicity and safety of tetravalent dengue vaccine in 2-11 year-olds previously vaccinated against yellow fever: randomized, controlled, phase II study in Piura, Peru.

    PubMed

    Lanata, Claudio F; Andrade, Teresa; Gil, Ana I; Terrones, Cynthia; Valladolid, Omar; Zambrano, Betzana; Saville, Melanie; Crevat, Denis

    2012-09-01

    In a randomized, placebo-controlled, monocenter, observer blinded study conducted in an area where dengue is endemic, we assessed the safety and immunogenicity of a recombinant, live, attenuated, tetravalent dengue vaccine candidate (CYD-TDV) in 2-11 year-olds with varying levels of pre-existing yellow-fever immunity due to vaccination 1-7 years previously. 199 children received 3 injections of CYD-TDV (months 0, 6 and 12) and 99 received placebo (months 0 and 6) or pneumococcal polysaccharide vaccine (month 12). One month after the third dengue vaccination, serotype specific neutralizing antibody GMTs were in the range of 178-190 (1/dil) (versus 16.7-38.1 in the control group), a 10-20 fold-increase from baseline, and 94% of vaccines were seropositive to all four serotypes (versus 39% in the control group). There were no vaccine-related SAEs. The observed reactogenicity profile was consistent with phase I studies, with severity grade 1-2 injection site pain, headache, malaise and fever most frequently reported and no increase after subsequent vaccinations. Virologically confirmed dengue cases were seen after completion of the 3 doses: 1 in the CYD-TDV group (N=199), and 3 in the control group (N=99). A 3-dose regimen of CYD-TDV had a good safety profile in 2-11 year olds with a history of YF vaccination and elicited robust antibody responses that were balanced against the four serotypes. PMID:22863660

  20. 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

    2011-01-01

    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. PMID:21619598

  1. Defining travel-associated cases of enteric fever.

    PubMed

    Freedman, Joanne; Lighton, Lorraine; Jones, Jane

    2014-01-01

    There is no internationally recognized case-definition for travel-associated enteric fever in non-endemic countries. This study describes the patterns of case reporting between 2007 and 2011 as travel-associated or not from the surveillance data in England, Wales and Northern Ireland (EWNI), before and after a change in the time component of the case-definition in January 2011. It examines in particular the role of a time frame based on the reported typical incubation period in defining a case of travel-associated enteric fever. The results showed no significant differences in the distribution of cases of enteric fever in regards to the interval between the onset and UK arrival in 2011 compared to 2007-2010 (p=0.98 for typhoid and paratyphoid A); the distribution for paratyphoid B was also similar in both time periods. During 2007-2010, 93% (1730/1853) of all of the cases were classified as travel-associated compared to 94% (448/477) in 2011. This difference was not statistically significant. Changing the time component of the definition of travel-associated enteric fever did not make a significant difference to the proportion of travel-associated cases reported by investigators. Our analysis suggests that time might be subordinate to other considerations when investigators classify a case as travel-associated. PMID:24602772

  2. A Case of Pediatric Q Fever Osteomyelitis Managed Without Antibiotics.

    PubMed

    Khatami, Ameneh; Sparks, Rebecca T; Marais, Ben J

    2015-12-01

    Q fever osteomyelitis, caused by infection with Coxiella burnetti, is rare but should be included in the differential diagnosis of children with culture-negative osteomyelitis, particularly if there is a history of contact with farm animals, and/or granulomatous change on histologic examination of a bone biopsy specimen. We describe a case of Q fever osteomyelitis in a 6-year-old boy in which a decision was made not to treat the patient with combination antimicrobial agents, balancing possible risks of recurrence against potential side effects of prolonged antibiotic treatment. The patient had undergone surgical debridement of a single lesion and was completely asymptomatic after recovery from surgery. This case suggests that a conservative approach of watchful waiting in an asymptomatic patient with chronic Q fever osteomyelitis may be warranted in select cases when close follow-up is possible. PMID:26574586

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

    PubMed

    Yeşilyurt, Murat; Kılıç, Selçuk; Gürsoy, Bensu; Celebi, Bekir; Yerer, Mehmet

    2012-07-01

    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

  4. [Yellow fever virus, dengue 2 and other arboviruses isolated from mosquitos, in Burkina Faso, from 1983 to 1986. Entomological and epidemiological considerations].

    PubMed

    Robert, V; Lhuillier, M; Meunier, D; Sarthou, J L; Monteny, N; Digoutte, J P; Cornet, M; Germain, M; Cordellier, R

    1993-01-01

    An arbovirus surveillance was carried out in Burkina Faso from 1983 to 1986. It was based on crepuscular catches of mosquitoes on human bait in some wooded areas and in one town. The total collection was 228 catches with an average of 8 men per catch. The total number of mosquitoes caught was 44,956 among which 32,010 potential vector of yellow fever; all these mosquitoes were analysed for arbovirology. In the south-western part of the country (region of Bobo-Dioulasso), surveillance was conducted each year from August to November, whilst the circulation of Aedes-borne arboviruses is well known to be favoured. In 1983, 1984 and 1986, seven strains of yellow fever virus were isolated in circumstances remarkably similar. They came from selvatic areas and never from the town. They concerned only Aedes (Stegomyia) luteocephalus which is the very predominant potential vector of yellow fever in the region. They were obtained in low figure, between 1 and 4 per year. They occurred from 27th of October to 21th of November. These observations confirm that the southern portion of the Sudan savanna zone of West Africa is the setting of a customary circulation of yellow fever virus and therefore belongs to the endemic emergence zone. In 1986, two strains of dengue 2 virus were isolated. One concerned Ae. luteocephalus from the selvatic area, the other Ae. (St.) aegypti from the heart of town. These data suggest two distinct cycles for dengue 2 virus, one urban and one selvatic, which could coexist simultaneously in the same region. In the south-eastern part of the country (region of Fada-N'Gourma) a yellow fever epidemic occurred between September and December 1983; its study has enable to precise their entomological aspects. The entomological inoculation rate of yellow fever virus has been evaluated to 22 infected bites per man during the month of october, for a man living close to forest gallery. 25 strains of yellow fever virus strains was isolated from Ae. (Diceromyia

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

    PubMed

    Gotuzzo, Eduardo; Yactayo, Sergio; Córdova, Erika

    2013-09-01

    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

  6. Efficacy and Duration of Immunity after Yellow Fever Vaccination: Systematic Review on the Need for a Booster Every 10 Years

    PubMed Central

    Gotuzzo, Eduardo; Yactayo, Sergio; Córdova, Erika

    2013-01-01

    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

  7. Inhibitory effect of essential oils obtained from plants grown in Colombia on yellow fever virus replication in vitro

    PubMed Central

    Meneses, Rocío; Ocazionez, Raquel E; Martínez, Jairo R; Stashenko, Elena E

    2009-01-01

    Background An antiviral drug is needed for the treatment of patients suffering from yellow fever. Several compounds present in plants can inactive in vitro a wide spectrum of animal viruses. Aim In the present study the inhibitory effect of essential oils of Lippia alba, Lippia origanoides, Oreganum vulgare and Artemisia vulgaris on yellow fever virus (YFV) replication was investigated. Methods The cytotoxicity (CC50) on Vero cells was evaluated by the MTT reduction method. The minimum concentration of the essential oil that inhibited virus titer by more than 50% (MIC) was determined by virus yield reduction assay. YFV was incubated 24 h at 4°C with essential oil before adsorption on Vero cell, and viral replication was carried out in the absence or presence of essential oil. Vero cells were exposed to essential oil 24 h at 37°C before the adsorption of untreated-virus. Results The CC50 values were less than 100 μg/mL and the MIC values were 3.7 and 11.1 μg/mL. The CC50/MIC ratio was of 22.9, 26.4, 26.5 and 8.8 for L. alba, L origanoides, O. vulgare and A. vulgaris, respectively. The presence of essential oil in the culture medium enhances the antiviral effect: L. origanoides oil at 11.1 μg/mLproduced a 100% reduction of virus yield, and the same result was observed with L. alba, O. vulgare and A. vulgaris oils at100 μg/mL. No reduction of virus yield was observed when Vero cells were treated with essential oil before the adsorption of untreated-virus. Conclusion The essential oils evaluated in the study showed antiviral activities against YFV. The mode of action seems to be direct virus inactivation. PMID:19267922

  8. [Dengue fever in internal medicine: a case report].

    PubMed

    Rebuttato, Anna Maria; Califfi, Silvano; De Franceschi, Teresiano; Dodero, Claudio; Durante, Roberto; Falletti, Piera; Gianfreda, Maurizio; Schivo, Andrea; Tassara, Rodolfo

    2002-03-01

    Authors describe a case of dengue fever, accidentally seen for appearance of purple at the lower limbs, fever and fatigue. They want to signal this case not for the difficulty of the diagnosis, because the patient was just arrived from Venezuela and he went, during his travel, in endemic zones for dengue, but because this illness is very uncommon in our Country. Diagnosis was confirmed with the presence of antibody in the serum of the patient and treatment was limited to a careful monitoring of laboratory examination and at an hydratation. Recovery with return to normal value of renal and hepatic function was obtained after 15 days. PMID:12700442

  9. FATAL RHABDOMYOLYSIS IN DENGUE HEMORRHAGIC FEVER: A CASE REPORT.

    PubMed

    Siriyakorn, Nirada; Insiripong, Somchai

    2015-01-01

    Dengue hemorrhagic fever is caused by dengue virus infection. The classical manifestations consist of fever, thrombocytopenia, and hemoconcentration. However, its unusual complications may be fatal, such as prolong shock, massive bleeding, volume overload, and unusual manifestations, for example, severe rhabdomyolysis. Here we report a case of 17-year old Thai man who was referred to our hospital because of 7-day fever with thrombocytopenia, hemoconcentration and right pleural effusion. The serology tests confirmed to be dengue infection. He developed various complications: severe hepatitis, coagulopathy, and heavy proteinuria; encephalopathy that needed a respiratory ventilator. On day 12 of fever, he had myalgia and passed dark urine. Serum creatinine and serum creatinine phosphokinase (CPK) were found abnormally high. He was diagnosed as severe rhabdomyolysis with acute kidney injury, and immediate hemodialysis was performed. He did not respond to treatment and expired within three hours. Although the mechanism of severe rhabdomyolysis in dengue fever is not clearly known, it may theoretically be proposed such as direct muscle cell injury leading to myositis by dengue virus, myotoxic cytokines which are produced in response to viral infection, dehydration or hypophosphatemia. PMID:26506741

  10. The first case of Lassa fever imported from Mali to the United Kingdom, February 2009.

    PubMed

    Atkin, S; Anaraki, S; Gothard, P; Walsh, A; Brown, D; Gopal, R; Hand, J; Morgan, D

    2009-03-12

    This is the first case of Lassa fever to be imported from Mali to the United Kingdom. This paper discusses the investigations, the virological analysis, the surveillance and management of contacts undertaken following a case of Lassa fever. PMID:19317988

  11. First case of imported African tick-bite fever in Poland - Case report.

    PubMed

    Tomasiewicz, Krzysztof; Krzowska-Firych, Joanna; Bielec, Dariusz; Socolovschi, Cristina; Raoult, Didier

    2015-01-01

    This is the first report of a case of African tick bite fever (ATBF) imported to Poland from South-Africa. The patient presented with fever of 38.4(o)C, generalized maculopapular rash and single eschar. Diagnosis was confirmed by polymerase chain reaction (PCR) from eschar biopsies. The patient recovered without any sequelae after 7 days treatment with doxycycline. PMID:26403104

  12. A Possible connection between the 1878 yellow fever epidemic in the southern United States and the 1877-78 El Niño episode

    USGS Publications Warehouse

    Diaz, Henry F.; McCabe, Gregory J.

    1999-01-01

    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.

  13. [Probable case of flea-borne spotted fever (Rickettsia felis)].

    PubMed

    Faccini-Martínez, Álvaro A; Forero-Becerra, Elkin G; Cortés-Vecino, Jesús A; Polo-Teran, Luis J; Jácome, Jorge H; Vargas, Jimmy J; Valbuena, Gustavo; Hidalgo, Marylin

    2013-09-01

    Rickettsia felis is the etiologic agent of flea-borne spotted fever, with Ctenocephalides felis as its main vector and reservoir. Typically, the disease presents as acute fever associated with headache, asthenia, generalized maculo-papular rash, and in some cases, an inoculation eschar. In recent years, R. felis has acquired an important role in the etiology of the acute febrile syndrome; it is indeed an emerging infectious disease, albeit underdiagnosed. Indirect immunofluorescence assay (IFA) is currently the reference diagnostic method. However, this technique has limitations related to the cross reactivity among different species of rickettsiae. Herein, we describe a case of a 16 year-old patient with an acute febrile syndrome secondary to probable infection with R. felis. PMID:24652244

  14. Human impacts have shaped historical and recent evolution in Aedes aegypti, the dengue and yellow fever mosquito

    PubMed Central

    Brown, Julia E.; Evans, Benjamin R.; Zheng, Wei; Obas, Vanessa; Barrera-Martinez, Laura; Egizi, Andrea; Zhao, Hongyu; Caccone, Adalgisa; Powell, Jeffrey R.

    2013-01-01

    Though anthropogenic impacts are often considered harmful to species, human modifications to the landscape can actually create novel niches to which other species can adapt. These “domestication” processes are especially important in the context of arthropod disease vectors, where ecological overlap of vector and human populations may lead to epidemics. Here, we present results of a global genetic study of one such species, the dengue and yellow fever mosquito, Aedes aegypti, whose evolutionary history and current distribution have been profoundly shaped by humans. We used DNA sequences of four nuclear genes and 1504 SNP markers developed with RAD-tag sequencing to test the hypothesis that Ae. aegypti originated in Africa, where a domestic form arose and spread throughout the tropical and subtropical world with human trade and movement. Results confirmed African ancestry of the species, and supported a single subspeciation event leading to the pantropical domestic form. Additionally, genetic data strongly supported the hypothesis that human trade routes first moved domestic Ae. aegypti out of Africa into the New World, followed by a later invasion from the New World into Southeast Asia and the Pacific. These patterns of domestication and invasion are relevant to many species worldwide, as anthropogenic forces increasingly impact evolutionary processes. PMID:24111703

  15. Analysis of a Reverse Transcription Loop-mediated Isothermal Amplification (RT-LAMP) for yellow fever diagnostic.

    PubMed

    Nunes, Marcio R T; Vianez, João Lídio; Nunes, Keley N B; da Silva, Sandro Patroca; Lima, Clayton P S; Guzman, Hilda; Martins, Lívia C; Carvalho, Valéria L; Tesh, Robert B; Vasconcelos, Pedro F C

    2015-12-15

    Yellow Fever virus (YFV) is an important human pathogen in tropical areas of Africa and South America. Although an efficient vaccine is available and has been used since the early 1940s, sylvatic YFV transmission still occurs in forested areas where anthropogenic actions are present, such as mineral extraction, rearing livestock and agriculture, and ecological tourism. In this context, two distinct techniques based on the RT-PCR derived method have been previously developed, however both methods are expensive due to the use of thermo cyclers and labeled probes. We developed isothermal genome amplification, which is a rapid, sensitive, specific and low cost molecular approach for YFV genome detection. This assay used a set of degenerate primers designed for the NS1 gene and was able to amplify, within 30 min in isothermal conditions, the YFV 17D vaccine strain derived from an African wild prototype strain (Asibi), as well as field strains from Brazil, other endemic countries from South and Central America, and the Caribbean. The generic RT-LAMP assay could be helpful for YFV surveillance in field and rapid response during outbreaks in endemic areas. PMID:26459206

  16. Human impacts have shaped historical and recent evolution in Aedes aegypti, the dengue and yellow fever mosquito.

    PubMed

    Brown, Julia E; Evans, Benjamin R; Zheng, Wei; Obas, Vanessa; Barrera-Martinez, Laura; Egizi, Andrea; Zhao, Hongyu; Caccone, Adalgisa; Powell, Jeffrey R

    2014-02-01

    Although anthropogenic impacts are often considered harmful to species, human modifications to the landscape can actually create novel niches to which other species can adapt. These "domestication" processes are especially important in the context of arthropod disease vectors, where ecological overlap of vector and human populations may lead to epidemics. Here, we present results of a global genetic study of one such species, the dengue and yellow fever mosquito, Aedes aegypti, whose evolutionary history and current distribution have been profoundly shaped by humans. We used DNA sequences of four nuclear genes and 1504 single nucleotide polymorphism (SNP) markers developed with restriction-site associated DNA (RAD) sequencing to test the hypothesis that Ae. aegypti originated in Africa, where a domestic form arose and spread throughout the tropical and subtropical world with human trade and movement. Results confirmed African ancestry of the species, and supported a single subspeciation event leading to the pantropical domestic form. In addition, genetic data strongly supported the hypothesis that human trade routes first moved domestic Ae. aegypti out of Africa into the New World, followed by a later invasion from the New World into Southeast Asia and the Pacific. These patterns of domestication and invasion are relevant to many species worldwide, as anthropogenic forces increasingly impact evolutionary processes. PMID:24111703

  17. A Multipurpose, High-Throughput Single-Nucleotide Polymorphism Chip for the Dengue and Yellow Fever Mosquito, Aedes aegypti.

    PubMed

    Evans, Benjamin R; Gloria-Soria, Andrea; Hou, Lin; McBride, Carolyn; Bonizzoni, Mariangela; Zhao, Hongyu; Powell, Jeffrey R

    2015-05-01

    The dengue and yellow fever mosquito, Aedes aegypti, contributes significantly to global disease burden. Genetic study of Aedes aegypti is essential to understanding its evolutionary history, competence as a disease vector, and the effects and efficacy of vector control methods. The prevalence of repeats and transposable elements in the Aedes aegypti genome complicates marker development and makes genome-wide genetic study challenging. To overcome these challenges, we developed a high-throughput genotyping chip, Axiom_aegypti1. This chip screens for 50,000 single-nucleotide polymorphisms present in Aedes aegypti populations from around the world. The array currently used genotypes 96 samples simultaneously. To ensure that these markers satisfy assumptions commonly made in many genetic analyses, we tested for Mendelian inheritance and linkage disequilibrium in laboratory crosses and a wild population, respectively. We have validated more than 25,000 of these markers to date, and expect this number to increase with more sampling. We also present evidence of the chip's efficacy in distinguishing populations throughout the world. The markers on this chip are ideal for applications ranging from population genetics to genome-wide association studies. This tool makes rapid, cost-effective, and comparable genotype data attainable to diverse sets of Aedes aegypti researchers, from those interested in potential range shifts due to climate change to those characterizing the genetic underpinnings of its competence to transmit disease. PMID:25721127

  18. A Multipurpose, High-Throughput Single-Nucleotide Polymorphism Chip for the Dengue and Yellow Fever Mosquito, Aedes aegypti

    PubMed Central

    Evans, Benjamin R.; Gloria-Soria, Andrea; Hou, Lin; McBride, Carolyn; Bonizzoni, Mariangela; Zhao, Hongyu; Powell, Jeffrey R.

    2015-01-01

    The dengue and yellow fever mosquito, Aedes aegypti, contributes significantly to global disease burden. Genetic study of Aedes aegypti is essential to understanding its evolutionary history, competence as a disease vector, and the effects and efficacy of vector control methods. The prevalence of repeats and transposable elements in the Aedes aegypti genome complicates marker development and makes genome-wide genetic study challenging. To overcome these challenges, we developed a high-throughput genotyping chip, Axiom_aegypti1. This chip screens for 50,000 single-nucleotide polymorphisms present in Aedes aegypti populations from around the world. The array currently used genotypes 96 samples simultaneously. To ensure that these markers satisfy assumptions commonly made in many genetic analyses, we tested for Mendelian inheritance and linkage disequilibrium in laboratory crosses and a wild population, respectively. We have validated more than 25,000 of these markers to date, and expect this number to increase with more sampling. We also present evidence of the chip’s efficacy in distinguishing populations throughout the world. The markers on this chip are ideal for applications ranging from population genetics to genome-wide association studies. This tool makes rapid, cost-effective, and comparable genotype data attainable to diverse sets of Aedes aegypti researchers, from those interested in potential range shifts due to climate change to those characterizing the genetic underpinnings of its competence to transmit disease. PMID:25721127

  19. Efficient transposition of the youngest miniature inverted repeat transposable element family of yellow fever mosquito in yeast.

    PubMed

    Fattash, Isam; Lee, Chia-Ni; Mo, Kaiguo; Yang, Guojun

    2015-05-01

    Miniature inverted repeat transposable elements (MITEs) are often the most numerous DNA transposons in plant and animal genomes. The dramatic amplification of MITE families during evolution is puzzling, because the transposase sources for the vast majority of MITE families are unknown. The yellow fever mosquito genome contains > 220-Mb MITE sequences; however, transposition activity has not been demonstrated for any of the MITE families. The Gnome elements are the youngest MITE family in this genome, with at least 116 identical copies. To test whether the putative autonomous element Ozma is capable of mobilizing Gnome and its two sibling MITEs, analyses were performed in a yeast transposition assay system. Whereas the wild-type transposase resulted in very low transposition activity, mutations in the region containing a putative nuclear export signal motif resulted in a dramatic (at least 4160-fold) increase in transposition frequency. We have also demonstrated that each residue of the novel DD37E motif is required for the activity of the Ozma transposase. Footprint sequences left at the donor sites suggest that the transposase may cleave between the second and the third nucleotides from the 5' ends of the elements. The excised elements reinsert specifically at dinucleotide 'TA', ~ 55% of them in yeast genes. The elements described in this article could potentially be useful as genetic tools for genetic manipulation of mosquitoes. PMID:25754725

  20. The interferon signaling antagonist function of yellow fever virus NS5 protein is activated by Type I interferon

    PubMed Central

    Rajsbaum, Ricardo; Macleod, Jesica M. Levingston; Pisanelli, Giuseppe; Pham, Alissa; Ayllon, Juan; Miorin, Lisa; Martinez, Carles; tenOever, Benjamin R; García-Sastre, Adolfo

    2014-01-01

    Summary To successfully establish infection Flaviviruses have to overcome the antiviral state induced by type I interferon (IFN-I). The nonstructural NS5 proteins of several flaviviruses antagonize IFN-I signaling. Here we show that yellow fever virus (YFV) inhibits IFN-I signaling through a unique mechanism that involves binding of YFV NS5 to the IFN-activated transcription factor STAT2 only in cells that have been stimulated with IFN-I. This NS5-STAT2 interaction requires IFN-I-induced tyrosine phosphorylation of STAT1 and the K63-linked polyubiquitination at a lysine in the N-terminal region of YFV NS5. We identified TRIM23 as the E3 ligase that interacts with and polyubiquitinates YFV NS5 to promote its binding to STAT2 and trigger IFN-I signaling inhibition. Our results demonstrate the importance of YFV NS5 in overcoming the antiviral action of IFN-I and offer a unique example of a viral protein that is activated by the same host pathway that it inhibits. PMID:25211074

  1. First report on invasion of yellow fever mosquito, Aedes aegypti, at Narita International Airport, Japan in August 2012.

    PubMed

    Sukehiro, Nayu; Kida, Nori; Umezawa, Masahiro; Murakami, Takayuki; Arai, Naoko; Jinnai, Tsunesada; Inagaki, Shunichi; Tsuchiya, Hidetoshi; Maruyama, Hiroshi; Tsuda, Yoshio

    2013-01-01

    The invasion of the yellow fever mosquito Aedes aegypti at Narita International Airport, Japan was detected for the first time. During the course of routine vector surveillance at Narita International Airport, 27 Ae. aegypti adults emerged from larvae and pupae collected from a single larvitrap placed near No. 88 spot at passenger terminal 2 on August 8, 2012. After the appearance of Ae. aegypti in the larvitrap, we defined a 400-m buffer zone and started an intensive vector survey using an additional 34 larvitraps and 15 CO2 traps. International aircraft and passenger terminal 2 were also inspected, and one Ae. aegypti male was collected from the cargo space of an international aircraft from Darwin via Manila on August 28, 2012. Larvicide treatment with 1.5% fenitrothion was conducted in 64 catch basins and one ditch in the 400-m buffer zone. Twenty-four large water tanks were also treated at least once with 0.5% pyriproxyfen, an insect growth regulator. No Ae. aegypti eggs or adults were found during the 1-month intensive vector survey after finding larvae and pupae in the larvitrap. We concluded that Ae. aegypti had failed to establish a population at Narita International Airport. PMID:23698478

  2. Defining Risk Groups to Yellow Fever Vaccine-Associated Viscerotropic Disease in the Absence of Denominator Data

    PubMed Central

    Seligman, Stephen J.; Cohen, Joel E.; Itan, Yuval; Casanova, Jean-Laurent; Pezzullo, John C.

    2014-01-01

    Several risk groups are known for the rare but serious, frequently fatal, viscerotropic reactions following live yellow fever virus vaccine (YEL-AVD). Establishing additional risk groups is hampered by ignorance of the numbers of vaccinees in factor-specific risk groups thus preventing their use as denominators in odds ratios (ORs). Here, we use an equation to calculate ORs using the prevalence of the factor-specific risk group in the population who remain well. The 95% confidence limits and P values can also be calculated. Moreover, if the estimate of the prevalence is imprecise, discrimination analysis can indicate the prevalence at which the confidence interval results in an OR of ∼1 revealing if the prevalence might be higher without yielding a non-significant result. These methods confirm some potential risk groups for YEL-AVD and cast doubt on another. They should prove useful in situations in which factor-specific risk group denominator data are not available. PMID:24394480

  3. Immunogenicity of Yellow Fever Vaccine Coadministered With MenAfriVac in Healthy Infants in Ghana and Mali

    PubMed Central

    Roy Chowdhury, Panchali; Meier, Christian; Laraway, Hewad; Tang, Yuxiao; Hodgson, Abraham; Sow, Samba O.; Enwere, Godwin C.; Plikaytis, Brian D.; Kulkarni, Prasad S.; Preziosi, Marie-Pierre; Niedrig, Matthias

    2015-01-01

    Background. Yellow fever (YF) is still a major public health problem in endemic regions of Africa and South America. In Africa, one of the main control strategies is routine vaccination within the Expanded Programme on Immunization (EPI). A new meningococcal A conjugate vaccine (PsA-TT) is about to be introduced in the EPI of countries in the African meningitis belt, and this study reports on the immunogenicity of the YF-17D vaccines in infants when administered concomitantly with measles vaccine and PsA-TT. Methods. Two clinical studies were conducted in Ghana and in Mali among infants who received PsA-TT concomitantly with measles and YF vaccines at 9 months of age. YF neutralizing antibody titers were measured using a microneutralization assay. Results. In both studies, the PsA-TT did not adversely affect the immune response to the concomitantly administered YF vaccine at the age of 9 months. The magnitude of the immune response was different between the 2 studies, with higher seroconversion and seroprotection rates found in Mali vs Ghana. Conclusions. Immunogenicity to YF vaccine is unaffected when coadministered with PsA-TT at 9 months of age. Further studies are warranted to better understand the determinants of the immune response to YF vaccine in infancy. Clinical Trials Registration. ISRCTN82484612 (PsA-TT-004); PACTR201110000328305 (PsA-TT-007). PMID:26553692

  4. 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)

    Diaz, Henry F.; McCabe, Gregory J.

    1999-01-01

    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.

  5. [Two imported cases of West Nile fever in Denmark].

    PubMed

    Knudsen, Troels Bygum; Wilcke, Jon Torgny R; Andersen, Ove

    2003-05-01

    In the light of the current American epidemic, and since West Nile fever (WNF) has never previously been reported in Denmark, we describe two cases imported from Israel and Canada, respectively. WNF was diagnosed in a 46-year-old Danish tourist returning from Israel and a visiting 73-year-old Canadian citizen with Danish ancestry. The former manifested itself clinically as a mild flu-like illness, the latter as serious infection of the central nervous system. Thus, in addition to representing a rare case of West Nile encephalitis, it also constitutes one of the first reported cases of human infection of Canadian origin. PMID:12795078

  6. The 17D-204 Vaccine Strain-Induced Protection against Virulent Yellow Fever Virus Is Mediated by Humoral Immunity and CD4+ but not CD8+ T Cells.

    PubMed

    Watson, Alan M; Lam, L K Metthew; Klimstra, William B; Ryman, Kate D

    2016-07-01

    A gold standard of antiviral vaccination has been the safe and effective live-attenuated 17D-based yellow fever virus (YFV) vaccines. Among more than 500 million vaccinees, only a handful of cases have been reported in which vaccinees developed a virulent wild type YFV infection. This efficacy is presumed to be the result of both neutralizing antibodies and a robust T cell response. However, the particular immune components required for protection against YFV have never been evaluated. An understanding of the immune mechanisms that underlie 17D-based vaccine efficacy is critical to the development of next-generation vaccines against flaviviruses and other pathogens. Here we have addressed this question for the first time using a murine model of disease. Similar to humans, vaccination elicited long-term protection against challenge, characterized by high neutralizing antibody titers and a robust T cell response that formed long-lived memory. Both CD4+ and CD8+ T cells were polyfunctional and cytolytic. Adoptive transfer of immune sera or CD4+ T cells provided partial protection against YFV, but complete protection was achieved by transfer of both immune sera and CD4+ T cells. Thus, robust CD4+ T cell activity may be a critical contributor to protective immunity elicited by highly effective live attenuated vaccines. PMID:27463517

  7. Development of a SYBR green I based RT-PCR assay for yellow fever virus: application in assessment of YFV infection in Aedes aegypti

    PubMed Central

    2012-01-01

    Background Yellow Fever virus (YFV) is an important arboviral pathogen in much of sub-Saharan Africa and the tropical Americas. It is the prototype member of the genus Flavivirus and is transmitted primarily by Aedes (Stegomyia) mosquitoes. The incidence of human infections in endemic areas has risen in recent years. Prompt and dependable identification of YFV is a critical component of response to suspect cases. Results We developed a one-step SYBR Green I-based real-time quantitative RT-PCR (qRT-PCR) assay targeting the 5'NTR and capsid-gene junction--for rapid detection and quantification of YFV. The detection limit was 1 PFU/mL, 10-fold more sensitive than conventional RT-PCR, and there was no cross-reactivity with closely related flaviviruses or with alphaviruses. Viral load in samples was determined by standard curve plotted from cycle threshold (Ct) values and virus concentration. The efficacy of the assay in mosquitoes was assessed with spiked samples. The utility of the assay for screening of pooled mosquitoes was also confirmed. Replication of a Cameroon isolate of YFV in Ae. aegypti revealed a marked variation in susceptibility among different colonies at different days post infection (pi). Conclusions The SYBR Green-1 based qRT-PCR assay is a faster, simpler, more sensitive and less expensive procedure for detection and quantification of YFV than other currently used methods. PMID:22264275

  8. The 17D-204 Vaccine Strain-Induced Protection against Virulent Yellow Fever Virus Is Mediated by Humoral Immunity and CD4+ but not CD8+ T Cells

    PubMed Central

    Lam, L. K. Metthew; Klimstra, William B.

    2016-01-01

    A gold standard of antiviral vaccination has been the safe and effective live-attenuated 17D-based yellow fever virus (YFV) vaccines. Among more than 500 million vaccinees, only a handful of cases have been reported in which vaccinees developed a virulent wild type YFV infection. This efficacy is presumed to be the result of both neutralizing antibodies and a robust T cell response. However, the particular immune components required for protection against YFV have never been evaluated. An understanding of the immune mechanisms that underlie 17D-based vaccine efficacy is critical to the development of next-generation vaccines against flaviviruses and other pathogens. Here we have addressed this question for the first time using a murine model of disease. Similar to humans, vaccination elicited long-term protection against challenge, characterized by high neutralizing antibody titers and a robust T cell response that formed long-lived memory. Both CD4+ and CD8+ T cells were polyfunctional and cytolytic. Adoptive transfer of immune sera or CD4+ T cells provided partial protection against YFV, but complete protection was achieved by transfer of both immune sera and CD4+ T cells. Thus, robust CD4+ T cell activity may be a critical contributor to protective immunity elicited by highly effective live attenuated vaccines. PMID:27463517

  9. [From unexplained fever to visceral leishmaniasis--a case report].

    PubMed

    Marković, Ivan; Gudelj-Gracanin, Ana; Culo, Melanie-Ivana; Stoos-Veić, Tajana; Vicković, Ninoslava; Desnica, Bosko; Morović-Vergles, Jadranka

    2014-01-01

    Visceral leishmaniasis or kala-azar is a systemic infectious vector-borne disease caused by protozoa Leishmania donovani and Leishmania infantum that are transmitted to mammalian hosts by sand flies. It occurrs sporadically in endemic areas, including Mediterranean basin. Southern coastal territories of Croatia have been recognized as the foci of the disease. Dogs are the main reservoir of human infection. Clinical features include prolonged fever, malaise, hepatosplenomegaly, pancytopenia and inversion of albumin-globulin ratio. If left untreated, the disease causes death in majority of cases. We report a 47-year-old Croatian patient who was admitted to hospital with 2-month history of fever of unknown origin. Based on bone marrow aspirate findings and positive serological tests, the diagnosis of visceral leishmaniasis was established. We also considered secondary hemophagocytic lymphohystiocytosis in the differential diagnosis. After a 4-week treatment with sodium-stibogluconate clinical remission was achieved as well as complete recovery of hematopoesis. The aim of our case-report is to stress the importance of considering visceral leishmaniasis in patients with longstanding fever in endemic areas. PMID:24720151

  10. A case of familial Mediterranean fever who complained of periodic fever and abdominal pain diagnosed by MEFV gene analysis.

    PubMed

    Ogita, Chie; Matsui, Kiyoshi; Kisida, Dai; Kakudou, Mariko; Yazaki, Masahide; Nakamura, Akinori; Azuma, Kouta; Tsuboi, Kazuyuki; Abe, Takeo; Yokoyama, Yuichi; Furukawa, Tetsuya; Maruoka, Momo; Tamura, Masao; Yoshikawa, Takahiro; Saito, Atsushi; Nishioka, Aki; Sekiguchi, Masahiro; Azuma, Naoto; Kitano, Masayasu; Tsunoda, Shinichiro; Hashimoto-Tamaoki, Tomoko; Sano, Hajime

    2016-01-01

      Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease caused by Mediterranean FeVergene (MEFV) mutations on Chromosome 16, and characterized by periodic fever of and serositis. FMF is the result of gain-of-function mutations in pyrin that lead to interleukin-1β activation. FMF can be classified as "typical" and "atypical" types based on clinical finding and genetic screening. Although MEFV genotyping has enabled FMF to be confirmed in some cases, the diagnosis remains predominantly clinical since genotyping has shown that the disease is characterized by variable manifestations in Japanese. In 1976, the first report performed on the case of Japanese FMF with periodic fever of and serositis. Since 2002, genetic analyses are performed on Japanese FMF patients by K. Shiozaki et al. and N. Tomiyama et al. In our case, she was a 25-year-old Japanese woman with at periodic fever and abdominal pain. MEFV gene analysis demonstrated a heterozygous mutation of variant M694I, leading to a diagnosis of FMF. After the increase dose (up to 3 mg/day) of colchicine, periodic fever and abdominal pain disappeared. It is the important candidate of FMF for differential diagnosis with unexplained periodic fever and serositis, such as our case. PMID:27181238

  11. Clozapine and Fever: A Case of Continued Therapy With Clozapine.

    PubMed

    Bruno, Valentina; Valiente-Gómez, Alicia; Alcoverro, Oscar

    2015-01-01

    Clozapine is a major atypical antipsychotic drug used in treatment-resistant schizophrenia (Patel and Allin. Ther Adv Psychopharmacol 2011;1:25-29). It interferes with dopamine binding to D1, D2, D3, and D5 receptors but has high affinity to D4. It also has an anticholinergic effect and antagonizes α-adrenergic, histaminergic, and serotoninergic receptors (Oerther and Ahlenius. J Pharmacol Exp Ther 2000;292:731-736). Clozapine has proved effective in treating positive and negative symptoms in patients with refractory schizophrenia, thus accounting for its frequent use. Despite its effectiveness, this drug is not without its adverse effects. The most well known is agranulocytosis. There are, however, many others, such as myocarditis, aspiration pneumonia, ileus, fever, hyperglycemia, hyperlipidemia, hypertriglycemia, tachycardia, and weight gain, among others (Bruijnzeel et al. Asian J Psychiatr 2014;11:3-7). Fever induced by clozapine is a common phenomenon (Lowe et al. Ann Pharmacother 2007;41:1700-1704), which usually occurs in the first 4 weeks of treatment, and its prevalence oscillates from 0.5% and 55%, depending on the study (Jeong et al. Schizophr Res 2002;56:191-193; Young et al. Schizophr Bull 1998;24:381-390). The fever lasts for 2.5 days on average, and unless the treatment is discontinued, it generally abates between day 8 and 16 of treatment (Kohen et al. Ann Pharmacother 2009;43:143-146). There are several different theories about the physiopathological mechanism; it could be a variation of malignant neuroleptic syndrome, an infection secondary to neutropenia, and allergic reaction or the emergence of the immunomodulating effect of clozapine. Some case reports in the bibliography have shown that patients in treatment with clozapine can develop a mild leukocytosis, but the presence of other concurrent symptoms, which indicate infection, is not common (Tham and Dickson. J Clin Psychiatry 2002;63:880-884). The theory of an allergic reaction is

  12. Development and validation of an ELISA kit (YF MAC-HD) to detect IgM to yellow fever virus.

    PubMed

    Basile, Alison Jane; Goodman, Christin; Horiuchi, Kalanthe; Laven, Janeen; Panella, Amanda J; Kosoy, Olga; Lanciotti, Robert S; Johnson, Barbara W

    2015-12-01

    Yellow fever virus (YFV) is endemic in tropical and sub-tropical regions of the world, with around 180,000 human infections a year occurring in Africa. Serologic testing is the chief laboratory diagnostic means of identifying an outbreak and to inform the decision to commence a vaccination campaign. The World Health Organization disseminates the reagents for YFV testing to African reference laboratories, and the US Centers for Disease Control and Prevention (CDC) is charged with producing and providing these reagents. The CDC M-antibody capture ELISA is a 2-day test, requiring titration of reagents when new lots are received, which leads to inconsistency in testing and wastage of material. Here we describe the development of a kit-based assay (YF MAC-HD) based upon the CDC method, that is completed in approximately 3.5h, with equivocal samples being reflexed to an overnight protocol. The kit exhibits >90% accuracy when compared to the 2-day test. The kits were designed for use with a minimum of equipment and are stored at 4°C, removing the need for freezing capacity. This kit is capable of tolerating temporary sub-optimal storage conditions which will ease shipping or power outage concerns, and a shelf life of >6 months was demonstrated with no deterioration in accuracy. All reagents necessary to run the YF MAC-HD are included in the kit and are single-use, with 8 or 24 sample options per kit. Field trials are envisioned for the near future, which will enable refinement of the method. The use of the YF MAC-HD is anticipated to reduce materials wastage, and improve the quality and consistency of YFV serologic testing in endemic areas. PMID:26342907

  13. Imidacloprid impairs the post-embryonic development of the midgut in the yellow fever mosquito Stegomyia aegypti (=Aedes aegypti).

    PubMed

    Fernandes, K M; Gonzaga, W G; Pascini, T V; Miranda, F R; Tomé, H V V; Serrão, J E; Martins, G F

    2015-09-01

    The mosquito Stegomyia aegypti (=Aedes aegypti) (Diptera: Culicidae) is a vector for the dengue and yellow fever viruses. As blood digestion occurs in the midgut, this organ constitutes the route of entry of many pathogens. The effects of the insecticide imidacloprid on the survival of St. aegypti were investigated and the sub-lethal effects of the insecticide on midgut development were determined. Third instar larvae were exposed to different concentrations of imidacloprid (0.15, 1.5, 3.0, 6.0 and 15.0 p.p.m.) and survival was monitored every 24 h for 10 days. Midguts from imidacloprid-treated insects at different stages of development were dissected and processed for analyses by transmission electron microscopy, immunofluorescence microscopy and terminal deoxynucleotidyl transferase dUTP nick-end labelling (TUNEL) assays. Imidacloprid concentrations of 3.0 and 15.0 p.p.m. were found to affect midgut development similarly. Digestive cells of the fourth instar larvae (L4) midgut exposed to imidacloprid had more multilamellar bodies, abundantly found in the cell apex, and more electron-lucent vacuoles in the basal region compared with those from untreated insects. Moreover, imidacloprid interfered with the differentiation of regenerative cells, dramatically reducing the number of digestive and endocrine cells and leading to malformation of the midgut epithelium in adults. The data demonstrate that imidacloprid can reduce the survival of mosquitoes and thus indicate its potentially high efficacy in the control of St. aegypti populations. PMID:25968596

  14. Pharmacological and Genetic Evidence for Gap Junctions as Potential New Insecticide Targets in the Yellow Fever Mosquito, Aedes aegypti

    PubMed Central

    Calkins, Travis L.; Piermarini, Peter M.

    2015-01-01

    The yellow fever mosquito Aedes aegypti is an important vector of viral diseases that impact global health. Insecticides are typically used to manage mosquito populations, but the evolution of insecticide resistance is limiting their effectiveness. Thus, identifying new molecular and physiological targets in mosquitoes is needed to facilitate insecticide discovery and development. Here we test the hypothesis that gap junctions are valid molecular and physiological targets for new insecticides. Gap junctions are intercellular channels that mediate direct communication between neighboring cells and consist of evolutionarily distinct proteins in vertebrate (connexins) and invertebrate (innexins) animals. We show that the injection of pharmacological inhibitors of gap junctions (i.e., carbenoxolone, meclofenamic acid, or mefloquine) into the hemolymph of adult female mosquitoes elicits dose-dependent toxic effects, with mefloquine showing the greatest potency. In contrast, when applied topically to the cuticle, carbenoxolone was the only inhibitor to exhibit full efficacy. In vivo urine excretion assays demonstrate that both carbenoxolone and mefloquine inhibit the diuretic output of adult female mosquitoes, suggesting inhibition of excretory functions as part of their mechanism of action. When added to the rearing water of 1st instar larvae, carbenoxolone and meclofenamic acid both elicit dose-dependent toxic effects, with meclofenamic acid showing the greatest potency. Injecting a double-stranded RNA cocktail against innexins into the hemolymph of adult female mosquitoes knock down whole-animal innexin mRNA expression and decreases survival of the mosquitoes. Taken together these data indicate that gap junctions may provide novel molecular and physiological targets for the development of insecticides. PMID:26325403

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

    SciTech Connect

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

    2009-06-12

    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.

  16. Vaccine and Wild-Type Strains of Yellow Fever Virus Engage Distinct Entry Mechanisms and Differentially Stimulate Antiviral Immune Responses

    PubMed Central

    Fernandez-Garcia, Maria Dolores; Meertens, Laurent; Chazal, Maxime; Hafirassou, Mohamed Lamine; Dejarnac, Ophélie; Zamborlini, Alessia; Despres, Philippe; Sauvonnet, Nathalie; Arenzana-Seisdedos, Fernando

    2016-01-01

    ABSTRACT The live attenuated yellow fever virus (YFV) vaccine 17D stands as a “gold standard” for a successful vaccine. 17D was developed empirically by passaging the wild-type Asibi strain in mouse and chicken embryo tissues. Despite its immense success, the molecular determinants for virulence attenuation and immunogenicity of the 17D vaccine are poorly understood. 17D evolved several mutations in its genome, most of which lie within the envelope (E) protein. Given the major role played by the YFV E protein during virus entry, it has been hypothesized that the residues that diverge between the Asibi and 17D E proteins may be key determinants of attenuation. In this study, we define the process of YFV entry into target cells and investigate its implication in the activation of the antiviral cytokine response. We found that Asibi infects host cells exclusively via the classical clathrin-mediated endocytosis, while 17D exploits a clathrin-independent pathway for infectious entry. We demonstrate that the mutations in the 17D E protein acquired during the attenuation process are sufficient to explain the differential entry of Asibi versus 17D. Interestingly, we show that 17D binds to and infects host cells more efficiently than Asibi, which culminates in increased delivery of viral RNA into the cytosol and robust activation of the cytokine-mediated antiviral response. Overall, our study reveals that 17D vaccine and Asibi enter target cells through distinct mechanisms and highlights a link between 17D attenuation, virus entry, and immune activation. PMID:26861019

  17. The single kinin receptor signals to separate and independent physiological pathways in Malpighian tubules of the yellow fever mosquito

    PubMed Central

    Schepel, Stephen A.; Fox, Andrew J.; Miyauchi, Jeremy T.; Sou, Tiffany; Yang, Jason D.; Lau, Kenneth; Blum, Austin W.; Nicholson, Linda K.; Tiburcy, Felix; Nachman, Ronald J.; Piermarini, Peter M.

    2010-01-01

    In the past, we have used the kinins of the cockroach Leucophaea (the leucokinins) to evaluate the mechanism of diuretic action of kinin peptides in Malpighian tubules of the yellow fever mosquito Aedes aegypti. Now using the kinins of Aedes (the aedeskinins), we have found that in isolated Aedes Malpighian tubules all three aedeskinins (1 μM) significantly 1) increased the rate of fluid secretion (V̇S), 2) hyperpolarized the basolateral membrane voltage (Vbl), and 3) decreased the input resistance (Rin) of principal cells, consistent with the known increase in the Cl− conductance of the paracellular pathway in Aedes Malpighian tubules. Aedeskinin-III, studied in further detail, significantly increased V̇S with an EC50 of 1.5 × 10−8 M. In parallel, the Na+ concentration in secreted fluid significantly decreased, and the K+ concentration significantly increased. The concentration of Cl− remained unchanged. While the three aedeskinins triggered effects on Vbl, Rin, and V̇S, synthetic kinin analogs, which contain modifications of the COOH-terminal amide pentapeptide core sequence critical for biological activity, displayed variable effects. For example, kinin analog 1578 significantly stimulated V̇S but had no effect on Vbl and Rin, whereas kinin analog 1708 had no effect on V̇S but significantly affected Vbl and Rin. These observations suggest separate signaling pathways activated by kinins. One triggers the electrophysiological response, and the other triggers fluid secretion. It remains to be determined whether the two signaling pathways emanate from a single kinin receptor via agonist-directed signaling or from a differentially glycosylated receptor. Occasionally, Malpighian tubules did not exhibit a detectable response to natural and synthetic kinins. Hypothetically, the expression of the kinin receptor may depend on developmental, nutritional, and/or reproductive signals. PMID:20538895

  18. 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

    PubMed Central

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

    2013-01-01

    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

  19. Yellow Fever, as seen by the Medical Officers of the Royal Navy in the Nineteenth Century

    PubMed Central

    Dudley, Sheldon F.

    1933-01-01

    A critical review of old Naval Reports, showing how some difficulties in the epidemiology vanished when the mosquito means of transmission was discovered. Data are abstracted to show that the fatality, while generally exaggerated by missed cases, was often as high as recorded—also that latent immunization accounts for some types of immunity, and that the disease was always more virulent in Africa—where it probably originated—rather than in the New World. PMID:19989150

  20. Characterization of Yellow Fever Virus Infection of Human and Non-human Primate Antigen Presenting Cells and Their Interaction with CD4+ T Cells.

    PubMed

    Cong, Yu; McArthur, Monica A; Cohen, Melanie; Jahrling, Peter B; Janosko, Krisztina B; Josleyn, Nicole; Kang, Kai; Zhang, Tengfei; Holbrook, Michael R

    2016-05-01

    Humans infected with yellow fever virus (YFV), a mosquito-borne flavivirus, can develop illness ranging from a mild febrile disease to hemorrhagic fever and death. The 17D vaccine strain of YFV was developed in the 1930s, has been used continuously since development and has proven very effective. Genetic differences between vaccine and wild-type viruses are few, yet viral or host mechanisms associated with protection or disease are not fully understood. Over the past 20 years, a number of cases of vaccine-associated disease have been identified following vaccination with 17D; these cases have been correlated with reduced immune status at the time of vaccination. Recently, several studies have evaluated T cell responses to vaccination in both humans and non-human primates, but none have evaluated the response to wild-type virus infection. In the studies described here, monocyte-derived macrophages (MDM) and dendritic cells (MoDC) from both humans and rhesus macaques were evaluated for their ability to support infection with either wild-type Asibi virus or the 17D vaccine strain and the host cytokine and chemokine response characterized. Human MoDC and MDM were also evaluated for their ability to stimulate CD4+ T cells. It was found that MoDC and MDM supported viral replication and that there were differential cytokine responses to infection with either wild-type or vaccine viruses. Additionally, MoDCs infected with live 17D virus were able to stimulate IFN-γ and IL-2 production in CD4+ T cells, while cells infected with Asibi virus were not. These data demonstrate that wild-type and vaccine YFV stimulate different responses in target antigen presenting cells and that wild-type YFV can inhibit MoDC activation of CD4+ T cells, a critical component in development of protective immunity. These data provide initial, but critical insight into regulatory capabilities of wild-type YFV in development of disease. PMID:27191161

  1. Characterization of Yellow Fever Virus Infection of Human and Non-human Primate Antigen Presenting Cells and Their Interaction with CD4+ T Cells

    PubMed Central

    Cong, Yu; McArthur, Monica A.; Cohen, Melanie; Jahrling, Peter B.; Janosko, Krisztina B.; Josleyn, Nicole; Kang, Kai; Zhang, Tengfei; Holbrook, Michael R.

    2016-01-01

    Humans infected with yellow fever virus (YFV), a mosquito-borne flavivirus, can develop illness ranging from a mild febrile disease to hemorrhagic fever and death. The 17D vaccine strain of YFV was developed in the 1930s, has been used continuously since development and has proven very effective. Genetic differences between vaccine and wild-type viruses are few, yet viral or host mechanisms associated with protection or disease are not fully understood. Over the past 20 years, a number of cases of vaccine-associated disease have been identified following vaccination with 17D; these cases have been correlated with reduced immune status at the time of vaccination. Recently, several studies have evaluated T cell responses to vaccination in both humans and non-human primates, but none have evaluated the response to wild-type virus infection. In the studies described here, monocyte-derived macrophages (MDM) and dendritic cells (MoDC) from both humans and rhesus macaques were evaluated for their ability to support infection with either wild-type Asibi virus or the 17D vaccine strain and the host cytokine and chemokine response characterized. Human MoDC and MDM were also evaluated for their ability to stimulate CD4+ T cells. It was found that MoDC and MDM supported viral replication and that there were differential cytokine responses to infection with either wild-type or vaccine viruses. Additionally, MoDCs infected with live 17D virus were able to stimulate IFN-γ and IL-2 production in CD4+ T cells, while cells infected with Asibi virus were not. These data demonstrate that wild-type and vaccine YFV stimulate different responses in target antigen presenting cells and that wild-type YFV can inhibit MoDC activation of CD4+ T cells, a critical component in development of protective immunity. These data provide initial, but critical insight into regulatory capabilities of wild-type YFV in development of disease. PMID:27191161

  2. Localization and role of inward rectifier K(+) channels in Malpighian tubules of the yellow fever mosquito Aedes aegypti.

    PubMed

    Piermarini, Peter M; Dunemann, Sonja M; Rouhier, Matthew F; Calkins, Travis L; Raphemot, Rene; Denton, Jerod S; Hine, Rebecca M; Beyenbach, Klaus W

    2015-12-01

    Malpighian tubules of adult female yellow fever mosquitoes Aedes aegypti express three inward rectifier K(+) (Kir) channel subunits: AeKir1, AeKir2B and AeKir3. Here we 1) elucidate the cellular and membrane localization of these three channels in the Malpighian tubules, and 2) characterize the effects of small molecule inhibitors of AeKir1 and AeKir2B channels (VU compounds) on the transepithelial secretion of fluid and electrolytes and the electrophysiology of isolated Malpighian tubules. Using subunit-specific antibodies, we found that AeKir1 and AeKir2B localize exclusively to the basolateral membranes of stellate cells and principal cells, respectively; AeKir3 localizes within intracellular compartments of both principal and stellate cells. In isolated tubules bathed in a Ringer solution containing 34 mM K(+), the peritubular application of VU590 (10 μM), a selective inhibitor of AeKir1, inhibited transepithelial fluid secretion 120 min later. The inhibition brings rates of transepithelial KCl and fluid secretion to 54% of the control without a change in transepithelial NaCl secretion. VU590 had no effect on the basolateral membrane voltage (Vbl) of principal cells, but it significantly reduced the cell input conductance (gin) to values 63% of the control within ∼90 min. In contrast, the peritubular application of VU625 (10 μM), an inhibitor of both AeKir1 and AeKir2B, started to inhibit transepithelial fluid secretion as early as 60 min later. At 120 min after treatment, VU625 was more efficacious than VU590, inhibiting transepithelial KCl and fluid secretion to ∼35% of the control without a change in transepithelial NaCl secretion. Moreover, VU625 caused the Vbl and gin of principal cells to respectively drop to values 62% and 56% of the control values within only ∼30 min. Comparing the effects of VU590 with those of VU625 allowed us to estimate that AeKir1 and AeKir2B respectively contribute to 46% and 20% of the transepithelial K

  3. 17DD and 17D-213/77 Yellow Fever Substrains Trigger a Balanced Cytokine Profile in Primary Vaccinated Children

    PubMed Central

    Luiza-Silva, Maria; Batista, Maurício 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, José Geraldo Leite; Lemos, Jandira Aparecida Campos; Auxiliadora-Martins, Maria; Caldas, Iramaya Rodrigues; Elói-Santos, Silvana Maria; Teixeira-Carvalho, Andréa; Martins-Filho, Olindo Assis

    2012-01-01

    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-α 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

  4. Travelers' Health: Yellow Fever

    MedlinePlus

    ... Global TravEpiNet Mobile Apps RSS Feeds Chapter 3 Infectious Diseases Related to Travel Recommend on Facebook Tweet Share ... and Prevention National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Division of Global Migration and Quarantine (DGMQ) ...

  5. A case of brucellosis mimicking Crimean-Congo hemorrhagic fever.

    PubMed

    Metin, Ozge; Teke, Turkan A; Gayretli Aydin, Zeynep G; Kaman, Ayse; Oz, Fatma N; Bayhan, Gulsum I; Tanir, Gonul

    2015-01-01

    Brucellosis is a zoonotic disease caused by Brucella spp. that is transmitted to humans by the ingestion of unpasteurized milk and other dairy products from infected animals or through close contact with secretions. Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease caused by a virus that is transmitted to humans by ixoid tick bites, contact with blood and tissue of infected animals or contact with infected humans. The symptoms of brucellosis are non-specific; it can mimic other diseases. In this paper, we present a case of brucellosis that was initially evaluated as CCHF. We emphasize that brucellosis should be considered in the differential diagnosis of CCHF, especially in endemic countries. PMID:25467988

  6. Diagnosis and management of imported Chikungunya fever in Taiwan: a case report.

    PubMed

    Chang, Ko; Hsieh, Hsiao-Chen; Tsai, Jih-Jin; Lin, Wei-Ru; Lu, Po-Liang; Chen, Yen-Hsu

    2010-05-01

    Chikungunya virus, a mosquito-borne alphavirus, is endemic in Africa and Southeast Asia but is rarely reported in Taiwan. We report the case of a Taiwanese woman who developed Chikungunya fever, which was first diagnosed by a clinician rather than by fever screening at an airport. The woman presented with fever, maculopapular rash, and arthralgia, the triad for the disease, on the day she returned home after a trip to Malaysia. These symptoms are very similar to those of dengue fever, which is endemic in Southern Taiwan. Chikungunya infection was confirmed by reverse transcriptase-polymerase chain reaction and seroconversion on paired serum specimens. For approximately 40 years until 2006, no cases of Chikungunya fever had been found in Taiwan. Clinicians in Taiwan should consider Chikungunya fever as a possible diagnosis for a febrile patient with arthralgia, rash, and a history of travel to an endemic area, such as Africa or Southeast Asia. PMID:20466336

  7. [Clinical aspects observed during an epidemic of 415 cases of Q fever].

    PubMed

    Dupuis, G; Péter, O; Pedroni, D; Petite, J

    1985-06-15

    The clinical findings during a major epidemic of Q-fever which affected 415 people in the Val de Bagnes (Valais, Switzerland) in the autumn of 1983 are reported. Q-fever symptoms were evident in 191 cases but inconspicuous or absent in 224 cases. The symptoms most frequently reported were prolonged high fever, headaches, severe exhaustion, loss of appetite, cough and myalgia. Amongst disorders which accompany acute Q-fever, pneumonia and granulomatous hepatitis are very frequent, while myopericarditis and glomerulonephritis are less frequently observed. Endocarditis, a later complication of Q-fever, is a severe illness which more frequently affects patients with underlying valvular lesions. New serological techniques now permit more rapid and more accurate diagnosis of both acute and chronic Q-fever. PMID:3892664

  8. Yellow fever 17D-vectored vaccines expressing Lassa virus GP1 and GP2 glycoproteins provide protection against fatal disease in guinea pigs.

    PubMed

    Jiang, Xiaohong; Dalebout, Tim J; Bredenbeek, Peter J; Carrion, Ricardo; Brasky, Kathleen; Patterson, Jean; Goicochea, Marco; Bryant, Joseph; Salvato, Maria S; Lukashevich, Igor S

    2011-02-01

    Yellow Fever (YF) and Lassa Fever (LF) are two prevalent hemorrhagic fevers co-circulating in West Africa and responsible for thousands of deaths annually. The YF vaccine 17D has been used as a vector for the Lassa virus glycoprotein precursor (LASV-GPC) or their subunits, GP1 (attachment glycoprotein) and GP2 (fusion glycoprotein). Cloning shorter inserts, LASV-GP1 and -GP2, between YF17D E and NS1 genes enhanced genetic stability of recombinant viruses, YF17D/LASV-GP1 and -GP2, in comparison with YF17D/LASV-GPC recombinant. The recombinant viruses were replication competent and properly processed YF proteins and LASV GP antigens in infected cells. YF17D/LASV-GP1 and -GP2 induced specific CD8+ T cell responses in mice and protected strain 13 guinea pigs against fatal LF. Unlike immunization with live attenuated reassortant vaccine ML29, immunization with YF17D/LASV-GP1 and -GP2 did not provide sterilizing immunity. This study demonstrates the feasibility of YF17D-based vaccine to control LF in West Africa. PMID:21145373

  9. Yellow fever 17D-vectored vaccines expressing Lassa virus GP1 and GP2 glycoproteins provide protection against fatal disease in guinea pigs

    PubMed Central

    Jiang, Xiaohong; Dalebout, Tim J.; Bredenbeek, Peter J.; Carrion, Ricardo; Brasky, Kathleen; Patterson, Jean; Goicochea, Marco; Bryant, Joseph; Salvato, Maria S.; Lukashevich, Igor S.

    2010-01-01

    Yellow Fever (YF) and Lassa Fever (LF) are two prevalent hemorrhagic fevers co-circulating in West Africa and responsible for thousands of deaths annually. The YF vaccine 17D has been used as a vector for the Lassa virus glycoprotein precursor (LASV-GPC) or their subunits, GP1 (attachment glycoprotein) and GP2 (fusion glycoprotein). Cloning shorter inserts, LASV GP1 and GP2, between YF17D E and NS1 genes enhanced genetic stability of recombinant viruses, YF17D/LASV-GP1 and –GP2, in comparison with YF17D/LASV-GPC recombinant. The recombinant viruses were replication competent and properly processed YF and LASV GP proteins in infected cells. YF17D/LASV-GP1&GP2 induced specific CD8+ T cell responses in mice and protected strain 13 guinea pigs against fatal LF. Unlike immunization with live attenuated reassortant vaccine ML29, immunization with YF17D/LASV-GP1&GP2 did not provide sterilizing immunity. This study demonstrates the feasibility of YF17D-based vaccine to control LF in West Africa. PMID:21145373

  10. Two Cases of Q-Fever in Hairy Cell Leukemia

    PubMed Central

    Iannitto, Emilio; Tick, Lidwine W.; Arents, Nicolaas L. A.; Kuijper, Philip H.; Nijziel, Marten R.

    2014-01-01

    Hairy cell leukemia (HCL) is a rare B-cell lymphoproliferative disorder accounting for about 2% of all leukemias. The clinical course is indolent, however HCL patients are particularly susceptible to infections. Here we report two cases of Q-fever as first manifestation of disease in two patients affected by HCL. Both patients described in this report showed an unusually sluggish clinical response to the antibiotic treatment with ciprofloxacin probably because of the marked immunodeficiency. However, treatment of HCL with cladribine administered soon after the resolution of QF pneumonitis was uneventful and led to a complete remission in both cases. Most probably the association of Coxiella burnetii (CB) infection and HCL that we observed in two patients is due to chance. However, a hairy cell resembling transformation of freshly isolated human peripheral blood lymphocytes upon CB has been showed. We think that the possibility of CB infection in febrile HCL patient should be always taken in mind, especially in endemic areas. In addition the potential for such infections to become chronic in HCL patients should not be overlooked and the reporting of further cases should be encouraged. PMID:25180111

  11. Acute Scrotal Ulcers in Typhoid Fever: Case Report and Literature Review

    PubMed Central

    Choi, Hil Yin; Nickless, David; Tee, Wennie; Tong, En’en; Aboltins, Craig A.

    2015-01-01

    Background. In developed countries, typhoid fever is a travel-associated disease that is often overlooked. However, as standard blood and stool culture methods have relatively low sensitivity, diagnosis depends heavily on clinical signs and symptoms and on a high level of suspicion. Methods. Reported here is the case of an 18-year-old male who presented with fever and acute scrotal ulcers and whose blood cultures were positive for Salmonella enterica serotype Typhi. A review of genital ulcers associated with typhoid fever in the literature is discussed. Conclusion. This report suggests that typhoid fever is a differential diagnosis of acute genital ulcers. PMID:25859155

  12. Child-Invented Health Education Games: A Case Study for Dengue Fever

    ERIC Educational Resources Information Center

    Lennon, Jeffrey L.; Coombs, David W.

    2006-01-01

    The study's goal was to demonstrate the ability of an 8-year-old child to create educational games for the topic of dengue fever control. A naturalistic descriptive case study method was employed. The child had two dengue fever educational game creation activities. The study demonstrated that a child could develop functional games related to…

  13. Limitations of the complement-fixation test for distinguishing naturally acquired from vaccine-induced yellow fever infection in flavivirus-hyperendemic areas.

    PubMed

    Monath, T P; Craven, R B; Muth, D J; Trautt, C J; Calisher, C H; Fitzgerald, S A

    1980-07-01

    On the basis of previous studies, it has long been stated that 17D yellow fever (YF) vaccine generally does not induce complement-fixing (CF) antibodies, and that the presence of CF antibodies could be used in epidemiological studies to distinguish individuals infected with wild YF virus from vaccinated persons. In January 1979, seroepidemiological investigations were conducted during a YF epidemic in The Gambia, West Africa. Since a mass vaccination campaign was also in progress, it was important to confirm that the CF test could be used for serodiagnosis and determination of the incidence of natural YF infections. The serological responses of 58 individuals who received 17D YF vaccine were studied. The vaccinees fell into three gorups: 1) those with prevaccination YF neutralizing (N) antibodies; 2) immunological virgins without prevaccination YF-N antibody or hemagglutination-inhibiting (HI) antibodies to heterologous flaviviruses (Zika, West Nile, dengue 1, Uganda S, Spondweni, or Ntaya; and 3) those without prevaccination YF-N antibodies but with heterologous flaviviral HI antibodies. Vaccination of persons without prior flaviviral immunological experience resulted in monotypic YF HI and/or N antibody seroconversions, but no CF antibody response. The presence of prevaccination YF N antibodies blocked serological response to the vaccine in a high proportion of the cases; however, 24% of vaccinees in this group had a marked rise in log2 YF CF antibody titer (mean increase of 3.9). Thirteen (46%) of 28 persons without prevaccination YF N, but with heterologous flaviviral HI antibodies demonstrated YF CF antibody seroconversion or increase in titer following vaccination; in this group the mean increase in log2/ YF CF antibody titer was 2.1. The CF antibody response was generally broadly cross-reactive; but in a few individuals, the YF CF antibody response was homotypic. Nine different patterns of HI and CF homologous and heterologous antibody responses were defined

  14. Samuel Holden Parsons Lee (1772-1863): American physician, entrepreneur and selfless fighter of the 1798 Yellow Fever epidemic of New London, Connecticut.

    PubMed

    Mattie, James K; Desai, Sukumar P

    2015-02-01

    Samuel Holden Parsons Lee practised medicine at a time when the germ theory of disease had not yet been proposed and antibiotics remained undiscovered. In 1798 he served selflessly as the only physician in town who was willing to battle the Yellow Fever outbreak of New London, Connecticut. Because he practised at the dawn of the age of patent medicine, unfortunately his name also came to be associated with medical quackery. We argue that his contributions have been grossly underestimated. He compounded and vended medications - including bilious pills and bitters - that were gold standards of the day. Moreover, one preparation for treatment of kidney stones led to his sub-specialization in this field and was met with such success that its sale continued for nearly 100 years after his death. While a talented medical man, Lee also had a knack for business, finding success in trading, whaling and real estate. PMID:24585580

  15. Pulmonary hemorrhage syndrome associated with an autochthonous case of dengue hemorrhagic fever.

    PubMed

    Setlik, Robert F; Ouellette, Daniel; Morgan, Julia; McAllister, C Kenneth; Dorsey, David; Agan, Brian K; Horvath, Lynn; Zimmerman, Michelle K; Purcell, Bret

    2004-07-01

    Dengue fever is a major public health problem worldwide. Dengue hemorrhagic fever, a much rarer form of the disease, occurs when a person previously infected with dengue is re-infected with a different viral serotype. In recent years the infection rates of dengue and both clinical syndromes have increased along the United States-Mexico border. We present the case of a 61-year-old Laotian female who presented with a 1-week history of fever, altered mental status, oral ulceration, and rash. The patient developed diffuse pulmonary hemorrhage and anemia requiring multiple transfusions. She eventually sustained multi-organ system failure and expired. Both the titer data and serologies were consistent with the diagnosis of dengue hemorrhagic fever. We hypothesize that this syndrome was the result of re-infection occurring within the United States. This case is also unusual in that it is the second reported in the literature of pulmonary hemorrhages associated with dengue hemorrhagic fever. PMID:15301127

  16. A case of Lassa fever: experience at St Thomas's Hospital.

    PubMed Central

    Cooper, C B; Gransden, W R; Webster, M; King, M; O'Mahony, M; Young, S; Banatvala, J E

    1982-01-01

    An 18-year-old Nigerian girl, normally resident in Jos, was admitted to hospital for five days before she was diagnosed as having Lassa fever. There were several atypical features in the early stages of here illness, notably the absence of prostration, pharyngitis, or bradycardia and the development of appreciable leucocytosis. Consequent control and surveillance measures required checks for 21 days on 173 people who had had contact with as first line if they had handled her or specimens without taking precautions to avoid direct skin contact with her excretions, secretions, and blood; other contacts were categorised as second line. During her time in hospital she was managed in a single room on a general ward. She visited a number of investigative departments within the hospital, and her specimens were examined in five clinical laboratories. Despite this no secondary cases occurred among either first- or second-line contacts, and there was no serological evidence of subclinical infection among any of the contacts tested (159 people). PMID:6812717

  17. Molecular Differentiation of the African Yellow Fever Vector Aedes bromeliae (Diptera: Culicidae) from Its Sympatric Non-vector Sister Species, Aedes lilii

    PubMed Central

    Bennett, Kelly Louise; Linton, Yvonne-Marie; Shija, Fortunate; Kaddumukasa, Martha; Djouaka, Rousseau; Misinzo, Gerald; Lutwama, Julius; Huang, Yiau-Min; Mitchell, Luke B.; Richards, Miriam; Tossou, Eric; Walton, Catherine

    2015-01-01

    Introduction Yellow fever continues to be a problem in sub-Saharan Africa with repeated epidemics occurring. The mosquito Aedes bromeliae is a major vector of yellow fever, but it cannot be readily differentiated from its non-vector zoophilic sister species Ae. lilii using morphological characters. Genetic differences have been reported between anthropophilic Ae. bromeliae and zoophilic Ae. lilii and between forest and domestic populations. However, due to the application of different molecular markers and non-overlapping populations employed in previous studies, interpretation of species delimitation is unclear. Methodology/Principle Findings DNA sequences were generated from specimens of Ae. simpsoni s.l. from the Republic of Benin, Tanzania and Uganda for two nuclear genes apolipophorin 2 (apoLp2) and cytochrome p450 (CYPJ92), the ribosomal internal transcribed spacer region (ITS) and the mitochondrial cytochrome c oxidase (COI) barcoding region. Nuclear genes apoLp2 and CYPJ92 were unable to differentiate between species Ae. bromeliae and Ae. lilii due to ancestral lineage sorting, while ITS sequence data provided clear topological separation on a phylogeny. The standard COI barcoding region was shown to be subject to species introgression and unable to clearly distinguish the two taxa. Here we present a reliable direct PCR-based method for differentiation of the vector species Ae. bromeliae from its isomorphic, sympatric and non-biomedically important sister taxon, Ae. lilii, based on the ITS region. Using molecular species verification, we describe novel immature habitats for Ae. lilii and report both sympatric and allopatric populations. Whereas only Ae. lilii is found in the Republic of Benin and only Ae. bromeliae in Tanzania, both species are sympatric in Uganda. Conclusions/Significance Our accurate identification method will allow informed distribution and detailed ecological studies that will facilitate assessment of arboviral disease risk and

  18. Evaluation of AaDOP2 receptor antagonists reveals antidepressants and antipsychotics as novel lead molecules for control of the yellow fever mosquito, Aedes aegypti.

    PubMed

    Conley, Jason M; Meyer, Jason M; Nuss, Andrew B; Doyle, Trevor B; Savinov, Sergey N; Hill, Catherine A; Watts, Val J

    2015-01-01

    The yellow fever mosquito, Aedes aegypti, vectors disease-causing agents that adversely affect human health, most notably the viruses causing dengue and yellow fever. The efficacy of current mosquito control programs is challenged by the emergence of insecticide-resistant mosquito populations, suggesting an urgent need for the development of chemical insecticides with new mechanisms of action. One recently identified potential insecticide target is the A. aegypti D1-like dopamine receptor, AaDOP2. The focus of the present study was to evaluate AaDOP2 antagonism both in vitro and in vivo using assay technologies with increased throughput. The in vitro assays revealed AaDOP2 antagonism by four distinct chemical scaffolds from tricyclic antidepressant or antipsychotic chemical classes, and elucidated several structure-activity relationship trends that contributed to enhanced antagonist potency, including lipophilicity, halide substitution on the tricyclic core, and conformational rigidity. Six compounds displayed previously unparalleled potency for in vitro AaDOP2 antagonism, and among these, asenapine, methiothepin, and cis-(Z)-flupenthixol displayed subnanomolar IC50 values and caused rapid toxicity to A. aegypti larvae and/or adults in vivo. Our study revealed a significant correlation between in vitro potency for AaDOP2 antagonism and in vivo toxicity, suggesting viability of AaDOP2 as an insecticidal target. Taken together, this study expanded the repertoire of known AaDOP2 antagonists, enhanced our understanding of AaDOP2 pharmacology, provided further support for rational targeting of AaDOP2, and demonstrated the utility of efficiency-enhancing in vitro and in vivo assay technologies within our genome-to-lead pipeline for the discovery of next-generation insecticides. PMID:25332454

  19. Evaluation of AaDOP2 Receptor Antagonists Reveals Antidepressants and Antipsychotics as Novel Lead Molecules for Control of the Yellow Fever Mosquito, Aedes aegypti

    PubMed Central

    Conley, Jason M.; Meyer, Jason M.; Nuss, Andrew B.; Doyle, Trevor B.; Savinov, Sergey N.; Hill, Catherine A.

    2015-01-01

    The yellow fever mosquito, Aedes aegypti, vectors disease-causing agents that adversely affect human health, most notably the viruses causing dengue and yellow fever. The efficacy of current mosquito control programs is challenged by the emergence of insecticide-resistant mosquito populations, suggesting an urgent need for the development of chemical insecticides with new mechanisms of action. One recently identified potential insecticide target is the A. aegypti D1-like dopamine receptor, AaDOP2. The focus of the present study was to evaluate AaDOP2 antagonism both in vitro and in vivo using assay technologies with increased throughput. The in vitro assays revealed AaDOP2 antagonism by four distinct chemical scaffolds from tricyclic antidepressant or antipsychotic chemical classes, and elucidated several structure-activity relationship trends that contributed to enhanced antagonist potency, including lipophilicity, halide substitution on the tricyclic core, and conformational rigidity. Six compounds displayed previously unparalleled potency for in vitro AaDOP2 antagonism, and among these, asenapine, methiothepin, and cis-(Z)-flupenthixol displayed subnanomolar IC50 values and caused rapid toxicity to A. aegypti larvae and/or adults in vivo. Our study revealed a significant correlation between in vitro potency for AaDOP2 antagonism and in vivo toxicity, suggesting viability of AaDOP2 as an insecticidal target. Taken together, this study expanded the repertoire of known AaDOP2 antagonists, enhanced our understanding of AaDOP2 pharmacology, provided further support for rational targeting of AaDOP2, and demonstrated the utility of efficiency-enhancing in vitro and in vivo assay technologies within our genome-to-lead pipeline for the discovery of next-generation insecticides. PMID:25332454

  20. T-Cell Memory Responses Elicited by Yellow Fever Vaccine are Targeted to Overlapping Epitopes Containing Multiple HLA-I and -II Binding Motifs

    PubMed Central

    de Melo, Andréa Barbosa; Nascimento, Eduardo J. M.; Braga-Neto, Ulisses; Dhalia, Rafael; Silva, Ana Maria; Oelke, Mathias; Schneck, Jonathan P.; Sidney, John; Sette, Alessandro; Montenegro, Silvia M. L.; Marques, Ernesto T. A.

    2013-01-01

    The yellow fever vaccines (YF-17D-204 and 17DD) are considered to be among the safest vaccines and the presence of neutralizing antibodies is correlated with protection, although other immune effector mechanisms are known to be involved. T-cell responses are known to play an important role modulating antibody production and the killing of infected cells. However, little is known about the repertoire of T-cell responses elicited by the YF-17DD vaccine in humans. In this report, a library of 653 partially overlapping 15-mer peptides covering the envelope (Env) and nonstructural (NS) proteins 1 to 5 of the vaccine was utilized to perform a comprehensive analysis of the virus-specific CD4+ and CD8+ T-cell responses. The T-cell responses were screened ex-vivo by IFN-γ ELISPOT assays using blood samples from 220 YF-17DD vaccinees collected two months to four years after immunization. Each peptide was tested in 75 to 208 separate individuals of the cohort. The screening identified sixteen immunodominant antigens that elicited activation of circulating memory T-cells in 10% to 33% of the individuals. Biochemical in-vitro binding assays and immunogenetic and immunogenicity studies indicated that each of the sixteen immunogenic 15-mer peptides contained two or more partially overlapping epitopes that could bind with high affinity to molecules of different HLAs. The prevalence of the immunogenicity of a peptide in the cohort was correlated with the diversity of HLA-II alleles that they could bind. These findings suggest that overlapping of HLA binding motifs within a peptide enhances its T-cell immunogenicity and the prevalence of the response in the population. In summary, the results suggests that in addition to factors of the innate immunity, “promiscuous” T-cell antigens might contribute to the high efficacy of the yellow fever vaccines. PMID:23383350

  1. Dengue as a cause of fever during pregnancy: a report of two cases.

    PubMed

    Souza, Ariani Impieri; Ferreira, Ana Laura Carneiro Gomes; Arraes, Matheus Alencar; Moura, Bruno Marcelo; Braga, Maria Cynthia

    2016-01-01

    Dengue infection has not been routinely investigated among pregnant women and parturients with acute febrile syndrome in endemic settings. Here, we report two cases of dengue fever detected at the time of delivery in parturients enrolled in a cohort prospective study conducted in a hospital in Recife, Brazil. The parturients reported fever onset within seven days prior to delivery, and dengue infection was confirmed upon detection of viral ribonucleic acid (RNA) by using the reverse transcriptase-polymerase chain reaction. Dengue infection should be considered as a diagnostic possibility in cases of fever during pregnancy and labor, especially in endemic areas. PMID:27384840

  2. Endemic Q Fever in New South Wales, Australia: A Case Series (2005-2013).

    PubMed

    Graves, Stephen R; Islam, Aminul

    2016-07-01

    Q fever is endemic in Australia, and during the period 2005-2013 our laboratory diagnosed 379 cases in New South Wales. To evaluate clinical symptoms, epidemiology, mode of diagnosis, antibody profiles, and treatment, a subset of 160 (42%) Q fever cases were analyzed in detail following the return of a questionnaire by the patient's doctor and from their laboratory reports. Overall, 82% patients were male and predominantly middle aged. The majority of patients (89%) had animal contact among which 63% were with cattle, 11% with sheep, and 7% with kangaroos. Clinical symptoms were nonspecific: myalgia (94%), fever (91%), headache (80%), acute fatigue (64%), and arthralgia (55%). Most cases (93%) were acute, and serology (immunofluorescence) was the main diagnostic modality. Positive real-time polymerase chain reaction results were useful in the diagnosis of both acute and chronic Q fever, as was the isolation of Coxiella burnetii in cell culture. Doxycycline was the antibiotic most commonly used. PMID:27139451

  3. An unnoticed origin of fever: periapical tooth abscess. Three case reports and literature review.

    PubMed

    Arslan, Ferhat; Karagöz, Ergenekon; Arslan, Birsen Yigit; Mert, Ali

    2016-01-01

    Dental infections may lead to severe local or systemic infections such as endocarditis, brain abscesses and mediastinitis. Fever may be the only symptom. We aim to highlight dental/odontogenic abscesses as the occult source of unexplained fever by reporting on three cases and reviewing the relevant literature. Early dental evaluation and referral of patients with persistent fever (even without any oral symptoms) to a dentist plays a critical role in preventing unnecessary, time-consuming and high-cost further diagnostic tests and invasive procedures. A simple panoramic dental radiography may suffice to establish the diagnosis. PMID:27031901

  4. Chronic Q Fever with No Elevation of Inflammatory Markers: A Case Report

    PubMed Central

    Boattini, Matteo; Almeida, André; Moura, Rita Barata; Abreu, João; Santos, Ana Sofia; Toscano Rico, Miguel

    2012-01-01

    We describe the case of a 55-year-old man with a biological prosthetic aortic valve who suffered from epigastrium and right hypochondrium pain associated with intermittent night sweats. Liver biopsy showed infectious hepatitis pattern without pathognomonic features. Coxiella burnetii serology was suggestive of chronic Q fever, and modified Duke's criteria for endocarditis were also fulfilled. The authors present a brief literature review concerning chronic Q fever, emphasizing absent previous reports of chronic Q fever with hepatitis and endocarditis and no increase in inflammatory markers. PMID:22792113

  5. First case of Q fever endocarditis in Croatia and a short review.

    PubMed

    Zekanović, Drazen; Morović, Miro; Borcilo, Marina Nekić; Rode, Oktavija Daković

    2010-09-01

    We present a 70-year-old man from Dalmatia, Croatia, with a history of prolonged high fever diagnosed as Q fever endocarditis. As far as we know, this is the first case of chronic Q fever in Croatia. The treatment was started as for culture-negative endocarditis, but was without clinical response. After significantly high anti-phase I IgG plus IgA antibodies titers to Coxiella burnetii were shown, the initial treatment with doxycycline was changed and ciprofloxacin was started with good clinical response. PMID:20977118

  6. Large vessel vasculitis in a patient with acute Q-fever: A case report

    PubMed Central

    Baziaka, Fotini; Karaiskos, Ilias; Galani, Lamprini; Barmpouti, Eleftheria; Konstantinidis, Stilianos; Kitas, George; Giamarellou, Helen

    2014-01-01

    Q fever is a zoonosis caused by the rickettsial organism Coxiella burnetii. Infection has an acute course, usually with a self-limited febrile illness and the possibility of the evaluation to a chronic course with endocardial involvement. The presence of autoantibodies and various autoimmune disorders have also been associated with C. burnetii infection. We report a case of acute Q fever in which the patient developed large vessel vasculitis. The FDG-PET/CT scan detected inflammation of the thoracic aortic wall, suggesting an unusual immunologic host response to acute Q fever infection. PMID:26952153

  7. Chimeric Yellow Fever Virus 17D-Japanese Encephalitis Virus Vaccine: Dose-Response Effectiveness and Extended Safety Testing in Rhesus Monkeys

    PubMed Central

    Monath, T. P.; Levenbook, I.; Soike, K.; Zhang, Z.-X.; Ratterree, M.; Draper, K.; Barrett, A. D. T.; Nichols, R.; Weltzin, R.; Arroyo, J.; Guirakhoo, F.

    2000-01-01

    ChimeriVax-JE is a live, attenuated recombinant virus prepared by replacing the genes encoding two structural proteins (prM and E) of yellow fever 17D virus with the corresponding genes of an attenuated strain of Japanese encephalitis virus (JE), SA14-14-2 (T. J. Chambers et al., J. Virol. 73:3095–3101, 1999). Since the prM and E proteins contain antigens conferring protective humoral and cellular immunity, the immune response to vaccination is directed principally at JE. The prM-E genome sequence of the ChimeriVax-JE in diploid fetal rhesus lung cells (FRhL, a substrate acceptable for human vaccines) was identical to that of JE SA14-14-2 vaccine and differed from sequences of virulent wild-type strains (SA14 and Nakayama) at six amino acid residues in the envelope gene (E107, E138, E176, E279, E315, and E439). ChimeriVax-JE was fully attenuated for weaned mice inoculated by the intracerebral (i.c.) route, whereas commercial yellow fever 17D vaccine (YF-Vax) caused lethal encephalitis with a 50% lethal dose of 1.67 log10 PFU. Groups of four rhesus monkeys were inoculated by the subcutaneous route with 2.0, 3.0, 4.0, and 5.0 log10 PFU of ChimeriVax-JE. All 16 monkeys developed low viremias (mean peak viremia, 1.7 to 2.1 log10 PFU/ml; mean duration, 1.8 to 2.3 days). Neutralizing antibodies appeared between days 6 and 10; by day 30, neutralizing antibody responses were similar across dose groups. Neutralizing antibody titers to the homologous (vaccine) strain were higher than to the heterologous wild-type JE strains. All immunized monkeys and sham-immunized controls were challenged i.c. on day 54 with 5.2 log10 PFU of wild-type JE. None of the immunized monkeys developed viremia or illness and had mild residual brain lesions, whereas controls developed viremia, clinical encephalitis, and severe histopathologic lesions. Immunized monkeys developed significant (≥4-fold) increases in serum and cerebrospinal fluid neutralizing antibodies after i.c. challenge. In a

  8. The eukaryotic translation initiation factor 3 subunit L protein interacts with Flavivirus NS5 and may modulate yellow fever virus replication

    PubMed Central

    2013-01-01

    Background Yellow fever virus (YFV) belongs to the Flavivirus genus and causes an important disease. An alarming resurgence of viral circulation and the expansion of YFV-endemic zones have been detected in Africa and South America in recent years. NS5 is a viral protein that contains methyltransferase and RNA-dependent RNA polymerase (RdRp) domains, which are essential for viral replication, and the interactions between NS5 and cellular proteins have been studied to better understand viral replication. The aim of this study was to characterize the interaction of the NS5 protein with eukaryotic translation initiation factor 3 subunit L (eIF3L) and to evaluate the role of eIF3L in yellow fever replication. Methods To identify interactions of YFV NS5 with cellular proteins, we performed a two-hybrid screen using the YFV NS5 RdRp domain as bait with a human cDNA library, and RNApol deletion mutants were generated and analyzed using the two-hybrid system for mapping the interactions. The RNApol region involved was segmented into three fragments and analyzed using an eIF3L-expressing yeast strain. To map the NS5 residues that are critical for the interactions, we performed site-direct mutagenesis in segment 3 of the interaction domain (ID) and confirmed the interaction using in vitro assays and in vivo coimmunoprecipitation. The significance of eIF3L for YFV replication was investigated using eIF3L overexpression and RNA interference. Results In this work, we describe and characterize the interaction of NS5 with the translation factor eIF3L. The interaction between NS5 and eIF3L was confirmed using in vitro binding and in vivo coimmunoprecipitation assays. This interaction occurs at a region (the interaction domain of the RNApol domain) that is conserved in several flaviviruses and that is, therefore, likely to be relevant to the genus. eIF3L overexpression and plaque reduction assays showed a slight effect on YFV replication, indicating that the interaction of eIF3L

  9. Typhoid fever during pregnancy: case report and review

    PubMed Central

    Touchan, Faraj; Hall, John D; Lee, Richard V

    2009-01-01

    Typhoid fever, like many gastroenteric infections, is considered a particular risk during pregnancy because of reduced peristaltic activity in the gastrointestinal and biliary tracts and increased prevalence of biliary ‘sludge’ and concretions. Antibiotic resistance among salmonellae makes the choice of antibiotics for initial treatment of infection difficult before cultures and sensitivities are reported. Because of the potential risks of some antimicrobial agents for pregnancy, the selection of antibiotic therapy is further complicated.

  10. Q Fever in the United States: Summary of Case Reports from Two National Surveillance Systems, 2000–2012

    PubMed Central

    Dahlgren, F. Scott; McQuiston, Jennifer H.; Massung, Robert F.; Anderson, Alicia D.

    2015-01-01

    Q fever is a worldwide zoonosis historically associated with exposure to infected livestock. This study summarizes cases of Q fever, a notifiable disease in the United States, reported to the Centers for Disease Control and Prevention through two national surveillance systems with onset during 2000–2012. The overall incidence rate during this time was 0.38 cases per million persons per year. The reported case fatality rate was 2.0%, and the reported hospitalization rate was 62%. Most cases (61%) did not report exposure to cattle, goats, or sheep, suggesting that clinicians should consider Q fever even in the absence of livestock exposure. The prevalence of drinking raw milk among reported cases of Q fever (8.4%) was more than twice the national prevalence for the practice. Passive surveillance systems for Q fever are likely impacted by underreporting and underdiagnosis because of the nonspecific presentation of Q fever. PMID:25404080

  11. Q fever in the United States: summary of case reports from two national surveillance systems, 2000-2012.

    PubMed

    Dahlgren, F Scott; McQuiston, Jennifer H; Massung, Robert F; Anderson, Alicia D

    2015-02-01

    Q fever is a worldwide zoonosis historically associated with exposure to infected livestock. This study summarizes cases of Q fever, a notifiable disease in the United States, reported to the Centers for Disease Control and Prevention through two national surveillance systems with onset during 2000-2012. The overall incidence rate during this time was 0.38 cases per million persons per year. The reported case fatality rate was 2.0%, and the reported hospitalization rate was 62%. Most cases (61%) did not report exposure to cattle, goats, or sheep, suggesting that clinicians should consider Q fever even in the absence of livestock exposure. The prevalence of drinking raw milk among reported cases of Q fever (8.4%) was more than twice the national prevalence for the practice. Passive surveillance systems for Q fever are likely impacted by underreporting and underdiagnosis because of the nonspecific presentation of Q fever. PMID:25404080

  12. Genome-wide RNA profiling of long-lasting stem cell-like memory CD8 T cells induced by Yellow Fever vaccination in humans.

    PubMed

    Fuertes Marraco, Silvia A; Soneson, Charlotte; Delorenzi, Mauro; Speiser, Daniel E

    2015-09-01

    The live-attenuated Yellow Fever (YF) vaccine YF-17D induces a broad and polyfunctional CD8 T cell response in humans. Recently, we identified a population of stem cell-like memory CD8 T cells induced by YF-17D that persists at stable frequency for at least 25 years after vaccination. The YF-17D is thus a model system of human CD8 T cell biology that furthermore allows to track and study long-lasting and antigen-specific human memory CD8 T cells. Here, we describe in detail the sample characteristics and preparation of a microarray dataset acquired for genome-wide gene expression profiling of long-lasting YF-specific stem cell-like memory CD8 T cells, compared to the reference CD8 T cell differentiation subsets from total CD8 T cells. We also describe the quality controls, annotations and exploratory analyses of the dataset. The microarray data is available from the Gene Expression Omnibus (GEO) public repository with accession number GSE65804. PMID:26484272

  13. Birth of three stowaway-like MITE families via microhomology-mediated miniaturization of a Tc1/Mariner element in the yellow fever mosquito.

    PubMed

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

    2013-01-01

    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. PMID:24068652

  14. Yellow fever impact on brown howler monkeys (Alouatta guariba clamitans) in Argentina: a metamodelling approach based on population viability analysis and epidemiological dynamics

    PubMed Central

    Moreno, Eduardo S; Agostini, Ilaria; Holzmann, Ingrid; Di Bitetti, Mario S; Oklander, Luciana I; Kowalewski, Martín M; Beldomenico, Pablo M; Goenaga, Silvina; Martínez, Mariela; Lestani, Eduardo; Desbiez, Arnaud LJ; Miller, Philip

    2015-01-01

    In South America, yellow fever (YF) is an established infectious disease that has been identified outside of its traditional endemic areas, affecting human and nonhuman primate (NHP) populations. In the epidemics that occurred in Argentina between 2007-2009, several outbreaks affecting humans and howler monkeys (Alouatta spp) were reported, highlighting the importance of this disease in the context of conservation medicine and public health policies. Considering the lack of information about YF dynamics in New World NHP, our main goal was to apply modelling tools to better understand YF transmission dynamics among endangered brown howler monkey (Alouatta guariba clamitans) populations in northeastern Argentina. Two complementary modelling tools were used to evaluate brown howler population dynamics in the presence of the disease: Vortex, a stochastic demographic simulation model, and Outbreak, a stochastic disease epidemiology simulation. The baseline model of YF disease epidemiology predicted a very high probability of population decline over the next 100 years. We believe the modelling approach discussed here is a reasonable description of the disease and its effects on the howler monkey population and can be useful to support evidence-based decision-making to guide actions at a regional level. PMID:26517499

  15. Evaluation of accuracy and reliability of the plaque reduction neutralization test (micro-PRNT) in detection of yellow fever virus antibodies.

    PubMed

    Simões, Marisol; Camacho, Luiz Antonio B; Yamamura, Anna M Y; Miranda, Emily Hime; Cajaraville, Ana Carolina R A; da Silva Freire, Marcos

    2012-11-01

    Yellow fever is a disease caused by the prototype virus of the genus Flavivirus and remains endemic in tropical forest regions from Africa and South America, despite the availability of effective vaccines. These are capable of inducing a rapid specific immune response, with the formation of neutralizing antibodies that appear early, are protective and long lasting. The Plaque Reduction Neutralization Test is considered the most sensitive and specific test for quantification of neutralizing antibodies, and the reference method for assessing the protective immune response after vaccination. This study evaluated the reliability (repeatability and reproducibility) and accuracy (sensitivity, specificity and overall accuracy) of micro-PRNT50 and compared its performance with the micro-PRNT90. Although the micro-PRNT50 has showed satisfactory levels of reliability (ICCs ranged from 0.62 to 0.NorNormas e Manuais Técnicosas e Manuais Técnicos6 for repeatability and 0.72 for reproducibility) and accuracy (sensitivity of 91.1%, specificity of 72.9% and overall accuracy of 78%), the micro-PRNT90 showed higher performance, with ICCs for repeatability ranged from 0.78 to 0.79 and 0.81 for reproducibility, sensitivity of 100%, specificity of 94.7% and overall accuracy of 95%. Modifications in the test methodology and changes in the classification criteria in the readings of the results obtained will be important to improve the accuracy of micro-PRNT. PMID:23034357

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

    PubMed Central

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

    2013-01-01

    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. PMID:24068652

  17. Yellow fever impact on brown howler monkeys (Alouatta guariba clamitans) in Argentina: a metamodelling approach based on population viability analysis and epidemiological dynamics.

    PubMed

    Moreno, Eduardo S; Agostini, Ilaria; Holzmann, Ingrid; Di Bitetti, Mario S; Oklander, Luciana I; Kowalewski, Martín M; Beldomenico, Pablo M; Goenaga, Silvina; Martínez, Mariela; Lestani, Eduardo; Desbiez, Arnaud L J; Miller, Philip

    2015-11-01

    In South America, yellow fever (YF) is an established infectious disease that has been identified outside of its traditional endemic areas, affecting human and nonhuman primate (NHP) populations. In the epidemics that occurred in Argentina between 2007-2009, several outbreaks affecting humans and howler monkeys (Alouatta spp) were reported, highlighting the importance of this disease in the context of conservation medicine and public health policies. Considering the lack of information about YF dynamics in New World NHP, our main goal was to apply modelling tools to better understand YF transmission dynamics among endangered brown howler monkey (Alouatta guariba clamitans) populations in northeastern Argentina. Two complementary modelling tools were used to evaluate brown howler population dynamics in the presence of the disease: Vortex, a stochastic demographic simulation model, and Outbreak, a stochastic disease epidemiology simulation. The baseline model of YF disease epidemiology predicted a very high probability of population decline over the next 100 years. We believe the modelling approach discussed here is a reasonable description of the disease and its effects on the howler monkey population and can be useful to support evidence-based decision-making to guide actions at a regional level. PMID:26517499

  18. A case of Lassa fever: clinical and virological findings.

    PubMed Central

    Emond, R T; Bannister, B; Lloyd, G; Southee, T J; Bowen, E T

    1982-01-01

    Five days after arriving in London from Jos a young Nigerian women developed a severe and prolonged illness that proved to be Lassa fever. Virus was not detected in urine during the first three weeks but then appeared and reached a peak during the sixth week, with continuing excretion for 67 days after the onset of illness. Laboratory investigations showed evidence of extensive tissue damage and disturbance of clotting, but there was no serious bleeding and she eventually made a complete recovery despite a high sustained viraemia and severe liver damage. Convalescent serum was used in treatment but it was difficult to assess its contribution to the favourable outcome. PMID:6812716

  19. Acute Q fever infection in Thuringia, Germany, after burial of roe deer fawn cadavers (Capreolus capreolus): a case report

    PubMed Central

    Schleenvoigt, B.T.; Sprague, L.D.; Mertens, K.; Moog, U.; Schmoock, G.; Wolf, G.; Neumann, M.; Pletz, M.W.; Neubauer, H.

    2015-01-01

    We report on a case of a 48-year-old man who presented with acute Q fever infection after burying two fawn cadavers (Capreolus capreolus). Recent outbreaks of Q fever in Europe have been traced back to intensive goat breeding units, sheep flocks in the proximity of highly populated urban areas or to farmed deer. To our knowledge, this is the first case report describing Q fever infection in a human linked to roe deer as a source of infection. PMID:26566445

  20. Primary splenic angiosarcoma with fever and anemia: a case report and literature review

    PubMed Central

    Deng, Rui; Chang, Weilong; Wu, Xiuli; Chen, Junhua; Tao, Kaixiong; Zhang, Peng

    2015-01-01

    Primary splenic angiosarcoma is an extremely rare and aggressive neoplasm. The prognosis of this disease is dismal, and the mean survival is less than 6 months after the diagnosis. This neoplasm typically presents with abdominal pain, splenomegaly, weight loss, and spontaneous splenic rupture. Fever is a very rare presentation of splenic angiosarcoma. Here we report the case of a 64-year-old man who presented with fever and anemia. A laparoscopic splenectomy was performed and revealed splenic angiosarcoma. The postoperative course was uneventful and the patient received 5 cycles of adjuvant chemotherapy with ifosfamide plus epirubicin. He remained disease free at 9 months after surgery. This is the first case of splenic angiosarcoma with fever as the initial presentation that was treated with laparoscopic splenectomy to be reported in the English literature. PMID:26823717

  1. Yellow Nail Syndrome: Report of a Case Successfully Treated with Octreotide

    PubMed Central

    Lotfollahi, Legha; Abedini, Atefeh; Alavi Darazam, Ilad; Fadaii, Abbas

    2015-01-01

    Yellow nail syndrome (YNS) is an uncommon condition characterized by a triad of yellow nail coloration, lymphedema and respiratory tract involvement. This syndrome typically affects middle-aged persons. Although several etiologies have been described, to date; the exact etiology remains unclear. Different treatment plans have been suggested, but all data available emphasize the fact that treatment is mainly symptomatic and the underlying disease is not targeted. The most reported treatment protocol is chemical pleurodesis combined with alpha-tocopherol (vitamin E). Hereby, we describe a case of YNS in a 34 year-old woman with the onset of symptoms in childhood. The symptoms improved dramatically after treatment with octreotide. PMID:26221155

  2. [The 451(th) case: intermittent rash, fever and headache].

    PubMed

    Zhao, J L; Zhang, Y; Zhang, S; Li, J; Wang, Q; Zhao, Y; Zeng, X F

    2016-07-01

    A 29-year-old woman was admitted to the Department of Rheumatology, Peking Union Medical College Hospital due to intermittent rashes, fever and headache. Palpable purpura were symmetrically distributed on the extremities and trunk. Other manifestations included headache with nausea and vomiting. Elevated white blood cell (WBC) count, platelet (PLT) count, erythrocyte sedimentation rate (ESR) and C-reactive protein were the main laboratory findings. Antinuclear antibodies and antineutrophil cytoplasmic antibodies were negative. Examination of the cerebrospinal fluid (CSF) revealed high intracranial pressure, while routine cytology and biochemical tests of CSF were normal. Head MRI scan and PET-CT did not detect remarkable findings. A diagnosis of systemic vasculitis was confirmed by the biopsy of skin lesion which showed inflammatory infiltration of the muscular vessel wall. Combination therapy of corticosteroids and cyclophosphamide lead to a rapid improvement in clinical symptoms and laboratory parameters. The patient was in stable remission till 6 month follow-up. PMID:27373302

  3. Live virus vaccines based on a yellow fever vaccine backbone: standardized template with key considerations for a risk/benefit assessment.

    PubMed

    Monath, Thomas P; Seligman, Stephen J; Robertson, James S; Guy, Bruno; Hayes, Edward B; Condit, Richard C; Excler, Jean Louis; Mac, Lisa Marie; Carbery, Baevin; Chen, Robert T

    2015-01-01

    The Brighton Collaboration Viral Vector Vaccines Safety Working Group (V3SWG) was formed to evaluate the safety of live, recombinant viral vaccines incorporating genes from heterologous viruses inserted into the backbone of another virus (so-called "chimeric virus vaccines"). Many viral vector vaccines are in advanced clinical trials. The first such vaccine to be approved for marketing (to date in Australia, Thailand, Malaysia, and the Philippines) is a vaccine against the flavivirus, Japanese encephalitis (JE), which employs a licensed vaccine (yellow fever 17D) as a vector. In this vaccine, two envelope proteins (prM-E) of YF 17D virus were exchanged for the corresponding genes of JE virus, with additional attenuating mutations incorporated into the JE gene inserts. Similar vaccines have been constructed by inserting prM-E genes of dengue and West Nile into YF 17D virus and are in late stage clinical studies. The dengue vaccine is, however, more complex in that it requires a mixture of four live vectors each expressing one of the four dengue serotypes. This vaccine has been evaluated in multiple clinical trials. No significant safety concerns have been found. The Phase 3 trials met their endpoints in terms of overall reduction of confirmed dengue fever, and, most importantly a significant reduction in severe dengue and hospitalization due to dengue. However, based on results that have been published so far, efficacy in preventing serotype 2 infection is less than that for the other three serotypes. In the development of these chimeric vaccines, an important series of comparative studies of safety and efficacy were made using the parental YF 17D vaccine virus as a benchmark. In this paper, we use a standardized template describing the key characteristics of the novel flavivirus vaccine vectors, in comparison to the parental YF 17D vaccine. The template facilitates scientific discourse among key stakeholders by increasing the transparency and comparability of

  4. Live Virus Vaccines Based on a Yellow Fever Vaccine Backbone: Standardized Template with Key Considerations for a Risk/Benefit Assessment*

    PubMed Central

    Monath, Thomas P.; Seligman, Stephen J.; Robertson, James S.; Guy, Bruno; Hayes, Edward B.; Condit, Richard C.; Excler, Jean Louis; Mac, Lisa Marie; Carbery, Baevin; Chen, Robert T

    2015-01-01

    The Brighton Collaboration Viral Vector Vaccines Safety Working Group (V3SWG) was formed to evaluate the safety of live, recombinant viral vaccines incorporating genes from heterologous viruses inserted into the backbone of another virus (so-called “chimeric virus vaccines”). Many viral vector vaccines are in advanced clinical trials. The first such vaccine to be approved for marketing (to date in Australia, Thailand, Malaysia, and the Philippines) is a vaccine against the flavivirus Japanese encephalitis (JE), which employs a licensed vaccine (yellow fever 17D) as a vector. In this vaccine, two envelope proteins (prM-E) of YF 17D virus were replaced by the corresponding genes of JE virus, with additional attenuating mutations incorporated into the JE gene inserts. Similar vaccines have been constructed by inserting prM-E genes of dengue and West Nile into YF 17D virus and are in late stage clinical studies. The dengue vaccine is, however, more complex in that it requires a mixture of four live vectors each expressing one of the four dengue serotypes. This vaccine has been evaluated in multiple clinical trials. No significant safety concerns have been found. The Phase 3 trials met their endpoints in terms of overall reduction of confirmed dengue fever, and, most importantly a significant reduction in severe dengue and hospitalization due to dengue. However, based on results that have been published so far, efficacy in preventing serotype 2 infection is less than that for the other three serotypes. In the development of these chimeric vaccines, an important series of comparative studies of safety and efficacy were made using the parental YF 17D vaccine virus as a benchmark. In this paper, we use a standardized template describing the key characteristics of the novel flavivirus vaccine vectors, in comparison to the parental YF 17D vaccine. The template facilitates scientific discourse among key stakeholders by increasing the transparency and comparability of

  5. [An imported dengue Fever case in Turkey and review of the literature].

    PubMed

    Uyar, Yavuz; Aktaş, Eray; Yağcı Çağlayık, Dilek; Ergönül, Onder; Yüce, Ayşe

    2013-01-01

    Dengue fever is an acute viral disease that can affect all age groups in tropical and subtropical countries. The predominant vectors are the mosquitoes namely Aedes aegypti and A.albopictus. Although there have been no case reports in Turkey due to DF, there is seroepidemiological evidence indicating the presence of Dengue virus (DENV) in Turkey. In this case report we presented an imported dengue fever case. The patient was 40 years old, previously healthy male, Switzerland citizen. He had immigrated from Dubai to India two weeks ago and after one week from immigration he attended to a hospital in India because of high fever. The NS1 antigen test (Bio-Rad Laboratories, USA) was found positive and the patient was followed-up with diagnosis of dengue fever in India. During his visit to Turkey, he attended to the hospital for a routine control and his analysis revealed thrombocytopenia (PLT: 48.000/µl), leukopenia (white blood cell: 2800/µL) and elevated liver enzymes (AST: 76 U/L, ALT: 83 U/L). Fever was not detected in follow-up. The patient had petechial rash on his lower extremities. white blood cell and PLT count increased to 4100/µl and 93.000/µl, respectively. Liver function tests revealed a decrease in AST (63 U/L) and ALT (78 U/L) on the third day. The PLT count increased to 150.000/ml. Since the patient had no fever and had normal physical and laboratory findings, he was discharged from the hospital. For the confirmation of dengue fever diagnosis the serum sample was sent to National Public Health Center, Virology Reference and Research Laboratory where IgM and IgG antibodies against DENV types 1-4 were investigated by indirect immunofluorescence method (Euroimmun, Germany). The serum sample yielded positive result at the dilutions of 1/1000 for IgM and 1/10.000 for IgG. The last dilution of type 3 DENV IgM and IgG were determined high density of fluorescein, thus the serotype was identified as "DENV type 3". Travel-related diseases become important

  6. Rat-bite fever complicated by vertebral osteomyelitis: A case report.

    PubMed

    Sato, Ryota; Kuriyama, Akira; Nasu, Michitaka

    2016-08-01

    Rat-bite fever (RBF) is a challenging diagnosis transmitted by the bite of the rats. We present the first reported case of RBF complicated by vertebral osteomyelitis. It is important to consider performing the MRI to differentiate vertebral osteomyelitis from simple back pain to determine the appropriate duration of antibiotic therapy. PMID:26948832

  7. Culture proven Salmonella typhi co-infection in a child with Dengue fever: a case report.

    PubMed

    Srinivasaraghavan, Rangan; Narayanan, Parameswaran; Kanimozhi, Thandapani

    2015-09-01

    Infectious diseases are one of the major causes of morbidity and mortality in developing countries. Sometimes concurrent infections with multiple infectious agents may occur in one patient, which make the diagnosis and management a challenging task. The authors here present a case of co-infection of typhoid fever with dengue fever in a ten-year-old child and discuss the pertinent issues. The authors emphasize that the risk factors predicting the presence of such co-infections, if developed, will be immensely useful in areas where dengue outbreak occurs in the background of high transmission of endemic infections. PMID:26409747

  8. A humanized monoclonal antibody neutralizes yellow fever virus strain 17D-204 in vitro but does not protect a mouse model from disease.

    PubMed

    Calvert, Amanda E; Dixon, Kandice L; Piper, Joseph; Bennett, Susan L; Thibodeaux, Brett A; Barrett, Alan D T; Roehrig, John T; Blair, Carol D

    2016-07-01

    The yellow fever virus (YFV) vaccine 17D-204 is considered safe and effective, yet rare severe adverse events (SAEs), some resulting in death, have been documented following vaccination. Individuals exhibiting post-vaccinal SAEs are ideal candidates for antiviral monoclonal antibody (MAb) therapy; the time until appearance of clinical signs post-exposure is usually short and patients are quickly hospitalized. We previously developed a murine-human chimeric monoclonal antibody (cMAb), 2C9-cIgG, reactive with both virulent YFV and 17D-204, and demonstrated its ability to prevent and treat YF disease in both AG129 mouse and hamster models of infection. To counteract possible selection of 17D-204 variants that escape neutralization by treatment with a single MAb (2C9-cIgG), we developed a second cMAb, 864-cIgG, for use in combination with 2C9-cIgG in post-vaccinal therapy. MAb 864-cIgG recognizes/neutralizes only YFV 17D-204 vaccine substrain and binds to domain III (DIII) of the viral envelope protein, which is different from the YFV type-specific binding site of 2C9-cIgG in DII. Although it neutralized 17D-204 in vitro, administration of 864-cIgG had no protective capacity in the interferon receptor-deficient AG129 mouse model of 17D-204 infection. The data presented here show that although DIII-specific 864-cIgG neutralizes virus infectivity in vitro, it does not have the ability to abrogate disease in vivo. Therefore, combination of 864-cIgG with 2C9-cIgG for treatment of YF vaccination SAEs does not appear to provide an improvement on 2C9-cIgG therapy alone. PMID:27126613

  9. Binding of a fluorescence reporter and a ligand to an odorant-binding protein of the yellow fever mosquito, Aedes aegypti.

    PubMed

    Leal, Gabriel M; Leal, Walter S

    2014-01-01

    Odorant-binding proteins (OBPs), also named pheromone-binding proteins when the odorant is a pheromone, are essential for insect olfaction. They solubilize odorants that reach the port of entry of the olfactory system, the pore tubules in antennae and other olfactory appendages. Then, OBPs transport these hydrophobic compounds through an aqueous sensillar lymph to receptors embedded on dendritic membranes of olfactory receptor neurons. Structures of OBPs from mosquito species have shed new light on the mechanism of transport, although there is considerable debate on how they deliver odorant to receptors. An OBP from the southern house mosquito, Culex quinquefasciatus, binds the hydrophobic moiety of a mosquito oviposition pheromone (MOP) on the edge of its binding cavity. Likewise, it has been demonstrated that the orthologous protein from the malaria mosquito binds the insect repellent DEET on a similar edge of its binding pocket. A high school research project was aimed at testing whether the orthologous protein from the yellow fever mosquito, AaegOBP1, binds DEET and other insect repellents, and MOP was used as a positive control. Binding assays using the fluorescence reporter N-phenyl-1-naphtylamine (NPN) were inconclusive. However, titration of NPN fluorescence emission in AaegOBP1 solution with MOP led to unexpected and intriguing results. Quenching was observed in the initial phase of titration, but addition of higher doses of MOP led to a stepwise increase in fluorescence emission coupled with a blue shift, which can be explained at least in part by formation of MOP micelles to house stray NPN molecules. PMID:25671088

  10. The Human NK Cell Response to Yellow Fever Virus 17D Is Primarily Governed by NK Cell Differentiation Independently of NK Cell Education.

    PubMed

    Marquardt, Nicole; Ivarsson, Martin A; Blom, Kim; Gonzalez, Veronica D; Braun, Monika; Falconer, Karolin; Gustafsson, Rasmus; Fogdell-Hahn, Anna; Sandberg, Johan K; Michaëlsson, Jakob

    2015-10-01

    NK cells play an important role in the defense against viral infections. However, little is known about the regulation of NK cell responses during the first days of acute viral infections in humans. In this study, we used the live attenuated yellow fever virus (YFV) vaccine 17D as a human in vivo model to study the temporal dynamics and regulation of NK cell responses in an acute viral infection. YFV induced a robust NK cell response in vivo, with an early activation and peak in NK cell function at day 6, followed by a delayed peak in Ki67 expression, which was indicative of proliferation, at day 10. The in vivo NK cell response correlated positively with plasma type I/III IFN levels at day 6, as well as with the viral load. YFV induced an increased functional responsiveness to IL-12 and IL-18, as well as to K562 cells, indicating that the NK cells were primed in vivo. The NK cell responses were associated primarily with the stage of differentiation, because the magnitude of induced Ki67 and CD69 expression was distinctly higher in CD57(-) NK cells. In contrast, NK cells expressing self- and nonself-HLA class I-binding inhibitory killer cell Ig-like receptors contributed, to a similar degree, to the response. Taken together, our results indicate that NK cells are primed by type I/III IFN in vivo early after YFV infection and that their response is governed primarily by the differentiation stage, independently of killer cell Ig-like receptor/HLA class I-mediated inhibition or education. PMID:26283480

  11. The genetic architecture of a complex trait: Resistance to multiple toxins produced by Bacillus thuringiensis israelensis in the dengue and yellow fever vector, the mosquito Aedes aegypti.

    PubMed

    Bonin, Aurélie; Paris, Margot; Frérot, Hélène; Bianco, Erica; Tetreau, Guillaume; Després, Laurence

    2015-10-01

    The bacterial insecticide Bacillus thuringiensis subsp. israelensis (Bti) is an increasingly popular alternative to chemical insecticides for controlling mosquito populations. Because Bti toxicity relies on the action of four main toxins, resistance to Bti is very likely a complex phenotype involving several genes simultaneously. Dissecting the underlying genetic basis thus requires associating a quantitative measure of resistance to genetic variation at many loci in a segregating population. Here, we undertake this task using the dengue and yellow fever vector, the mosquito Aedes aegypti, as a study model. We conducted QTL (Quantitative Trait Locus) and admixture mapping analyses on two controlled crosses and on an artificial admixed population, respectively, all obtained from resistant and susceptible lab strains. We detected 16 QTL regions, among which four QTLs were revealed by different analysis methods. These four robust QTLs explained altogether 29.2% and 62.2% of the total phenotypic variance in the two QTL crosses, respectively. They also all showed a dominant mode of action. In addition, we found six loci showing statistical association with Bti resistance in the admixed population. Five of the supercontigs highlighted in this study contained candidate genes as suggested by their function, or by prior evidence from expression and/or outlier analyses. These genomic regions are thus good starting points for fine mapping of resistance to Bti or functional analyses aiming at identifying the underlying genes and mutations. Moreover, for the purpose of this work, we built the first Ae. aegypti genetic map based on markers associated with genes expressed in larvae. This genetic map harbors 229 SNP markers mapped across the three chromosomes for a total length of 311.9cM. It brought to light several assembly discrepancies with the reference genome, suggesting a high level of genome plasticity in Ae. aegypti. PMID:26238211

  12. Development and Characterization of Monoclonal Antibodies to Yellow Fever Virus and Application in Antigen Detection and IgM Capture Enzyme-Linked Immunosorbent Assay.

    PubMed

    Adungo, Ferdinard; Yu, Fuxun; Kamau, David; Inoue, Shingo; Hayasaka, Daisuke; Posadas-Herrera, Guillermo; Sang, Rosemary; Mwau, Matilu; Morita, Kouichi

    2016-08-01

    Yellow fever (YF) is an acute hemorrhagic viral infection transmitted by mosquitoes in Africa and South America. The major challenge in YF disease detection and confirmation of outbreaks in Africa is the limited availability of reference laboratories and the persistent lack of access to diagnostic tests. We used wild-type YF virus sequences to generate recombinant envelope protein in an Escherichia coli expression system. Both the recombinant protein and sucrose gradient-purified YF vaccine virus 17D (YF-17D) were used to immunize BALB/c mice to generate monoclonal antibodies (MAbs). Eight MAbs were established and systematically characterized by indirect enzyme-linked immunosorbent assay (ELISA), Western blot analysis, and immunofluorescence assay (IFA). The established MAbs showed strong reactivity with wild-type YF virus and recombinant protein with no detectable cross-reactivity to dengue virus or Japanese encephalitis virus. Epitope mapping showed strong binding of three MAbs to amino acid positions 1 to 51, while two MAbs mapped to amino acid positions 52 to 135 of the envelope protein. The remaining three MAbs did not show reactivity to envelope fragments. The established MAbs exert no neutralization against wild-type YF and 17D viruses (titer of <10 for both strains). The applicability of MAbs 8H3 and 3F4 was further evaluated using IgM capture ELISA. A total of 49 serum samples were analyzed, among which 12 positive patient and vaccinee samples were correctly identified. Using serum samples that were 2-fold serially diluted, the IgM capture ELISA was able to detect all YF-positive samples. Furthermore, MAb-based antigen detection ELISA enabled the detection of virus in culture supernatants containing titers of about 1,000 focus-forming units. PMID:27307452

  13. Binding of a fluorescence reporter and a ligand to an odorant-binding protein of the yellow fever mosquito, Aedes aegypti

    PubMed Central

    Leal, Gabriel M.; Leal, Walter S.

    2015-01-01

    Odorant-binding proteins (OBPs), also named pheromone-binding proteins when the odorant is a pheromone, are essential for insect olfaction. They solubilize odorants that reach the port of entry of the olfactory system, the pore tubules in antennae and other olfactory appendages. Then, OBPs transport these hydrophobic compounds through an aqueous sensillar lymph to receptors embedded on dendritic membranes of olfactory receptor neurons. Structures of OBPs from mosquito species have shed new light on the mechanism of transport, although there is considerable debate on how they deliver odorant to receptors. An OBP from the southern house mosquito, Culex quinquefasciatus, binds the hydrophobic moiety of a mosquito oviposition pheromone (MOP) on the edge of its binding cavity. Likewise, it has been demonstrated that the orthologous protein from the malaria mosquito binds the insect repellent DEET on a similar edge of its binding pocket. A high school research project was aimed at testing whether the orthologous protein from the yellow fever mosquito, AaegOBP1, binds DEET and other insect repellents, and MOP was used as a positive control. Binding assays using the fluorescence reporter N-phenyl-1-naphtylamine (NPN) were inconclusive. However, titration of NPN fluorescence emission in AaegOBP1 solution with MOP led to unexpected and intriguing results. Quenching was observed in the initial phase of titration, but addition of higher doses of MOP led to a stepwise increase in fluorescence emission coupled with a blue shift, which can be explained at least in part by formation of MOP micelles to house stray NPN molecules. PMID:25671088

  14. Processing of the yellow fever virus nonstructural polyprotein: a catalytically active NS3 proteinase domain and NS2B are required for cleavages at dibasic sites.

    PubMed Central

    Chambers, T J; Grakoui, A; Rice, C M

    1991-01-01

    The vaccinia virus-T7 transient expression system was used to further examine the role of the NS3 proteinase in processing of the yellow fever (YF) virus nonstructural polyprotein in BHK cells. YF virus-specific polyproteins and cleavage products were identified by immunoprecipitation with region-specific antisera, by size, and by comparison with authentic YF virus polypeptides. A YF virus polyprotein initiating with a signal sequence derived from the E protein fused to the N terminus of NS2A and extending through the N-terminal 356 amino acids of NS5 exhibited processing at the 2A-2B, 2B-3, 3-4A, 4A-4B, and 4B-5 cleavage sites. Similar results were obtained with polyproteins whose N termini began within NS2A (position 110) or with NS2B. When the NS3 proteinase domain was inactivated by replacing the proposed catalytic Ser-138 with Ala, processing at all sites was abolished. The results suggest that an active NS3 proteinase domain is necessary for cleavage at the diabasic nonstructural cleavage sites and that cleavage at the proposed 4A-4B signalase site requires prior cleavage at the 4B-5 site. Cleavages were not observed with a polyprotein whose N terminus began with NS3, but cleavage at the 4B-5 site could be restored by supplying the the NS2B protein in trans. Several experimental results suggested that trans cleavage at the 4B-5 site requires association of NS2B and the NS3 proteinase domain. Coexpression of different proteinases and catalytically inactive polyprotein substrates revealed that trans cleavage at the 2B-3 and 4B-5 sites was relatively efficient when compared with trans cleavage at the 2A-2B and 3-4A sites. Images PMID:1833562

  15. Development and Characterization of Monoclonal Antibodies to Yellow Fever Virus and Application in Antigen Detection and IgM Capture Enzyme-Linked Immunosorbent Assay

    PubMed Central

    Adungo, Ferdinard; Kamau, David; Inoue, Shingo; Hayasaka, Daisuke; Posadas-Herrera, Guillermo; Sang, Rosemary; Mwau, Matilu

    2016-01-01

    Yellow fever (YF) is an acute hemorrhagic viral infection transmitted by mosquitoes in Africa and South America. The major challenge in YF disease detection and confirmation of outbreaks in Africa is the limited availability of reference laboratories and the persistent lack of access to diagnostic tests. We used wild-type YF virus sequences to generate recombinant envelope protein in an Escherichia coli expression system. Both the recombinant protein and sucrose gradient-purified YF vaccine virus 17D (YF-17D) were used to immunize BALB/c mice to generate monoclonal antibodies (MAbs). Eight MAbs were established and systematically characterized by indirect enzyme-linked immunosorbent assay (ELISA), Western blot analysis, and immunofluorescence assay (IFA). The established MAbs showed strong reactivity with wild-type YF virus and recombinant protein with no detectable cross-reactivity to dengue virus or Japanese encephalitis virus. Epitope mapping showed strong binding of three MAbs to amino acid positions 1 to 51, while two MAbs mapped to amino acid positions 52 to 135 of the envelope protein. The remaining three MAbs did not show reactivity to envelope fragments. The established MAbs exert no neutralization against wild-type YF and 17D viruses (titer of <10 for both strains). The applicability of MAbs 8H3 and 3F4 was further evaluated using IgM capture ELISA. A total of 49 serum samples were analyzed, among which 12 positive patient and vaccinee samples were correctly identified. Using serum samples that were 2-fold serially diluted, the IgM capture ELISA was able to detect all YF-positive samples. Furthermore, MAb-based antigen detection ELISA enabled the detection of virus in culture supernatants containing titers of about 1,000 focus-forming units. PMID:27307452

  16. Purified mariner (Mos1) transposase catalyzes the integration of marked elements into the germ-line of the yellow fever mosquito, Aedes aegypti.

    PubMed

    Coates, C J; Jasinskiene, N; Morgan, D; Tosi, L R; Beverley, S M; James, A A

    2000-11-01

    Derivatives of the mariner transposable element, Mos1, from Drosophila mauritiana, can integrate into the germ-line of the yellow fever mosquito, Aedes aegypti. Previously, the transposase required to mobilize Mos1 was provided in trans by a helper plasmid expressing the enzyme under the control of the D. psuedoobscura heat-shock protein 82 promoter. Here we tested whether purified recombinant Mos1 transposase could increase the recovery of Ae. aegypti transformants. Mos1 transposase was injected into white-eyed, kh(w)/kh(w), Ae. aegypti embryos with a Mos1 donor plasmid containing a copy of the wild-type allele of the D. melanogaster cinnabar gene. Transformed mosquitoes were recognized by partial restoration of eye color in the G(1) animals and confirmed by Southern analyses of genomic DNA. At Mos1 transposase concentrations approaching 100 nM, the rate of germ-line transformants arising from independent insertions in G(0) animals was elevated 2-fold compared to that seen in experiments with helper plasmids. Furthermore, the recovery of total G(1) transformants was increased 7.5-fold over the frequency seen with co-injected helper plasmid. Southern blot analyses and gene amplification experiments confirmed the integration of the transposons into the mosquito genome, although not all integrations were of the expected cut-and-paste type transposition. The increased frequency of germ-line integrations obtained with purified transposase will facilitate the generation of Mos1 transgenic mosquitoes and the application of transgenic approaches to the biology of this important vector of multiple pathogens. PMID:10989286

  17. Vaccination with Replication Deficient Adenovectors Encoding YF-17D Antigens Induces Long-Lasting Protection from Severe Yellow Fever Virus Infection in Mice.

    PubMed

    Bassi, Maria R; Larsen, Mads A B; Kongsgaard, Michael; Rasmussen, Michael; Buus, Søren; Stryhn, Anette; Thomsen, Allan R; Christensen, Jan P

    2016-02-01

    The live attenuated yellow fever vaccine (YF-17D) has been successfully used for more than 70 years. It is generally considered a safe vaccine, however, recent reports of serious adverse events following vaccination have raised concerns and led to suggestions that even safer YF vaccines should be developed. Replication deficient adenoviruses (Ad) have been widely evaluated as recombinant vectors, particularly in the context of prophylactic vaccination against viral infections in which induction of CD8+ T-cell mediated immunity is crucial, but potent antibody responses may also be elicited using these vectors. In this study, we present two adenobased vectors targeting non-structural and structural YF antigens and characterize their immunological properties. We report that a single immunization with an Ad-vector encoding the non-structural protein 3 from YF-17D could elicit a strong CD8+ T-cell response, which afforded a high degree of protection from subsequent intracranial challenge of vaccinated mice. However, full protection was only observed using a vector encoding the structural proteins from YF-17D. This vector elicited virus-specific CD8+ T cells as well as neutralizing antibodies, and both components were shown to be important for protection thus mimicking the situation recently uncovered in YF-17D vaccinated mice. Considering that Ad-vectors are very safe, easy to produce and highly immunogenic in humans, our data indicate that a replication deficient adenovector-based YF vaccine may represent a safe and efficient alternative to the classical live attenuated YF vaccine and should be further tested. PMID:26886513

  18. Vaccination with Replication Deficient Adenovectors Encoding YF-17D Antigens Induces Long-Lasting Protection from Severe Yellow Fever Virus Infection in Mice

    PubMed Central

    Bassi, Maria R.; Larsen, Mads A. B.; Kongsgaard, Michael; Rasmussen, Michael; Buus, Søren; Stryhn, Anette; Thomsen, Allan R.; Christensen, Jan P.

    2016-01-01

    The live attenuated yellow fever vaccine (YF-17D) has been successfully used for more than 70 years. It is generally considered a safe vaccine, however, recent reports of serious adverse events following vaccination have raised concerns and led to suggestions that even safer YF vaccines should be developed. Replication deficient adenoviruses (Ad) have been widely evaluated as recombinant vectors, particularly in the context of prophylactic vaccination against viral infections in which induction of CD8+ T-cell mediated immunity is crucial, but potent antibody responses may also be elicited using these vectors. In this study, we present two adenobased vectors targeting non-structural and structural YF antigens and characterize their immunological properties. We report that a single immunization with an Ad-vector encoding the non-structural protein 3 from YF-17D could elicit a strong CD8+ T-cell response, which afforded a high degree of protection from subsequent intracranial challenge of vaccinated mice. However, full protection was only observed using a vector encoding the structural proteins from YF-17D. This vector elicited virus-specific CD8+ T cells as well as neutralizing antibodies, and both components were shown to be important for protection thus mimicking the situation recently uncovered in YF-17D vaccinated mice. Considering that Ad-vectors are very safe, easy to produce and highly immunogenic in humans, our data indicate that a replication deficient adenovector-based YF vaccine may represent a safe and efficient alternative to the classical live attenuated YF vaccine and should be further tested. PMID:26886513

  19. Fever after Cervical Ectopic Pregnancy; a case report from Gorgan, Iran

    PubMed Central

    Tabandeh, Afsaneh; Besharat, Mahsa

    2014-01-01

    Ectopic pregnancy is a rare condition, and, although its prevalence has decreased in recent years, it is still an important cause of mortality and morbidity in women. Cervical ectopic pregnancy is less than 1% of all ectopic pregnancies. Fever is one of signs of infection, and it is necessary to monitor patients closely for other signs of infection. This paper presents and discusses a case of cervical ectopic pregnancy with fever after treatment. The patient had a high fever that became worse after three hospitalizations. The probable cause of her pyelonephritis was a urinary catheter, although it had been removed earlier, and she was receiving antibiotic therapy. Even though cervical ectopic pregnancy is a rare condition, it has certain complications that must be managed appropriately. PMID:25763173

  20. Epidemiology of Pediatric Convulsive Status Epilepticus With Fever in the Emergency Department: A Cohort Study of 381 Consecutive Cases.

    PubMed

    Hayakawa, Itaru; Miyama, Sahoko; Inoue, Nobuaki; Sakakibara, Hiroshi; Hataya, Hiroshi; Terakawa, Toshiro

    2016-09-01

    Pediatric convulsive status epilepticus with fever is common in the emergency setting but leads to severe neurological sequelae in some patients. To explore the epidemiology of convulsive status epilepticus with fever, a retrospective cohort covering all convulsive status epilepticus cases with fever seen in the emergency department of a tertiary care children's hospital were consecutively collected. Of the 381 consecutive cases gathered, 81.6% were due to prolonged febrile seizure, 6.6% to encephalopathy/encephalitis, 0.8% to meningitis, and 7.6% to epilepsy. In addition, seizures were significantly longer in encephalopathy/encephalitis cases than in prolonged febrile seizure cases (log rank test, P < .001). These results provide for the first time the pretest probability of final diagnoses in children with convulsive status epilepticus with fever in the emergency setting, and will help optimize the management of pediatric patients presenting to the emergency department with convulsive status epilepticus with fever. PMID:27280723

  1. Chikungunya fever: Atypical and lethal cases in the Western hemisphere: A Venezuelan experience.

    PubMed

    Torres, Jaime R; Leopoldo Códova G; Castro, Julio S; Rodríguez, Libsen; Saravia, Víctor; Arvelaez, Joanne; Ríos-Fabra, Antonio; Longhi, María A; Marcano, Melania

    2015-01-01

    A large epidemic of Chikungunya fever currently affects the Caribbean, Central and South America. Despite a high number of reported cases, little is known on the occurrence of severe clinical complications. We describe four Venezuelan patients with a severe and/or lethal course who exhibit unusual manifestations of the disease. Case 1 describes a 75 year-old man with rapid onset of septic shock and multi-organ failure. Cases 2 and 3 describe two patients with rapid aggressive clinical course who developed shock, severe purpuric lesions and a distinct area large of necrosis in the nasal region. Case 4 depicts a splenectomized woman with shock, generalized purpuric lesions, bullous dermatosis and acronecrosis of an upper limb. Chikungunya fever in the Western hemisphere may also associate with atypical and severe manifestations. Some patients experience a life-threatening, aggressive clinical course, with rapid deterioration and death due to multisystem failure. PMID:26793440

  2. Direct determination of sorbitol and sodium glutamate by attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR) in the thermostabilizer employed in the production of yellow-fever vaccine.

    PubMed

    de Castro, Eduardo da S G; Cassella, Ricardo J

    2016-05-15

    Reference methods for quality control of vaccines usually require treatment of the samples before analysis. These procedures are expensive, time-consuming, unhealthy and require careful manipulation of the sample, making them a potential source of analytical errors. This work proposes a novel method for the quality control of thermostabilizer samples of the yellow fever vaccine employing attenuated total reflectance Fourier transform infrared spectrometry (ATR-FTIR). The main advantage of the proposed method is the possibility of direct determination of the analytes (sodium glutamate and sorbitol) without any pretreatment of the samples. Operational parameters of the FTIR technique, such as the number of accumulated scans and nominal resolution, were evaluated. The best conditions for sodium glutamate were achieved when 64 scans were accumulated using a nominal resolution of 4 cm(-1). The measurements for sodium glutamate were performed at 1347 cm(-1) (baseline correction between 1322 and 1369 cm(-1)). In the case of sorbitol, the measurements were done at 890cm(-1) (baseline correction between 825 and 910 cm(-1)) using a nominal resolution of 2 cm(-1) with 32 accumulated scans. In both cases, the quantitative variable was the band height. Recovery tests were performed in order to evaluate the accuracy of the method and recovery percentages in the range 93-106% were obtained. Also, the methods were compared with reference methods and no statistical differences were observed. The limits of detection and quantification for sodium glutamate were 0.20 and 0.62% (m/v), respectively, whereas for sorbitol they were 1 and 3.3% (m/v), respectively. PMID:26992492

  3. Two Case Reports on Thalamic and Basal Ganglia Involvement in Children with Dengue Fever

    PubMed Central

    Adhikari, Lihini; Wijesekera, Saraji; Wijayawardena, Maheshaka; Chandrasiri, Suchithra

    2016-01-01

    There have been increasing numbers of case reports of dengue infection with unusual manifestations. Such unusual manifestations including acute liver failure and encephalopathy could be manifested even in the absence of significant plasma leakage. Further, severe organ involvement including nervous system involvement indicates severe dengue infection. However, neurological manifestations of dengue fever are rare. This is the first case report of dengue infection with thalamic and basal ganglia involvement in Sri Lanka. PMID:27478661

  4. Two Case Reports on Thalamic and Basal Ganglia Involvement in Children with Dengue Fever.

    PubMed

    Liyanage, Guwani; Adhikari, Lihini; Wijesekera, Saraji; Wijayawardena, Maheshaka; Chandrasiri, Suchithra

    2016-01-01

    There have been increasing numbers of case reports of dengue infection with unusual manifestations. Such unusual manifestations including acute liver failure and encephalopathy could be manifested even in the absence of significant plasma leakage. Further, severe organ involvement including nervous system involvement indicates severe dengue infection. However, neurological manifestations of dengue fever are rare. This is the first case report of dengue infection with thalamic and basal ganglia involvement in Sri Lanka. PMID:27478661

  5. A Mixed Outbreak of Epidemic Typhus Fever and Trench Fever in a Youth Rehabilitation Center: Risk Factors for Illness from a Case-Control Study, Rwanda, 2012.

    PubMed

    Umulisa, Irenee; Omolo, Jared; Muldoon, Katherine A; Condo, Jeanine; Habiyaremye, Francois; Uwimana, Jean Marie; Muhimpundu, Marie Aimee; Galgalo, Tura; Rwunganira, Samuel; Dahourou, Anicet G; Tongren, Eric; Koama, Jean Baptiste; McQuiston, Jennifer; Raghunathan, Pratima L; Massung, Robert; Gatei, Wangeci; Boer, Kimberly; Nyatanyi, Thierry; Mills, Edward J; Binagwaho, Agnes

    2016-08-01

    In August 2012, laboratory tests confirmed a mixed outbreak of epidemic typhus fever and trench fever in a male youth rehabilitation center in western Rwanda. Seventy-six suspected cases and 118 controls were enrolled into an unmatched case-control study to identify risk factors for symptomatic illness during the outbreak. A suspected case was fever or history of fever, from April 2012, in a resident of the rehabilitation center. In total, 199 suspected cases from a population of 1,910 male youth (attack rate = 10.4%) with seven deaths (case fatality rate = 3.5%) were reported. After multivariate analysis, history of seeing lice in clothing (adjusted odds ratio [aOR] = 2.6, 95% confidence interval [CI] = 1.1-5.8), delayed (≥ 2 days) washing of clothing (aOR = 4.0, 95% CI = 1.6-9.6), and delayed (≥ 1 month) washing of beddings (aOR = 4.6, 95% CI = 2.0-11) were associated with illness, whereas having stayed in the rehabilitation camp for ≥ 6 months was protective (aOR = 0.20, 95% CI = 0.10-0.40). Stronger surveillance and improvements in hygiene could prevent future outbreaks. PMID:27352876

  6. High Dose Intraveneous Vitamin C and Chikungunya Fever: A Case Report

    PubMed Central

    Gonzalez, Michael J.; Miranda-Massari, Jorge R.; Berdiel, Miguel J.; Duconge, Jorge; Rodríguez-López, Joshua L.; Hunninghake, Ron; Cobas-Rosario, Vicente J.

    2015-01-01

    The Chikungunya (CHIKV) fever is a viral disease produced by a single-stranded RNA Alphavirus from the Togaviridae genus. Its transmission occurs only through mosquito vectors, principally Aedes aegypti. It requires a human-mosquito-human transmission cycle. It is associated with severe arthritis/arthralgias, myalgias, high fever, headache, and maculopapular rash. Joint ache appears to be symmetrical. The virus has an incubation period of 2 to 7 days, where the high fever is typically presented. It is followed by arthralgias and myalgias, and rashes, which last for 3 to 5 days. However, the arthralgias can persist for months after the infection, which can contribute to severe arthritis. As of now, no vaccine exists for the virus and no official treatment has been developed aside from standard procedures of the use of acetaminophen (paracetamol), and non-steroidal anti-inflammatory drugs. This is a case report of a 54-year old Hispanic individual that reported left shoulder pain, left knee pain and fever. The symptoms started on a Saturday in September 2014 in middle of the night. The patient was treated with high doses of intravenous vitamin C over two days. The symptoms resolved after the infusions without any side effects. Based on the positive outcome in this case, we propose that intravenous vitamin C should be studied further as a potential treatment for acute viral infections. PMID:25705076

  7. Regional dust storm modeling for health services: The case of valley fever

    NASA Astrophysics Data System (ADS)

    Sprigg, William A.; Nickovic, Slobodan; Galgiani, John N.; Pejanovic, Goran; Petkovic, Slavko; Vujadinovic, Mirjam; Vukovic, Ana; Dacic, Milan; DiBiase, Scott; Prasad, Anup; El-Askary, Hesham

    2014-09-01

    On 5 July 2011, a massive dust storm struck Phoenix, Arizona (USA), raising concerns for increased cases of valley fever (coccidioidomycosis, or, cocci). A quasi-operational experimental airborne dust forecast system predicted the event and provides model output for continuing analysis in collaboration with public health and air quality communities. An objective of this collaboration was to see if a signal in cases of valley fever in the region could be detected and traced to the storm - an American haboob. To better understand the atmospheric life cycle of cocci spores, the DREAM dust model (also herein, NMME-DREAM) was modified to simulate spore emission, transport and deposition. Inexact knowledge of where cocci-causing fungus grows, the low resolution of cocci surveillance and an overall active period for significant dust events complicate analysis of the effect of the 5 July 2011 storm. In the larger context of monthly to annual disease surveillance, valley fever statistics, when compared against PM10 observation networks and modeled airborne dust concentrations, may reveal a likely cause and effect. Details provided by models and satellites fill time and space voids in conventional approaches to air quality and disease surveillance, leading to land-atmosphere modeling and remote sensing that clearly mark a path to advance valley fever epidemiology, surveillance and risk avoidance.

  8. Yellow Nail Syndrome Associated with Pericarditis and Pericardial Effusion: a Case Report.

    PubMed

    Santos, Vitorino Modesto dos; Teixeira, Christiane Aires; Almeida, Ana Carla Andrade; Santos, Alessandra Maria Rodrigues Oliveira; Brito, Kátia Rejane Marques; Ferreira, Valerio Alves

    2015-12-01

    Yellow nail syndrome (YNS) is an uncommon condition characterized by nail changes, lymphedema, in addition to pulmonary disorders and pleural effusion. Pericarditis and non-cardiac disorders can evolve with pericardial effusions including autoimmune conditions, hypothyroidism, malignancies, tuberculosis, and uremia. A 72-year-old Brazilian woman under treatment for arterial hypertension and hypothyroidism was admitted with pericarditis and pericardial effusion concomitant with yellow nail syndrome. She denied tobacco smoking, alcohol abuse, and similar disorders in her family. Clinical and complementary evaluation ruled out infectious diseases, malignancies, and autoimmune disorders as etiologic factors in this case. Hypothyroidism is a well-known cause of pericardial effusion, the vast majority in the absence of pericarditis, and has been described as an associated condition in some individuals with YNS. Case studies might contribute to better understanding of these causal or casual relationships. PMID:26749238

  9. [Intravenous Minocycline and Levofloxacin for Treatment of Two Cases of Japanese Spotted Fever].

    PubMed

    Sato, Akihiro; Nakamura, Itaru; Ikeda, Hideki; Mizuno, Yasutaka; Fujii, Takeshi; Matsumoto, Tetsuya; Kanda, Tetsurou

    2015-09-01

    We report herein on two cases of Japanese spotted fever (JSF) treated with intravenous minocycline (MINO) and levofloxacin (LVFX). An 80 year-old woman (Case1) and a 63 year-old man (Case2) with high fever (> 39 degrees C) and wide-spread skin erythema were admitted because they were suspected of having developed JSF. After admission, we treated them with intravenous MINO and LVFX. The patients' fevers were resolved within 36 hours after antibiotics. They were diagnosed as having JSF based on the serological test, and Rickettsia japonica was detected from the genetic findings (PCR analysis from eschar) only in case 1. In the treatment of fulminant JSF (body temperature > 39 degrees C) the prompt administration of a combination of tetracycline and new quinolone has been recommended. The number of cases of JSF and its endemic area are gradually increasing in Japan. As for new quinolones, ciprofloxacin and tosufloxacin have been used against to JSF in Japan, but LVFX may become a new option. PMID:26630793

  10. Increase in paratyphoid fever cases in Japanese travellers returning from Cambodia in 2013.

    PubMed

    Saitoh, T; Morita, M; Shimada, T; Izumiya, H; Kanayama, A; Oishi, K; Ohnishi, M; Sunagawa, T

    2016-02-01

    In 2013, an unusual increase of paratyphoid fever cases in travellers returning from Cambodia was reported in Japan. From December 2012 to September 2013, 18 cases of Salmonella Paratyphi A infection were identified. Microbiological analyses revealed that most isolates had the same clonal identity, although the epidemiological link between these cases remains unclear. It was inferred that the outbreak was caused by a common and persistent source in Cambodia that was likely to have continued during 2014. The information of surveillance and laboratory data from cases arising in travellers from countries with limited surveillance systems should be timely shared with the country of origin. PMID:26169980

  11. NS2B-3 proteinase-mediated processing in the yellow fever virus structural region: in vitro and in vivo studies.

    PubMed Central

    Amberg, S M; Nestorowicz, A; McCourt, D W; Rice, C M

    1994-01-01

    Several of the cleavages required to generate the mature nonstructural proteins from the flaviviral polyprotein are known to be mediated by a complex consisting of NS2B and a serine proteinase domain located in the N-terminal one-third of NS3. These cleavages typically occur after two basic residues followed by a short side chain residue. Cleavage at a similar dibasic site in the structural region is believed to produce the C terminus of the virion capsid protein. To study this cleavage, we developed a cell-free trans cleavage assay for yellow fever virus (YF)-specific proteolytic activity by using a substrate spanning the C protein dibasic site. Cleavage at the predicted site was observed when the substrate was incubated with detergent-solubilized lysates from YF-infected BHK cells. NS2B and the NS3 proteinase domain were the only YF-specific proteins required for this cleavage. Cell fractionation studies demonstrated that the YF-specific proteolytic activity was membrane associated and that activity could be detected only after detergent solubilization. Previous cell-free studies led to a hypothesis that processing in the C-prM region involves (i) translation of C followed by translocation and core glycosylation of prM by using an internal signal sequence, (ii) signalase cleavage to produce a membrane-anchored form of the C protein (anchC) and the N terminus of prM, and (iii) NS2B-3-mediated cleavage at the anchC dibasic site to produce the C terminus of the virion C protein. However, the results of in vivo transient-expression studies do not support this temporal cleavage order. Rather, expression of a YF polyprotein extending from C through the N-terminal one-third of NS3 revealed that C-prM processing, but not translocation, was dependent on an active NS2B-3 proteinase. This suggests that signalase-mediated cleavage in the lumen of the endoplasmic reticulum may be dependent on prior cleavage at the anchC dibasic site. Possible pathways for processing in the C

  12. Bilateral eyelid ecchymosis and subconjunctival haemorrhage manifesting as presenting feature in a case of dengue haemorrhagic fever.

    PubMed

    Jain, Sparshi; Goswami, Anup; Singh, Nidhi; Kaur, Savleen

    2015-10-01

    We report a case of bilateral eyelid ecchymosis and subconjunctival haemorrhage, a rare presenting feature of dengue haemorrhagic fever. A 17-year-old boy presented to the emergency department with complaints of redness in both eyes and vomiting. He had bilateral eyelid ecchymosis with subconjunctival haemorrhage. Complete blood count revealed a significantly reduced platelet count of 11000/µL suggestive of dengue haemorrhagic fever (DHF). Ocular manifestations were followed by other systemic haemorrhagic manifestations of dengue later on which violates the usual sequence of events of dengue fever. Bilateral eyelid ecchymosis is a rare clinical manifestation and a rare presenting feature of dengue fever and one has to keep high index of suspicion for presence of dengue whenever a case of fever presents with lid ecchymosis/haemorrhage. PMID:25540163

  13. Chronic Q Fever in Alberta: A Case of Coxiella burnetii Mycotic Aneurysm and Concomitant Vertebral Osteomyelitis

    PubMed Central

    Janvier, Jack; Vaughan, Stephen

    2016-01-01

    Chronic Q fever is a potentially life-threatening infection from the intracellular, Gram-negative Coxiella burnetii. It presents most commonly as endocarditis or vascular infection in people with underlying cardiac or vascular disease. We discuss a case of a 67-year-old male with Coxiella burnetii vascular infection of a perirenal abdominal aortic graft. The patient had a history of an abdominal aortic aneurysm (AAA) repair 5 years earlier. He presented with a 12 × 6 × 8 cm perirenal pseudoaneurysm and concomitant L1, L2, and L3 vertebral body discitis. He underwent an open repair which revealed a grossly infected graft perioperatively. Q fever serology revealed phase I serological IgG titer of 1 : 2048 and phase II 1 : 1024 consistent with chronic Q fever. Polymerase chain reaction (PCR) on infected vascular tissue was positive for C. burnetii. The patient was started on doxycycline and hydroxychloroquine with good clinical response and decreasing serological titers. Recognizing chronic Q fever is a difficult task as symptoms are nonspecific, exposure risk is difficult to ascertain, and diagnosis is hidden from conventional microbiological investigations. Its recognition, however, is critical as C. burnetii is inherently resistant to standard empiric therapies used in cardiovascular infections. PMID:27366178

  14. Chronic Q Fever in Alberta: A Case of Coxiella burnetii Mycotic Aneurysm and Concomitant Vertebral Osteomyelitis.

    PubMed

    Stokes, William; Janvier, Jack; Vaughan, Stephen

    2016-01-01

    Chronic Q fever is a potentially life-threatening infection from the intracellular, Gram-negative Coxiella burnetii. It presents most commonly as endocarditis or vascular infection in people with underlying cardiac or vascular disease. We discuss a case of a 67-year-old male with Coxiella burnetii vascular infection of a perirenal abdominal aortic graft. The patient had a history of an abdominal aortic aneurysm (AAA) repair 5 years earlier. He presented with a 12 × 6 × 8 cm perirenal pseudoaneurysm and concomitant L1, L2, and L3 vertebral body discitis. He underwent an open repair which revealed a grossly infected graft perioperatively. Q fever serology revealed phase I serological IgG titer of 1 : 2048 and phase II 1 : 1024 consistent with chronic Q fever. Polymerase chain reaction (PCR) on infected vascular tissue was positive for C. burnetii. The patient was started on doxycycline and hydroxychloroquine with good clinical response and decreasing serological titers. Recognizing chronic Q fever is a difficult task as symptoms are nonspecific, exposure risk is difficult to ascertain, and diagnosis is hidden from conventional microbiological investigations. Its recognition, however, is critical as C. burnetii is inherently resistant to standard empiric therapies used in cardiovascular infections. PMID:27366178

  15. Fever as a first manifestation of advanced gastric adenosquamous carcinoma: A case report

    PubMed Central

    Ajoodhea, Harsha; Zhang, Ren-Chao; Xu, Xiao-Wu; Jin, Wei-Wei; Chen, Ke; He, Yong-Tao; Mou, Yi-Ping

    2014-01-01

    Gastric adenosquamous carcinoma (ASC) is a rare type of gastric cancer. It is a mixed neoplasm, consisting of glandular cells and squamous cells. It is often diagnosed at an advanced stage, thus carrying a poor prognosis. We describe a case of a 73-year-old male, who presented with refractory fever and an intra-abdominal mass on imaging. He underwent a laparoscopic exploration followed by a successful totally laparoscopic total gastrectomy with D2 lymphadenectomy for gastric cancer. Postoperative pathology revealed primary gastric ASC (T4aN0M0). The patient received adjuvant radiotherapy and chemotherapy with S1 and is alive 20 mo after surgery without recurrence. This is the first case of advanced gastric ASC with fever as the initial presentation treated with totally laparoscopic total gastrectomy reported in the English literature. PMID:25110448

  16. Report of nine cases of Crimean-Congo haemorrhagic fever From Iran

    PubMed Central

    Ayatollahi, Jamshid; Shahcheraghi, Seyed Hossein; Mirjalili, Mahmood

    2015-01-01

    Crimean-Congo haemorrhagic fever (CCHF) is an often fatal viral infection described in about 30 countries around the world. It is transmitted to humans by the bite of an infected tick and by direct contact with blood or tissue from infected humans and livestock. In the following, we report nine cases of CCHF disease. This paper reported nine human CCHF cases, two in Tabas and Bandar Abbas and seven in Yazd. They were 21-, 33-, 28-, 29-, 61, 34, 35, 36 and 52 year-old men. The first, second and third patients were butchers and other patients were farmers. CCHF should be investigated in the patients with fever, bleeding and low platelet counts. PMID:25838635

  17. Lassa Fever in Pregnancy: Report of 2 Cases Seen at the University College Hospital, Ibadan.

    PubMed

    Bello, O O; Akinajo, O R; Odubamowo, K H; Oluwasola, T A O

    2016-01-01

    Lassa fever (LF), an acute viral haemorrhagic fever, is an endemic zoonotic viral infection in West Africa countries with up to 15% case fatality rate. Though a rodent-borne infection, it can also be transmitted from person to person during the care of sick relations or more commonly in health care settings as a nosocomial infection. Vertical transmission from mother to child has been documented. We report 2 cases of LF among pregnant women which were managed at the University College Hospital, Ibadan, between September and October 2014. Both patients were in their early 20s with only one surviving the disease. Both had supportive therapy but none had antiviral therapy. This report emphasized the importance of early presentation, high index of suspicion, prompt diagnosis, and early commencement of supportive therapy in the management of patients suspected with LF especially in the era of other viral haemorrhagic infections. PMID:27051545

  18. Lassa Fever in Pregnancy: Report of 2 Cases Seen at the University College Hospital, Ibadan

    PubMed Central

    Akinajo, O. R.; Odubamowo, K. H.; Oluwasola, T. A. O.

    2016-01-01

    Lassa fever (LF), an acute viral haemorrhagic fever, is an endemic zoonotic viral infection in West Africa countries with up to 15% case fatality rate. Though a rodent-borne infection, it can also be transmitted from person to person during the care of sick relations or more commonly in health care settings as a nosocomial infection. Vertical transmission from mother to child has been documented. We report 2 cases of LF among pregnant women which were managed at the University College Hospital, Ibadan, between September and October 2014. Both patients were in their early 20s with only one surviving the disease. Both had supportive therapy but none had antiviral therapy. This report emphasized the importance of early presentation, high index of suspicion, prompt diagnosis, and early commencement of supportive therapy in the management of patients suspected with LF especially in the era of other viral haemorrhagic infections. PMID:27051545

  19. An Unusual Case of Crimean Congo Hemorrhagic Fever: Prolonged Bleeding with Successful Recovery.

    PubMed

    Hussain, Qurban; Shaikh, Bilal Hussain; Bhutto, Ali Raza; Sohaib, Muneebah

    2016-02-01

    Crimean Congo Hemorrhagic Fever (CCHF) is a tick-borne viral disease with a major reservoir in both domestic and wild animals. In Pakistan, it is endemic largely in rural areas and most cases occur in spring and autumn. Recently, cases are being reported throughout the year, including winter months, with some even from urban areas. Death from CCHF is most likely to occur during the hemorrhagic phase. We report a case presenting from an urban locality in December. Clinical presentation was characterized by a prolonged hemorrhagic phase and a delayed normalization of platelet counts. PMID:26876406

  20. Leiomyosarcoma of the Broad Ligament With Fever Presentation: A Case Report and Review of Literature

    PubMed Central

    Chaichian, Shahla; Mehdizadehkashi, Abolfazl; Tahermanesh, Kobra; Moazzami, Bahram; Jesmi, Fatemeh; Rafiee, Moezedinjavad; Goharimoghaddam, Katayoun

    2016-01-01

    Introduction Leiomyosarcoma is a rare gynecologic malignancy that accounts for less than 1% of gynecological malignancies. Leiomyosarcoma of the broad ligament is an even rarer condition. According to Gardner’s criteria, the diagnosis is made when the mass is completely separated from the uterus and adnexa. So far, 23 cases of primary leiomyosarcoma of the broad ligament have been reported in the literature published in English. Case Presentation In September 2014, a 55-year-old, gravida 3, para 3 woman with a BMI of 30 and a chief complaint of fever and dizziness was admitted to the infectious-diseases ward of the Pars general hospital affiliated with Iran University of Medical Sciences in Tehran, Iran. Her symptoms had begun two weeks before. The results of a fever workup and examination for infectious, metabolic, and immunologic problems were all negative. Imaging modalities revealed an endometrial polyp, two calcified myoma in the body of the uterus, and a solid, heterogeneous 70-mm mass in the right para-cervical space, posterior to the broad ligament, and far from the ovary. After surgery, a histologic report revealed leiomyosarcoma. Conclusions Although a leiomyosarcoma of the broad ligament is rare, practitioners should consider it when dealing with masses in the region of the broad ligament. If there is any suspicion of malignancy, especially in the presence of fever, it is recommended to avoid morcellation during laparoscopy. PMID:27330834

  1. An imported case of P. falciparum malaria presenting as black water fever with acute renal failure.

    PubMed

    Khan, Fahmi Yousef; Al-Haddad, Dalia

    2009-11-01

    This is a report of a case of blackwater fever in a 28-year-old Nigerian man who was admitted to hospital with fever, jaundice and passing dark urine. Abdominal examination revealed splenomegaly and an examination of the peripheral smear of the patient showed the ring form of the trophozoites of Plasmodium falciparum (P. falciparum). Serum creatinine was 200micromol/L. Treatment with quinine and doxycycline was started and intravenous fluids were administered with close monitoring of the urine output and serum electrolytes. Due to the alarming amount of fluid accumulation and his exacerbated azotaemia the decision was made to haemodialyse the patient; the patient required five haemodialysis sessions during his stay in the hospital. He was discharged on the sixteenth day after admission with a serum creatinine level of 160micromol/L. PMID:19945017

  2. Non-choroidal yellow melanoma showing positive staining with Sudan Black consistent with the presence of lipofuscin: a case report.

    PubMed

    Jegou Penouil, Marie Hélène; Gourhant, Jean-Yves; Segretin, Catherine; Weedon, David; Rosendahl, Cliff

    2014-04-01

    A case of a predominantly yellow primary superficial spreading melanoma arising on the back of a 44-year-old woman is presented. Possible causes of the clinical and dermatoscopic yellow color are discussed. Staining with the histochemical stain, Sudan Black, revealed a differential uptake compared to a closely matched control melanoma. We speculate that the clinical and dermatoscopic yellow color could be due to the presence of increased amounts of the pigment lipofuscin, which is known to produce subtle orange color in some choroidal melanomas. PMID:24855574

  3. [Fever of unknown origin and detection of Bartonella henselae IgG seropositivity: a case report].

    PubMed

    Celebi, Bekir; Yalçın, Ebru; Babür, Cahit

    2010-07-01

    Bartonella henselae, is a gram-negative bacterium which causes cat scratch disease (CSD) in man. There are sporadic case reports of CSD in Turkey. Cats play an important reservoir role for B.henselae transmission to man. In this report, a cat owner with fever of unknown origin was presented. Bartonella spp. was isolated from the blood culture of cat which had chronic progressive gingivostomatitis. B.henselae was identified by amplification of a region of citrate synthase (gltA) gene by using polymerase cha-in reaction and typed as genotype I by restriction fragment length polymorphism method. Following this identification the cat owner was investigated for the history of CSD and it was learned that he had a history of fever of unknown origin. The investigation of the patient's serum for the presence of specific B.henselae antibodies by immune fluorescence antibody test (Vircell, Spain) revealed B.henselae IgG type antibodies at a titer of 1:128. Gingivostomatitis in cats may act as a reservoir for Bartonella infection. Thus during the evaluation of patients with fever of unknown origin, Bartonella infections should be considered and possible contact with cats/dogs should be investigated. PMID:21064000

  4. Capacity building permitting comprehensive monitoring of a severe case of Lassa hemorrhagic fever in Sierra Leone with a positive outcome: case report.

    PubMed

    Grove, Jessica N; Branco, Luis M; Boisen, Matt L; Muncy, Ivana J; Henderson, Lee A; Schieffellin, John S; Robinson, James E; Bangura, James J; Fonnie, Mbalu; Schoepp, Randal J; Hensley, Lisa E; Seisay, Alhassan; Fair, Joseph N; Garry, Robert F

    2011-01-01

    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. PMID:21689444

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

    PubMed Central

    2011-01-01

    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. PMID:21689444

  6. [Cases of West Nile fever in Novosibirsk region in 2004, and the genotyping of its viral pathogen].

    PubMed

    Ternovoĭ, V A; Protopopova, E V; Kononova, Iu V; Ol'khovikova, E A; Spiridonova, E A; Akopov, G D; Shestopalov, A M; Loktev, V B

    2007-01-01

    Three cases of West Nile fever were registered for the first time in Novosibirsk region in 2004. The diagnosis was confirmed by revealing IgG against West Nile virus (three cases) and viral RNA (two cases). Sequence analysis of fragments of E protein gene showed that the virus belonged to Ia genotype. PMID:17338376

  7. Chronic Q-Fever (Coxiella burnetii) Causing Abdominal Aortic Aneurysm and Lumbar Osteomyelitis: A Case Report

    PubMed Central

    Leahey, P. Alexander; Tahan, Steven R.; Kasper, Ekkehard M.; Albrecht, Mary

    2016-01-01

    Coxiella burnetii is a rare cause of chronic infection that most frequently presents as endocarditis. We report a case of C burnetii causing an infected abdominal aortic aneurysm with contiguous lumbar osteomyelitis resulting in spinal cord compromise. The diagnosis was established by serologic studies consistent with chronic Q-fever (ratio of C burnetii immunoglobulin [Ig]G phase II titer to IgG phase I titer <1) and was confirmed by positive C burnetii polymerase chain reaction of vertebral tissue in addition to pathology of vertebral bone showing intracellular Gram-negative coccobacillary bacteria. The patient clinically improved after surgical decompression and prolonged treatment with doxycycline and hydroxychloroquine. PMID:26730393

  8. A case of Mediterranean spotted fever associated with severe respiratory distress syndrome.

    PubMed

    Dželalija, Boris; Punda-Polić, Volga; Medić, Alan; Mraović, Boris; Šimurina, Tatjana

    2015-01-01

    Mediterranean spotted fever (MSF) is usually a mild endemic rickettsial disease occurring in southern Croatia. We have reported the clinical and epidemiological characteristics of an acute MSF case associated with severe respiratory distress syndrome and hemodynamical instability. The patient recovered completely after antimicrobial treatment. Indirect immunofluorescence assay (FOCUS Diagnostics Inc.) was performed to detect IgM and IgG antibodies to Rickettsia conorii. A significant increase of both IgM and IgG antibody titres found in paired acute- and convalescent-phase serum confirmed the diagnosis of acute MSF. PMID:26344605

  9. Chronic Q-Fever (Coxiella burnetii) Causing Abdominal Aortic Aneurysm and Lumbar Osteomyelitis: A Case Report.

    PubMed

    Leahey, P Alexander; Tahan, Steven R; Kasper, Ekkehard M; Albrecht, Mary

    2016-01-01

    Coxiella burnetii is a rare cause of chronic infection that most frequently presents as endocarditis. We report a case of C burnetii causing an infected abdominal aortic aneurysm with contiguous lumbar osteomyelitis resulting in spinal cord compromise. The diagnosis was established by serologic studies consistent with chronic Q-fever (ratio of C burnetii immunoglobulin [Ig]G phase II titer to IgG phase I titer <1) and was confirmed by positive C burnetii polymerase chain reaction of vertebral tissue in addition to pathology of vertebral bone showing intracellular Gram-negative coccobacillary bacteria. The patient clinically improved after surgical decompression and prolonged treatment with doxycycline and hydroxychloroquine. PMID:26730393

  10. Maternal mortality in a rural Tanzanian hospital: fatal Jarisch-Herxheimer reaction in a case of relapsing fever in pregnancy.

    PubMed

    Rustenhoven-Spaan, Ilona; Melkert, Peter; Nelissen, Ellen; van Roosmalen, Jos; Stekelenburg, Jelle

    2013-10-01

    Relapsing fever is a disease caused by one of the species of Borrelia. It is often misdiagnosed as malaria and can have fatal complications such as the Jarisch-Herxheimer reaction (JHR) after the commencement of treatment with antibiotics. A 19-year-old Tanzanian woman was admitted after a term home delivery that day. She presented with a 2 day history of fever, headache, general body malaise and vomiting. She was misdiagnosed as having severe malaria and was treated with quinine. The blood slide showed Borrelia duttoni. The patient continued treatment with procaine penicillin fortified for relapsing fever. Several hours later the woman died, probably due to JHR. This case of a patient with relapsing fever who died from a JHR stresses the importance of adequate diagnosis and treatment which should include careful monitoring, especially for the first hours after starting antibiotics. PMID:23976777

  11. Notes from the Field: Outbreak of Locally Acquired Cases of Dengue Fever--Hawaii, 2015.

    PubMed

    Johnston, David; Viray, Melissa; Ushiroda, Jenny; Whelen, A Christian; Sciulli, Rebecca; Gose, Remedios; Lee, Roland; Honda, Eric; Park, Sarah Y

    2016-01-22

    On October 21, 2015, the Hawaii Department of Health (HDOH) was notified of a positive dengue immunoglobulin M (IgM) antibody result in a woman residing on Hawaii Island (also known as the Big Island). The patient had no history of travel off the island, and other family members reported having similar signs and symptoms, which consisted of fever, headache, myalgias and arthralgias, and a generalized erythematous rash. HDOH initiated an investigation to identify any additional cases and potential exposure sources. On October 24, HDOH received report of a group of mainland U.S. visitors who had traveled together on Hawaii Island, including several who had developed a febrile illness. Additionally, on October 27, HDOH was notified of an unrelated person, also on Hawaii Island, with a positive dengue IgM result. As of November 26, 2015, HDOH had identified 107 laboratory-confirmed cases of dengue fever, with dates of onset ranging from September 11 to November 18, 2015. PMID:26796994

  12. Review of cases of nosocomial Lassa fever in Nigeria: the high price of poor medical practice.

    PubMed Central

    Fisher-Hoch, S. P.; Tomori, O.; Nasidi, A.; Perez-Oronoz, G. I.; Fakile, Y.; Hutwagner, L.; McCormick, J. B.

    1995-01-01

    OBJECTIVE--To investigate two hospital outbreaks of Lassa fever in southern central Nigeria. SETTING--Hospitals and clinics in urban and rural areas of Imo State, Nigeria. DESIGN--Medical records were reviewed in hospitals and clinics in both areas. Patients with presumed and laboratory confirmed Lassa fever were identified and contracts traced. Hospital staff, patients, and local residents were questioned, records were carefully reviewed, and serum samples were taken. Serum samples were assayed for antibody specific to Lassa virus, and isolates of Lassa virus were obtained. RESULTS--Among 34 patients with Lassa fever, including 20 patients, six nurses, two surgeons, one physician, and the son of a patient, there were 22 deaths (65% fatality rate). Eleven cases were laboratory confirmed, five by isolation of virus. Most patients had been exposed in hospitals (attack rate in patients in one hospital 55%). Both outbreak hospitals were inadequately equipped and staffed, with poor medical practice. Compelling, indirect evidence revealed that parenteral drug rounds with sharing of syringes, conducted by minimally educated and supervised staff, fuelled the epidemic among patients. Staff were subsequently infected during emergency surgery and while caring for nosocomially infected patients. CONCLUSION--This outbreak illustrates the high price exacted by the practice of modern medicine, particularly use of parenteral injections and surgery, without due attention to good medical practice. High priority must be given to education of medical staff in developing countries and to guidelines for safe operation of clinics and hospitals. Failure to do so will have far reaching, costly, and ultimately devastating consequences. PMID:7580496

  13. Clinical, virological, and pathological findings in a fatal case of Q fever endocarditis

    PubMed Central

    Ferguson, I. C.; Craik, J. E.; Grist, N. R.

    1962-01-01

    A case resembling subacute bacterial endocarditis in which blood cultures were repeatedly negative is described. The patient had had an influenza-like illness nine months before admission to hospital followed by intervening vague illness and loss of weight. Serological tests revealed a high titre of complement-fixing antibodies to phase 1 and phase 2 antigens of Rickettsia burneti. After death R. burneti was isolated from the diseased aortic valve, liver, and kidneys. Bodies morphologically resembling rickettsiae were seen in the aortic valve and in a very few renal tubule cells. No specific pathological lesions were found but there was a widespread stimulation of reticulo-endothelial cells particularly in the aortic valve cusps, spleen, lymph nodes, and renal glomeruli. It is suggested that tests for Q fever should be carried out in suspected cases of subacute bacterial endocarditis when blood culture is negative. Images PMID:13892334

  14. Guidance for contact tracing of cases of Lassa fever, Ebola or Marburg haemorrhagic fever on an airplane: results of a European expert consultation

    PubMed Central

    2012-01-01

    Background Travel from countries where viral haemorrhagic fevers (VHF) are endemic has increased significantly over the past decades. In several reported VHF events on airplanes, passenger trace back was initiated but the scale of the trace back differed considerably. The absence of guidance documents to help the decision on necessity and scale of the trace back contributed to this variation. This article outlines the recommendations of an expert panel on Lassa fever, Ebola and Marburg haemorrhagic fever to the wider scientific community in order to advise the relevant stakeholders in the decision and scale of a possible passenger trace back. Method The evidence was collected through review of published literature and through the views of an expert panel. The guidance was agreed by consensus. Results Only a few events of VHF cases during air travel are reported in literature, with no documented infection in followed up contacts, so that no evidence of transmission of VHF during air travel exists to date. Based on this and the expert opinion, it was recommended that passenger trace back was undertaken only if: the index case had symptoms during the flight; the flight was within 21 days after detection of the event; and for Lassa fever if exposure of body fluid has been reported. The trace back should only be done after confirmation of the index case. Passengers and crew with direct contact, seat neighbours (+/− 1 seat), crew and cleaning personal of the section of the index case should be included in the trace back. Conclusion No evidence has been found for the transmission of VHF in airplanes. This information should be taken into account, when a trace back decision has to be taken, because such a measure produces an enormous work load. The procedure suggested by the expert group can guide decisions made in future events, where a patient with suspected VHF infection travelled on a plane. However, the actual decision on start and scale of a trace back always lies

  15. IgA-dominant acute poststreptococcal glomerulonephritis with concomitant rheumatic fever successfully treated with steroids: a case report

    PubMed Central

    Rus, Rina R; Toplak, Nataša; Vizjak, Alenka; Mraz, Jerica; Ferluga, Dušan

    2015-01-01

    There are only a few reports of the co-occurrence of acute poststreptococcal glomerulonephritis (APGN) and acute rheumatic fever. We report an unusual case of a 3-year-old boy with nephrotic syndrome and acute renal failure with the transitional need for peritoneal dialysis, biopsy-proven atypical IgA-dominant APGN, and concomitant acute rheumatic fever, successfully treated by steroids. Aggressive treatment with pulses of methylprednisolone proved to be successful and we recommend its use in this type of cases. PMID:26718763

  16. IgA-dominant acute poststreptococcal glomerulonephritis with concomitant rheumatic fever successfully treated with steroids: a case report.

    PubMed

    Rus, Rina R; Toplak, Nataša; Vizjak, Alenka; Mraz, Jerica; Ferluga, Dušan

    2015-12-01

    There are only a few reports of the co-occurrence of acute poststreptococcal glomerulonephritis (APGN) and acute rheumatic fever. We report an unusual case of a 3-year-old boy with nephrotic syndrome and acute renal failure with the transitional need for peritoneal dialysis, biopsy-proven atypical IgA-dominant APGN, and concomitant acute rheumatic fever, successfully treated by steroids. Aggressive treatment with pulses of methylprednisolone proved to be successful and we recommend its use in this type of cases. PMID:26718763

  17. Tick-bite fever in South Africa. The occurrence of severe cases on the Witwatersrand.

    PubMed

    Gear, J H; Miller, G B; Martins, H; Swanepoel, R; Wolstenholme, B; Coppin, A

    1983-05-21

    Tick-bite fever, the variety of tick typhus occurring in southern Africa, is caused by Rickettsia conori var. pijperi and is transmitted by hard or ixodid ticks. It is usually a mild disease, especially in children and young adults, but in middle-aged and elderly patients (and sometimes in young adults) it may assume a severe form. This is characterized by high fever, severe headache, delirium, stupor and occasionally coma, and a profuse maculopapular rash which becomes haemorrhagic and is associated with petechiae in the skin and later, but rarely, by the development of gangrene of the fingers and toes. During these severe attacks the central nervous system may be involved and marked disorders of liver and kidney function sometimes lead to kidney failure and the need for treatment and dialysis in an intensive care unit. Three illustrative cases are described in which diagnosis was delayed. One patient died; 2 patients responded to administration of tetracycline. The danger of allowing tick-infested dogs onto one's bed is stressed. Infections transmitted by dog ticks tend to be more severe than those acquired via ticks from the bushveld, possibly because they so often occur in middle-aged and elderly patients. Serological tests have recently indicated that there are antigenic differences between 'suburban' and 'bushveld' strains; these clearly require further study. PMID:6687765

  18. Combined hepatocellular-cholangiocarcinoma with fever of unknown origin: a case report and review of literature.

    PubMed

    E, Changyong; Xie, Yingjun; Yang, Yongsheng; Ji, Degang; Li, Wei; Zhang, Xuewen

    2014-05-01

    Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) is a rare form of primary liver cancer (PLC). It is difficult to make a correct preoperative diagnosis of cHCC-CC because of the lack of special features of the disease. We here present a case of a 68-year-old man who presented with fluctuant fever, chills, and sweating and was eventually diagnosed as cHCC-CC after surgery. The tumor was 6.0 cm in diameter with distinct borders and no satellite lesions or lymph nodes were observed during macroscopic examination of the resection specimen. The fever resolved in the postoperative period till the 28th day after surgery, when the patient developed extensive abdominal metastases and died shortly after. More attention should be paid to the patient with PLC showing abnormal features such as FUO, normal range of tumor markers, atypical imaging, and less cirrhosis. Hepatic resection is the treatment of choice although with short-term outcomes. PMID:24068520

  19. Acute and probable chronic Q fever during anti-TNFα and anti B-cell immunotherapy: a case report

    PubMed Central

    2014-01-01

    Background Q fever is caused by the intracellular bacterium Coxiella burnetii. Initial infection can present as acute Q fever, while a minority of infected individuals develops chronic Q fever endocarditis or vascular infection months to years after initial infection. Serology is an important diagnostic tool for both acute and chronic Q fever. However, since immunosuppressive drugs may hamper the humoral immune response, diagnosis of Q fever might be blurred when these drugs are used. Case presentation A 71-year-old Caucasian male was diagnosed with symptomatic acute Q fever (based on positive C. burnetii PCR followed by seroconversion) while using anti-tumor necrosis factor-α (anti-TNFα) drugs for rheumatoid arthritis (RA). He was treated for two weeks with moxifloxacin. After 24 months of follow-up, the diagnosis of probable chronic Q fever was established based on increasing anti-C. burnetii phase I IgG antibody titres in a immunocompromised patient combined with clinical suspicion of endocarditis. At the time of chronic Q fever diagnosis, he had been treated with anti B-cell therapy for 16 months. Antibiotic therapy consisting of 1.5 years doxycycline and hydroxychloroquine was started and successfully completed and no signs of relapse were seen after more than one year of follow-up. Conclusion The use of anti-TNFα agents for RA in the acute phase of Q fever did not hamper the C. burnetii-specific serological response as measured by immunofluorescence assay. However, in the presented case, an intact humoral response did not prevent progression to probable chronic C. burnetii infection, most likely because essential cellular immune responses were suppressed during the acute phase of the infection. Despite the start of anti-B-cell therapy with rituximab after the acute Q fever episode, an increase in anti-C. burnetii phase I IgG antibodies was observed, supporting the notion that C. burnetii specific CD20-negative memory B-cells are responsible for this

  20. Slow improvement of clinically-diagnosed dengue haemorrhagic fever case fatality rates.

    PubMed

    Magpusao, Nelma S; Monteclar, Alan; Deen, Jacqueline L

    2003-07-01

    Dengue haemorrhagic fever (DHF) is recognized as a leading cause of hospitalization and death among children in many Southeast Asian countries. This study reviews the case fatality rates of DHF cases admitted to a referral hospital in Cebu (Philippines) over the past 5 years. Information on patients 14 years old or younger admitted from 1 January 1997 to 31 December 2001 with the final clinical diagnosis of DHF was collated and analysed. Case fatality rates were compared before and after a standardized management protocol was implemented by the healthcare staff and after introduction of revisions to that protocol. The case fatality rate during the 2-year periods prior and after introduction of the management protocol decreased significantly from 197/2644 (7.45%) to 39/1182 (3.30%) (P < 0.01). Following the introduction of revisions to the protocol, the case fatality was reduced even further to 52/1697 (3.06%) (P = 0.7). In this government hospital the introduction of a standardized management protocol for DHF was associated with a significant improvement in the case fatality rate of hospitalized children with clinically diagnosed DHF. However, compared with reports from hospitals in other dengue-endemic countries, the improvement has been slow. Possible ways to decrease fatality rates further have been identified. PMID:12870602

  1. Surgical and Antimicrobial Management of a Thoracic Aortic Aneurysm Due to Q Fever: A Case Report and Brief Review.

    PubMed

    Robinson, William P; Schuksz, Manuela

    2016-05-01

    Coxiella burnetii, the etiologic agent of Q fever, has been associated with vascular infection and aneurysm formation. We report the case of a 36-year-old woman from Iraq who presented with long-standing malaise as well as vague chest and shoulder discomfort and was found to have a saccular aneurysm of the descending thoracic aorta. Serology assays were positive for chronic C burnetii infection. She was treated with successful aneurysm resection and aortic replacement with a rifampin-impregnated Maquet Hemashield (TM) Dacron interposition graft interposition graft in addition to 18 months of doxycycline and hydroxychloroquine. The patient is without evidence of recurrent infection on follow-up at 3 years. To our knowledge, this is the first case of aortic aneurysm secondary to Q fever reported in the United States. We review the diagnosis, surgical management, antibiotic therapy, and surveillance of a thoracic aortic aneurysm secondary to Q fever. PMID:27075992

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

    PubMed

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

    2016-04-01

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

  3. Psoas abscess and chronic Q fever: a contiguous or hematogenous complication? A case report and literature review.

    PubMed

    Galy, Adrien; Decousser, Jean Winoc; El-Anbassi, Sarra; Nebbad, Biba; Belzunce, Carine; Cochennec, Frédéric; Deforges, Lionel; Lepeule, Raphaël

    2016-08-01

    Few cases of psoas abscesses (PA) during chronic Q fever have been reported, and the route of transmission remains unknown. Here, we report a new case and have performed a systematic literature review to determinate the spreading route of this complication. Medline, EMBASE and Web of Science were searched. Local spreading was supported by endocarditis exclusion, evidence of vascular infection and absence of distantly infected sites. Among 275 retrieved references, 179 were initially rejected, and 85 additional references were rejected after full-text review. A total of 11 studies, reporting 13 cases, were included. Additionally, we reported one new case. A total of 14/14 cases reached Q fever vascular infection diagnostic criteria, and 7/14 provided adequate evidence supporting a causal relationship between Q fever vascular infection and PA. All patients presented aorta defects. In conclusion, Q fever PA results from the spreading of a local infection and occurs specifically in patients presenting a vascular graft or an abdominal aortic aneurysm. PMID:27167531

  4. Drug Fever Induced by Piperacillin/Tazobactam in a Scoliosis Patient: A Case Report.

    PubMed

    Li, Zheng; Shen, Jianxiong; Li, Qiyi; Chan, Matthew Tak Vai; Wu, William Ka Kei

    2015-11-01

    Drug fever is frequently underrecognized by clinicians despite its common occurrence. Fever induced by piperacillin/tazobactam has not been reported in scoliosis correction surgery.Drug fever caused by piperacillin/tazobactam in a scoliosis patient was described.A 36-year-old woman with adult scoliosis undergoing correction surgery was reported. She developed a fever after an intake of piperacillin/tazobactam for 3 days. Eosinophil count, erythrocyte sedimentation rate, and C-reactive proteins were increased in her blood examination. Thorough history, chest radiography, blood cultures, physical examination, and urinalysis revealed no evidences of fever. A drug fever is therefore considered. The fever lasted for 2 weeks and her body temperature come back to normal 4 days after piperacillin/tazobactam cessation.Fever could be caused by piperacillin/tazobactam. The drug fever's diagnosis is easily confounded by a co-occurring infection. Therefore, it is crucial for clinicians to doubt drugs as a reason when no other origin of fever could be identified in a patient. PMID:26579799

  5. Cases of travel-acquired dengue fever in Denmark 2001-2009.

    PubMed

    Vinner, L; Domingo, C; Ostby, A-C B; Rosenberg, K; Fomsgaard, A

    2012-02-01

    Dengue fever (DF) remains one of the most important emerging infectious diseases. Whereas DF is well recognized in endemic countries, there are indications that the disease is underdiagnosed among travellers to endemic regions. Here, we present the first descriptive survey on cases of travel-acquired DF imported to Denmark diagnosed at the national reference laboratory for dengue virus diagnostics during a 9-year period. In our study, 16 - 46 travel-acquired dengue virus infections were diagnosed per year. DF is mainly imported by adults, mostly men, returning from Southeast Asian countries. The minimum incidence of dengue virus infection among Danish travellers is estimated to be 4.9 per 100,000 travellers. Our results confirm and expand studies from other European countries, and underline the importance of surveillance based on relevant diagnostic analyses. PMID:21745259

  6. Two cases of cellulitis in the course of African tick bite fever: a fortuitous association?

    PubMed

    Bouvresse, Sophie; Del Giudice, Pascal; Franck, Nathalie; Buffet, Marc; Avril, Marie-Françoise; Mondain, Véronique; Rolain, Jean-Marc; Raoult, Didier; Dupin, Nicolas

    2008-01-01

    In African tick bite fever (ATBF), inoculation eschar - resulting from disruption of the cutaneous barrier - may be a risk factor for cellulitis. We report 2 cases of ATBF associated with cellulitis. A 77-year-old woman was referred for severe leg cellulitis upon returning from sub-Saharan Africa. She developed erythematous macules. Rickettsia africae was detected by PCR assay from a skin biopsy specimen, and ATBF diagnosis was confirmed. A 75-year-old man was hospitalized after his return from Zimbabwe for a maculopapular exanthema and erysipelas-like rash of the leg. The diagnosis of cellulitis associated with ATBF was confirmed by PCR and serological methods. Both patients were treated for ATBF and cellulitis by a combination of doxycycline and beta-lactam antibiotics, and both had a good recovery. Inoculation eschar may be a risk factor for cellulitis; thus, we hypothesize a non-fortuitous association between ATBF and cellulitis. PMID:18503259

  7. Coexistence of hereditary angioedema in a case of familial Mediterranean fever with partial response to colchicine

    PubMed Central

    Bahceci, Semiha Erdem; Genel, Ferah; Gulez, Nesrin

    2015-01-01

    Hereditary angioedema (HAE) is a very rare and potentially life-threatening genetic disease characterised by episodes of edema in various parts of the body, including the extremities, face, and airway. The disease is usually associated with attacks of abdominal pain. On the other hand, familial Mediterranean fever (FMF) is an inherited condition characterised by recurrent episodes of painful inflammation in the abdomen, chest, or joints. In this report, we present a child with FMF and undiagnosed HAE, which made him a partial responder to colchicine treatment. Consequently, HAE must be considered in differential diagnosis of cases in which a partial response is obtained from FMF treatment, particularly in countries where FMF is frequently encountered, because early diagnosis of HAE can facilitate prevention of life-threatening complications, such as upper airway obstruction. To our knowledge, our patient is the first patient reported in the literature with the diagnosis of HAE and FMF together. PMID:26155193

  8. Lie integrable cases of the simplified multistrain/two-stream model for tuberculosis and dengue fever

    NASA Astrophysics Data System (ADS)

    Nucci, M. C.; Leach, P. G. L.

    2007-09-01

    We apply the techniques of Lie's symmetry analysis to a caricature of the simplified multistrain model of Castillo-Chavez and Feng [C. Castillo-Chavez, Z. Feng, To treat or not to treat: The case of tuberculosis, J. Math. Biol. 35 (1997) 629-656] for the transmission of tuberculosis and the coupled two-stream vector-based model of Feng and Velasco-Hernandez [Z. Feng, J.X. Velasco-Hernandez, Competitive exclusion in a vector-host model for the dengue fever, J. Math. Biol. 35 (1997) 523-544] to identify the combinations of parameters which lead to the existence of nontrivial symmetries. In particular we identify those combinations which lead to the possibility of the linearization of the system and provide the corresponding solutions. Many instances of additional symmetry are analyzed.

  9. Cases of typhoid fever imported into England, Scotland and Wales (2000-2003).

    PubMed

    Cooke, Fiona J; Day, Martin; Wain, John; Ward, Linda R; Threlfall, E John

    2007-04-01

    Although typhoid fever is no longer endemic in most of the developed world, it remains a major infectious disease in less developed regions and imported cases continue to occur in returning travellers, immigrants or migrant workers. We analysed all 692 isolates of Salmonella enterica subspecies enterica serovar Typhi from cases in England, Scotland and Wales that were sent to the Laboratory of Enteric Pathogens at the Health Protection Agency, Centre for Infections, London, UK between 2000 and 2003. The country of acquisition was known for 416 isolates (60%), and the majority of these (70%) came from India or Pakistan. Overall, 24 countries were listed, mainly in Asia and Africa. A total of 48 phage types were detected, 41% of which were Vi-phage type E1. Antimicrobial susceptibility testing revealed that 22% of isolates were multidrug resistant (MDR) (defined as resistance to chloramphenicol, ampicillin and co-trimoxazole) and 39% were quinolone resistant. A significant number of isolates (n=49) were sensitive to nalidixic acid by disk test but exhibited low-level ciprofloxacin resistance, suggesting a novel mechanism of resistance and reinforcing the need for minimum inhibitory concentration determination. Overall, 13% of isolates were both MDR and likely to show a poor response to a fluoroquinolone. A third-generation cephalosporin (e.g. ceftriaxone) should be considered as empirical therapy in regions of the Indian subcontinent where resistance is now at high levels as well as in patients returning from these areas. This study helps to describe the epidemiology of antimicrobial drug resistance in typhoid fever. PMID:17014877

  10. A False Positive Dengue Fever Rapid Diagnostic Test Result in a Case of Acute Parvovirus B19 Infection.

    PubMed

    Izumida, Toshihide; Sakata, Hidenao; Nakamura, Masahiko; Hayashibara, Yumiko; Inasaki, Noriko; Inahata, Ryo; Hasegawa, Sumiyo; Takizawa, Takenori; Kaya, Hiroyasu

    2016-01-01

    An outbreak of dengue fever occurred in Japan in August 2014. We herein report the case of a 63-year-old man who presented with a persistent fever in September 2014. Acute parvovirus B19 infection led to a false positive finding of dengue fever on a rapid diagnostic test (Panbio Dengue Duo Cassette(TM)). To the best of our knowledge, there are no previous reports of a false positive result for dengue IgM with the dengue rapid diagnostic test. We believe that epidemiological information on the prevalence of parvovirus B19 is useful for guiding the interpretation of a positive result with the dengue rapid diagnostic test. PMID:27181552

  11. Severe fever with thrombocytopenia syndrome with myocardial dysfunction and encephalopathy: A case report.

    PubMed

    Kawaguchi, Takeshi; Matsuda, Motohiro; Takajo, Ichiro; Kawano, Ayako; Kariya, Yumi; Kubo, Kazuyoshi; Miyauchi, Syunichi; Umekita, Kunihiko; Nagatomo, Yasuhiro; Yano, Takao; Yano, Kouji; Okayama, Akihiko

    2016-09-01

    Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease in China, Korea and Japan caused by a novel bunyavirus, SFTS virus (SFTSV). Although central nervous system manifestations are common in SFTS patients, the pathogenesis has not been elucidated; and there are few reports of myocardial dysfunction. Here we report an elderly Japanese patient with reversible myocardial dysfunction and encephalopathy. A previously healthy 65-year-old male engaged in forestry got a tick bite and developed fever and fatigue in 3 days. Three days after onset, he presented to a local hospital where the diagnosis of SFTS with hemophagocytotic syndrome was made. The blood test showed leukopenia and thrombocytopenia as well as elevated levels of alanine aminotransferase and aspartate aminotransferase. Marked hemophagocytosis was found on bone marrow smear. Peripheral blood was positive for SFTSV gene by reverse-transcription polymerase chain reaction. On day 7, the patient was transferred to our hospital. We observed disturbance of consciousness, Kernig sign and myoclonus to face and limbs. Decreased blood flow of whole cerebral cortex was detected by single photon emission computed tomography (SPECT). Chest X-ray revealed cardiomegaly and electrocardiography (ECG) showed abnormal T waves. These data suggested acute encephalopathy and myocardial dysfunction. We treated him with corticosteroid and blood transfusion, which resulted in the complete recovery of the above abnormal symptoms and laboratory data including the findings in SPECT and ECG in about a month. This case demonstrated transient myocardial dysfunction and encephalopathy can occur in addition to typical clinical manifestation of SFTS. PMID:26943978

  12. Case Series of Imported Enteric Fever at a Referral Center in Tokyo, Japan: Antibiotic Susceptibility and Risk Factors for Relapse.

    PubMed

    Matono, Takashi; Kato, Yasuyuki; Morita, Masatomo; Izumiya, Hidemasa; Yamamoto, Kei; Kutsuna, Satoshi; Takeshita, Nozomi; Hayakawa, Kayoko; Mezaki, Kazuhisa; Kawamura, Maho; Konishi, Noriko; Mizuno, Yasutaka; Kanagawa, Shuzo; Ohmagari, Norio

    2016-07-01

    Owing to the increase in Salmonella strains with decreased fluoroquinolone susceptibility in the endemic areas, we have been treating enteric fever with intravenous ceftriaxone empirically since 2007. In this study, we reevaluated our treatment protocol. This retrospective cohort study was conducted at a single institute in Tokyo, Japan, between January 2006 and December 2013. Enteric fever was defined as isolation of Salmonella Typhi or Salmonella Paratyphi A, B, and C from the blood and/or stool of patients with fever. Of the 35 patients with imported enteric fever, 28 (80%) had returned from south Asia. Ciprofloxacin-susceptible strains were detected in only 12% of the cases. The isolates showed excellent susceptibility to ampicillin (91%), chloramphenicol (94%), ceftriaxone (97%), and azithromycin (97%). One case of Salmonella Paratyphi B was excluded, and of the remaining 34 patients, 56% were treated with ceftriaxone alone, 26% with ceftriaxone then fluoroquinolone, and 9% with levofloxacin alone. The overall relapse rate was 6.1%; however, among those receiving ceftriaxone monotherapy, the relapse rate was 11% (N = 2). The relapse group was characterized by longer times to treatment initiation (P = 0.035) and defervescence (> 7 days) after treatment initiation (P = 0.022). In such cases, we recommend that ceftriaxone treatment be continued for > 4 days after defervescence or be changed to fluoroquinolone if the strains are found to be susceptible to prevent relapse. Furthermore, ampicillin and chloramphenicol, which are no longer prescribed, may be reconsidered as treatment options in Asia. PMID:27162265

  13. [A Case of Brucellosis with Intermittent Fever in a Patient Returning from France].

    PubMed

    Ikeda, Hiroshi; Nagamine, Keisuke

    2016-03-01

    We herein report on a 62-year-old man who presented with symptoms of intermittent fever that persisted after returning from a trip to France. During his trip, he had eaten natural cheese. Although no bacteria could be isolated from blood culture, the serum agglutination test showed a positive antibody titer of 1 : 160 for Brucella canis. The patient responded well to combination antibiotic therapy consisting of gentamicin, rifampicin, and doxycycline, and his symptoms improved. He became antibody-negative after antibiotic therapy. Although the present case may have been a case of B. canis infection, considering the epidemiology of brucellosis in France, serological cross-reactivity with Brucella melitensis infection is also a possibility. Concerns regarding the reemergence of brucellosis have recently been reported in France, and most cases are caused by B. melitensis. Clinicians should be aware of the fact that blood cultures must be incubated for ≥ 21 days for isolation of Brucella and that in Japan, antibody measurement of B. melitensis cannot be performed on a commercial basis. PMID:27197442

  14. Clinical and Pathological Findings on Intoxication by Yellow Phosphorus After Ingesting Firework Cracker: A Rare Case of Autopsy.

    PubMed

    Türkmen Şamdanci, Emine; Çakir, Ebru; Şahin, Nurhan; Elmali, Candan; Sayin, Sadegül

    2016-01-01

    Yellow phosphorus is a toxic substance used in the production of firework cracker, fireworks, ammunition and agricultural dung. When ingested, it shows its effects mainly in the liver, the kidneys, and the brain. A four-year-old girl had died as a result of acute hepatic failure caused by ingesting a firework cracker. The case showed high levels of hepatic enzymes, along with non-specific signs such as nausea, vomiting and diarrhea. Autopsy revealed diffuse microvesicular steatosis in the liver and disseminated degeneration in the proximal tubules of the kidneys. In cases with concomitant hepatorenal failure and cardiovascular collapse, death is inevitable. However, when only hepatic failure develops, hepatic transplantation may be lifesaving. Although intoxication from ingesting yellow phosphorus has a very high rate of mortality, forensic cases are extremely rare in the literature. PMID:24272931

  15. Possible Case of Novel Spotted Fever Group Rickettsiosis in Traveler Returning to Japan from India

    PubMed Central

    Sekizuka, Tsuyoshi; Fujita, Hiromi; Kawano, Ayako; Kawaguchi, Takeshi; Matsuda, Motohiro; Kubo, Kazuyoshi; Miyauchi, Shunichi; Umekita, Kunihiko; Nagatomo, Yasuhiro; Kuroda, Makoto; Takasaki, Tomohiko; Okayama, Akihiko

    2016-01-01

    A 60-year-old woman experienced fever, headache, rash, and altered vision after returning to Japan from India. Testing detected elevated antibody titers to spotted fever group rickettsia; PCR on blood yielded positive results for the rickettsial outer membrane protein A gene. We isolated a unique rickettsial agent and performed a full-genome analysis. PMID:27192498

  16. Possible Case of Novel Spotted Fever Group Rickettsiosis in Traveler Returning to Japan from India.

    PubMed

    Takajo, Ichiro; Sekizuka, Tsuyoshi; Fujita, Hiromi; Kawano, Ayako; Kawaguchi, Takeshi; Matsuda, Motohiro; Kubo, Kazuyoshi; Miyauchi, Shunichi; Umekita, Kunihiko; Nagatomo, Yasuhiro; Kuroda, Makoto; Takasaki, Tomohiko; Okayama, Akihiko; Ando, Shuji

    2016-06-01

    A 60-year-old woman experienced fever, headache, rash, and altered vision after returning to Japan from India. Testing detected elevated antibody titers to spotted fever group rickettsia; PCR on blood yielded positive results for the rickettsial outer membrane protein A gene. We isolated a unique rickettsial agent and performed a full-genome analysis. PMID:27192498

  17. Q fever

    MedlinePlus

    ... fever is antibiotics. For early-stage Q fever, doxycycline is the recommended antibiotic. If you have the ... fever. Your health care provider may prescribe both doxycycline and hydroxychloroquine. You may need to take antibiotics ...

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

    PubMed Central

    2011-01-01

    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. PMID:22132808

  19. Thrombocytopenia with reticulin fibrosis accompanied by fever, anasarca and hepatosplenomegaly : a clinical report of five cases.

    PubMed

    Takai, Kazue; Nikkuni, Koji; Momoi, Akihito; Nagai, Koichi; Igarashi, Natsue; Saeki, Takako

    2013-01-01

    We report five cases that presented with high fever, anasarca, hepatosplenomegaly and severe thrombocytopenia with reticulin fibrosis of the bone marrow. The constellation of symptoms is not compatible with any known disease, and we had difficulty in diagnosis and treatment. The age distribution was from 47 to 56 years, and two men and three women were affected. Two patients needed hemodialysis because of renal dysfunction and oliguria with massive pleural effusion. Laboratory examinations showed normal immunoglobulin levels and no monoclonal protein. None of them showed diagnostic autoantibodies for any autoimmune diseases. Histological examination of the liver in three patients and spleen in two showed non-specific findings. Lymphadenopathy was tiny and lymph node biopsy was carried out in only one case. Histologically, paracortical hyperplasia with vascular proliferation and atrophic germinal centers resembling hyaline-vascular-type Castleman's disease or POEMS syndrome were detected. Without a definitive diagnosis, treatment was started with cyclophosphamide, hydroxydaunorubicin, vincristine and prednisolone (CHOP) regimen in one patient, semi-pulse therapy with methyl-predonisolone in three and cyclosporin A in three. Two patients achieved complete remission, two were steroid-dependent and the remaining one died of multiple organ failure. These findings suggest that this disease may be a novel clinical entity belonging to systemic inflammatory disorder with a background of immunological abnormality or a unique variant of multicentric Castleman's disease. [J Clin Exp Hematop 53(1): 63-68, 2013]. PMID:23801136

  20. De Novo Assembly and Annotation of the Asian Tiger Mosquito (Aedes albopictus) Repeatome with dnaPipeTE from Raw Genomic Reads and Comparative Analysis with the Yellow Fever Mosquito (Aedes aegypti)

    PubMed Central

    Goubert, Clément; Modolo, Laurent; Vieira, Cristina; ValienteMoro, Claire; Mavingui, Patrick; Boulesteix, Matthieu

    2015-01-01

    Repetitive DNA, including transposable elements (TEs), is found throughout eukaryotic genomes. Annotating and assembling the “repeatome” during genome-wide analysis often poses a challenge. To address this problem, we present dnaPipeTE—a new bioinformatics pipeline that uses a sample of raw genomic reads. It produces precise estimates of repeated DNA content and TE consensus sequences, as well as the relative ages of TE families. We shows that dnaPipeTE performs well using very low coverage sequencing in different genomes, losing accuracy only with old TE families. We applied this pipeline to the genome of the Asian tiger mosquito Aedes albopictus, an invasive species of human health interest, for which the genome size is estimated to be over 1 Gbp. Using dnaPipeTE, we showed that this species harbors a large (50% of the genome) and potentially active repeatome with an overall TE class and order composition similar to that of Aedes aegypti, the yellow fever mosquito. However, intraorder dynamics show clear distinctions between the two species, with differences at the TE family level. Our pipeline’s ability to manage the repeatome annotation problem will make it helpful for new or ongoing assembly projects, and our results will benefit future genomic studies of A. albopictus. PMID:25767248

  1. A randomised double-blind clinical trial of two yellow fever vaccines prepared with substrains 17DD and 17D-213/77 in children nine-23 months old.

    PubMed

    2015-09-01

    This randomised, double-blind, multicentre study with children nine-23 months old evaluated the immunogenicity of yellow fever (YF) vaccines prepared with substrains 17DD and 17D-213/77. YF antibodies were titered before and 30 or more days after vaccination. Seropositivity and seroconversion were analysed according to the maternal serological status and the collaborating centre. A total of 1,966 children were randomised in the municipalities of the states of Mato Grosso do Sul, Minas Gerais and São Paulo and blood samples were collected from 1,714 mothers. Seropositivity was observed in 78.6% of mothers and 8.9% of children before vaccination. After vaccination, seropositivity rates of 81.9% and 83.2%, seroconversion rates of 84.8% and 85.8% and rates of a four-fold increase over the pre-vaccination titre of 77.6% and 81.8% were observed in the 17D-213/77 and 17DD subgroups, respectively. There was no association with maternal immunity. Among children aged 12 months or older, the seroconversion rates of 69% were associated with concomitant vaccination against measles, mumps and rubella. The data were not conclusive regarding the interference of maternal immunity in the immune response to the YF vaccine, but they suggest interference from other vaccines. The failures in seroconversion after vaccination support the recommendation of a booster dose in children within 10 years of the first dose. PMID:26517656

  2. A randomised double-blind clinical trial of two yellow fever vaccines prepared with substrains 17DD and 17D-213/77 in children nine-23 months old

    PubMed Central

    2015-01-01

    This randomised, double-blind, multicentre study with children nine-23 months old evaluated the immunogenicity of yellow fever (YF) vaccines prepared with substrains 17DD and 17D-213/77. YF antibodies were tittered before and 30 or more days after vaccination. Seropositivity and seroconversion were analysed according to the maternal serological status and the collaborating centre. A total of 1,966 children were randomised in the municipalities of the states of Mato Grosso do Sul, Minas Gerais and São Paulo and blood samples were collected from 1,714 mothers. Seropositivity was observed in 78.6% of mothers and 8.9% of children before vaccination. After vaccination, seropositivity rates of 81.9% and 83.2%, seroconversion rates of 84.8% and 85.8% and rates of a four-fold increase over the pre-vaccination titre of 77.6% and 81.8% were observed in the 17D-213/77 and 17DD subgroups, respectively. There was no association with maternal immunity. Among children aged 12 months or older, the seroconversion rates of 69% were associated with concomitant vaccination against measles, mumps and rubella. The data were not conclusive regarding the interference of maternal immunity in the immune response to the YF vaccine, but they suggest interference from other vaccines. The failures in seroconversion after vaccination support the recommendation of a booster dose in children within 10 years of the first dose. PMID:26517656

  3. The geographic distribution of cases of Crimean-Congo hemorrhagic fever: Kastamonu, Turkey.

    PubMed

    Aker, Servet; Akıncı, Halil; Kılıçoğlu, Cem; Leblebicioglu, Hakan

    2015-09-01

    The purpose of this study was to analyze the epidemiological characteristics of cases diagnosed with Crimean-Congo Hemorrhagic Fever (CCHF) with the help of Geographic Information Systems (GIS) and to establish an epidemiological risk map. Data for 434 cases diagnosed with CCHF between 01.01.2004 and 31.12.2013 were subjected to statistical analysis SPSS 13.0 software. A digital map of Kastamonu was transferred onto ArcGIS 10.0 software in order to establish a risk map for CCHF. The highest cumulative incidence of CCHF is 41.29/10,000, and in people living at altitudes of 1001-1200 meters. ROC analysis of altitudes above sea level of residences with CCHF cases revealed an area under the curve of 74.5% (95% CI: 0.72-0.76, p<0.05). At a cut-off point of 836.5 meters, sensitivity was 0.74 and specificity 0.76. Cumulative incidence of CCHF was significantly positively correlated with number of animals per head (r=0.76) and area of agricultural land per head (r=0.59) (p<0.05). No significant correlation was determined between cumulative incidence and forested area percentages. This study reveals that both men and women living at more than 836.5 meters above sea level and working in agriculture and animal husbandry are at risk of CCHF between May and July. Detailed examination of the ecology of vector ticks is now needed in order to fully determine the epidemiology of the disease. PMID:26139033

  4. A climate-based spatiotemporal prediction for dengue fever epidemics: a case study in southern Taiwan

    NASA Astrophysics Data System (ADS)

    Yu, H.-L.; Yang, S.-J.; Lin, Y.-C.

    2012-04-01

    Dengue Fever (DF) has been identified by the World Health organization (WHO) as one of the most serious vector-borne infectious diseases in tropical and sub-tropical areas. DF has been one of the most important epidemics in Taiwan which occur annually especially in southern Taiwan during summer and autumn. Most DF studies have focused mainly on temporal DF patterns and its close association with climatic covariates, whereas few studies have investigated the spatial DF patterns (spatial dependence and clustering) and composite space-time effects of the DF epidemics. The present study proposes a spatio-temporal DF prediction approach based on stochastic Bayesian Maximum Entropy (BME) analysis. Core and site-specific knowledge bases are considered, including climate and health datasets under conditions of uncertainty, space-time dependence functions, and a Poisson regression model of climatic variables contributing to DF occurrences in southern Taiwan during 2007, when the highest number of DF cases was recorded in the history of Taiwan epidemics (over 2000). The obtained results show that the DF outbreaks in the study area are highly influenced by climatic conditions. Furthermore, the analysis can provide the required "one-week-ahead" outbreak warnings based on spatio-temporal predictions of DF distributions. Therefore, the proposed analysis can provide the Taiwan Disease Control Agency with a valuable tool to timely identify, control, and even efficiently prevent DF spreading across space-time.

  5. BIOPSY PROVEN ACUTE TUBULAR NECROSIS DUE TO RHABDOMYOLYSIS IN A DENGUE FEVER PATIENT: A CASE REPORT AND REVIEW OF LITERATURE

    PubMed Central

    Repizo, Liliany P.; Malheiros, Denise M.; Yu, Luis; Barros, Rui T.; Burdmann, Emmanuel A.

    2014-01-01

    Renal histology results are very scarce in dengue-associated rhabdomyolysis patients developing acute kidney injury (AKI). We report a case of dengue fever-induced AKI associated to rhabdomyolysis with a renal biopsy showing acute tubular necrosis (ATN) and renal deposition of myoglobin. A 28-year-old patient who presented dengue fever (DF) complicated by severe AKI and rhabdomyolysis is described. The patient required hemodialysis for three weeks. A renal biopsy revealed ATN with positive staining for myoglobin in the renal tubuli. The patient was discharged with recovered renal function. In conclusion, this case report described a biopsy proven ATN associated to DF-induced rhabdomyolysis, in which renal deposition of myoglobin was demonstrated. We suggest that serum creatine phosphokinase should be monitored in DF patients to allow for an early diagnosis of rhabdomyolysis and the institution of renal protective measures. PMID:24553615

  6. Fever and arthralgia as the initial symptoms of primary bone marrow diffuse large B-cell lymphoma: A case report

    PubMed Central

    REN, SAISAI; TAO, YANLING; JIA, LU; CHENG, PANPAN; ZHANG, JILEI; ZHANG, HAO

    2016-01-01

    Primary bone marrow diffuse large B-cell lymphoma (DLBCL) is rare, and only a few cases have been reported. Fever and arthralgia as the initial symptom are extremely rare; however, awareness must be made of this presentation. The current study describes the clinical and pathological findings of a 41-year-old man affected by fever and arthralgia. Blood tests revealed leukopenia and anemia. Multiple bone marrow biopsies were conducted and confirmed the diagnosis of primary bone marrow DLBCL. Primary bone marrow DLBCL is a rare and frequently misdiagnosed subset of non-Hodgkin's lymphoma. The current case demonstrates that utility of bone marrow biopsy for diagnosis should not be ignored, and that repeated bone marrow punctures in multiple locations may be necessary. PMID:27123129

  7. Rat bite fever, a fatal case of Streptobacillus moniliformis infection in a 14-month-old boy.

    PubMed

    Banerjee, Priya; Ali, Zabiullah; Fowler, David R

    2011-03-01

    Streptobacillus moniliformis is the primary cause of rat bite fever in North America. Children under 12 years of age are primarily infected, presenting with an acute syndrome of fever, rash, and polyarthritis. Common vectors include rats and mice. Transmission is predominantly from a bite or scratch, but contact with or ingestion of food contaminated with feces or saliva has also been reported. We report a fatal case of S. moniliformis infection in a 14-month-old-boy. At home, the child was exposed to filthy living conditions and the family had pet ferrets. Autopsy revealed a red-pink, mostly confluent rash and a circumscribed area suspicious for a possible bite mark. Cerebrospinal fluid cultures were positive for S. moniliformis. This case highlighted key features, such as the morbiliform rash, but lacked lymphadenopathy or joint manifestations. It is important to consider rat or rodent exposure as a source of infection. PMID:21306374

  8. Notes from the field: Increase in reported Crimean-Congo hemorrhagic fever cases--country of Georgia, 2014.

    PubMed

    Mamuchishvili, Nana; Salyer, Stephanie J; Stauffer, Kendra; Geleishvili, Marika; Zakhashvili, Khatuna; Morgan, Juliette

    2015-03-01

    During January-September 2014, Georgia's National Centers for Disease Control and Public Health (NCDC) detected 22 cases of Crimean-Congo hemorrhagic fever (CCHF) in the country. CCHF is caused by infection with a tickborne virus of the Bunyaviridae family. Transmission occurs from the bite of an infected tick or from crushing an infected tick with bare skin. Secondary transmission can result from contact with blood or tissues of infected animals and humans. CCHF initially manifests as a nonspecific febrile illness that progresses to a hemorrhagic phase, marked by rapidly developing symptoms leading to multiorgan failure, shock, and death in severe cases. The clinical severity, transmissibility, and infectiousness of CCHF are responsible for its categorization as a viral hemorrhagic fever high-priority bioterrorism agent. PMID:25742385

  9. Pulmonary hemorrhage syndrome associated with dengue fever, High-resolution computed tomography findings: a case report

    PubMed Central

    Marchiori, Edson; Ferreira, José Luiz N; Bittencourt, Carolina N; Neto, César A de Araújo; Zanetti, Gláucia; Mano, Cláudia M; Santos, Alair ASD; Vianna, Alberto D

    2009-01-01

    Dengue hemorrhagic fever is an acute infectious disease caused by dengue virus. We described the high-resolution CT findings in a 70-year-old male with the disease, which was diagnosed by clinical examination and confirmed by serological methods. High-resolution CT demonstrated bilateral areas of consolidation with air bronchogram and ground glass opacities, as well as small bilateral pleural effusions. Dengue hemorrhagic fever should be considered in the differential diagnosis of diffuse pulmonary hemorrhage. PMID:19265524

  10. Typhoid fever.

    PubMed

    Wain, John; Hendriksen, Rene S; Mikoleit, Matthew L; Keddy, Karen H; Ochiai, R Leon

    2015-03-21

    Control of typhoid fever relies on clinical information, diagnosis, and an understanding for the epidemiology of the disease. Despite the breadth of work done so far, much is not known about the biology of this human-adapted bacterial pathogen and the complexity of the disease in endemic areas, especially those in Africa. The main barriers to control are vaccines that are not immunogenic in very young children and the development of multidrug resistance, which threatens efficacy of antimicrobial chemotherapy. Clinicians, microbiologists, and epidemiologists worldwide need to be familiar with shifting trends in enteric fever. This knowledge is crucial, both to control the disease and to manage cases. Additionally, salmonella serovars that cause human infection can change over time and location. In areas of Asia, multidrug-resistant Salmonella enterica serovar Typhi (S Typhi) has been the main cause of enteric fever, but now S Typhi is being displaced by infections with drug-resistant S enterica serovar Paratyphi A. New conjugate vaccines are imminent and new treatments have been promised, but the engagement of local medical and public health institutions in endemic areas is needed to allow surveillance and to implement control measures. PMID:25458731

  11. Large-Scale Environmental Influences on the Onset, Maintenance, and Dissipation of Six Sea Fog Cases over the Yellow Sea

    NASA Astrophysics Data System (ADS)

    Li, Pengyuan; Fu, Gang; Lu, Chungu

    2012-05-01

    Sea fog is typically formed and developed under a set of favorable environmental conditions, which are associated with the station pressure changes, sea level pressure, winds, temperature, water vapor supply, and sea surface temperature. Understanding of these environmental factors during the evolution of a sea fog episode is crucial for forecasting the occurrence and severity of sea fogs over the ocean and adjacent coastal areas. In this study, the large-scale environment variability of six fog events over the Yellow Sea was investigated. It was realized in the present study that the northwest Pacific Ocean high (NPH) is vital to fog formation over the Yellow Sea. In our study, six fog cases can be basically divided into two types: (1) pressure-weakening type, (2) pressure-strengthening type. The former type happened in spring and the latter type in summer. Prevailing southerly winds, accompanied with the well-positioned NPH, may supply a large amount of warm water vapor for the fog formation and maintenance. The intensity of the air temperature inversion is stronger in summer cases than that in spring ones. The wind direction change from south to north and the unstable lower atmosphere may lead to fog's dissipation. This study may provide a comprehensive understanding of sea fog's onset, maintenance, and dissipation over the Yellow Sea.

  12. Mecillinam in enteric fever.

    PubMed Central

    Mandal, B K; Ironside, A G; Brennand, J

    1979-01-01

    Twelve consecutive patients with enteric fever entered a trial of 14 days' treatment with mecillinam. Only three patients became afebrile within three days; four continued unimproved with fever and toxaemia for seven to nine days, when treatment was changed to chloramphenicol with good results. In one case the fever did not settle until the 13th day, and five days later the patient had a clinical relapse. Although all organisms recovered were fully sensitive to mecillinam, this drug is not an effective or consistent treatment for enteric fever. PMID:218670

  13. [Louse-borne-relapsing-fever in refugees from the Horn of Africa; a case series of 25 patients].

    PubMed

    Seilmaier, M; Guggemos, W; Wieser, A; Fingerle, V; Balzer, L; Fenzl, T; Hoch, M; von Both, U; Schmidt, H U; Wendtner, C M; Strobel, E

    2016-07-01

    Background | Relapsing fever is divided into tick borne relapsing fever (TBRF) and louse borne relapsing fever (LBRF). This report describes 25 refugees from East Africa who were diagnosed to suffer from LBRF within a period of 6 month only at a single hospital in Munich / Germany. Material & Methods | The aim was to point out common clinical features as well as laboratory findings and clinical symptoms before and after initiation of treatment in 25 patients with louse borne relapsing fever (LBRF) who were diagnosed and treated at Klinikum München Schwabing from August 2015 to January 2016. To the best of our knowledge this is the largest case series of LBRF in the western world for decades. Main focus of the investigation was put on clinical aspects. Results | All 25 patients suffered from acute onset of high fever with chills, headache and severe prostration. Laboratory analysis showed high CRP and a marked thrombocytopenia. A Giemsa blood stain was procured immediately in order to look for malaria. In the blood smear spirochetes with typical shape and aspect of borrelia species could be detected.The further PCR analysis confirmed infection with Borrelia recurrentis. Treatment with Doxycycline was started forthwith. The condition improved already on the second day after treatment was started and all were restored to health in less than a week. Apart from a mild to moderate Jarisch-Herxheimer-reaction we didn`t see any side effects of the therapy. Conclusion | LBRF has to be taken into account in feverish patients who come as refugees from East-Africa. It seems that our patients belong to a cluster which probably has its origin in Libya and more patients are to be expected in the near future. As LBRF might cause outbreaks in refugee camps it is pivotal to be aware of this emerging infectious disease in refugees from East-Africa. PMID:27404939

  14. Q fever - a review.

    PubMed

    Marrie, T J

    1990-08-01

    Q or "query" fever is a zoonosis caused by the organism Coxiella burnetii. Cattle, sheep and goats are the most common reservoirs of this organism. The placenta of infected animals contains high numbers (up to 10(9)/g) of C. burnetii. Aerosols occur at the time of parturition and man becomes infected following inhalation of the microorganism. The spectrum of illness in man is wide and consists of acute and chronic forms. Acute Q fever is most often a self-limited flu-like illness but may include pneumonia, hepatitis, or meningoencephalitis. Chronic Q fever almost always means endocarditis and rarely osteomyelitis. Chronic Q fever is not known to occur in animals other than man. An increased abortion and stillbirth rate are seen in infected domestic ungulates.Four provinces (Nova Scotia, New Brunswick, Ontario and Alberta) reported cases of Q fever in 1989.A vaccine for Q fever has recently been licensed in Australia. PMID:17423643

  15. Malignant Mediterranean spotted fever

    PubMed Central

    Lunge, Snehal Balvant; Patil, Vaibhav; Ambar, Sameer; Naik, Vishwas

    2015-01-01

    Fever with rash is one of the most common causes of referral to a dermatologist. A plethora of conditions need to be considered in the differential diagnosis. They may be broadly classified into infectious causes, drug reactions, and autoimmune disorders. Here we present a rare case of rickettsial fever with cardiac involvement in an elderly male patient with no comorbidities. PMID:26904440

  16. Rat Bite Fever

    MedlinePlus

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

  17. Effect of Quorum Sensing by Staphylococcus epidermidis on the Attraction Response of Female Adult Yellow Fever Mosquitoes, Aedes aegypti aegypti (Linnaeus) (Diptera: Culicidae), to a Blood-Feeding Source

    PubMed Central

    Zhang, Xinyang; Crippen, Tawni L.; Coates, Craig J.; Wood, Thomas K.; Tomberlin, Jeffery K.

    2015-01-01

    Aedes aegypti, the principal vector of yellow fever and dengue fever, is responsible for more than 30,000 deaths annually. Compounds such as carbon dioxide, amino acids, fatty acids and other volatile organic compounds (VOCs) have been widely studied for their role in attracting Ae. aegypti to hosts. Many VOCs from humans are produced by associated skin microbiota. Staphyloccocus epidermidis, although not the most abundant bacteria according to surveys of relative 16S ribosomal RNA abundance, commonly occurs on human skin. Bacteria demonstrate population level decision-making through quorum sensing. Many quorum sensing molecules, such as indole, volatilize and become part of the host odor plum. To date, no one has directly demonstrated the link between quorum sensing (i.e., decision-making) by bacteria associated with a host as a factor regulating arthropod vector attraction. This study examined this specific question with regards to S. epidermidis and Ae. aegypti. Pairwise tests were conducted to examine the response of female Ae. aegypti to combinations of tryptic soy broth (TSB) and S. epidermidis wildtype and agr- strains. The agr gene expresses an accessory gene regulator for quorum sensing; therefore, removing this gene inhibits quorum sensing of the bacteria. Differential attractiveness of mosquitoes to the wildtype and agr- strains was observed. Both wildtype and the agr- strain of S. epidermidis with TSB were marginally more attractive to Ae. aegypti than the TSB alone. Most interestingly, the blood-feeder treated with wildtype S. epidermidis/TSB attracted 74% of Ae. aegypti compared to the agr- strain of S. epidermidis/TSB (P ≤ 0.0001). This study is the first to suggest a role for interkingdom communication between host symbiotic bacteria and mosquitoes. This may have implications for mosquito decision-making with regards to host detection, location and acceptance. We speculate that mosquitoes “eavesdrop” on the chemical discussions occurring

  18. An unusual case of seed dispersal in an invasive aquatic; yellow flag iris (Iris pseudacorus)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Understanding reproductive mode of invasive plants can help managers plan more efficacious control. Invasive aquatics typically reproduce primarily through vegetative means. Yellow flag iris is an invasive plant species often growing as an emergent aquatic. There have been contradictory reports of i...

  19. YELLOW BERRY

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Yellow berry refers to the non-vitreous form of the wheat kernel. Individual kernels may be vitreous, non-vitreous (yellow berry) or have varying proportions of each (“mottled”). Yellow berry, in and of itself, represents no defect of the kernel. As in maize, rice and other cereals, the non-vitre...

  20. Erysipelas-like erythema of familial Mediterranean fever syndrome: a case report with emphasis on histopathologic diagnostic clues.

    PubMed

    Kolivras, Athanassios; Provost, Philippe; Thompson, Curtis T

    2013-06-01

    We report histopathological findings in a case of familial Mediterranean fever (FMF) syndrome with an erysipelas-like erythema (ELE). ELE is the only pathognomic cutaneous manifestation of FMF. ELE is characterized by well-demarcated, tender, erythematous and infiltrated plaques recurring on the same site and resolving spontaneously within 48-72 h. FMF is a monogenic autoinflammatory syndrome highlighted by recurrent fever associated with polyserositis involving mainly the peritoneum, synovium and pleura. FMF results from a mutation of the MEFV gene, which encodes for pyrin, leading to Il-1β activation and promoting neutrophil migration into the dermis. Histopathological findings in our case showed a sparse superficial perivascular and interstitial lymphocytic infiltrate admixed with some neutrophils, no eosinophils and mild papillary dermal edema. Venules and lymphatics were dilated, though no vasculitis was identified. Neutrophils are the most common cutaneous marker of autoinflammation, and cutaneous manifestations of monogenic autoinflammatory syndromes are represented by the spectrum of aseptic neutrophilic dermatoses. Neutrophils in the presence of recurrent fever and in the correct clinical context of recurrent erysipelas in the same site are a diagnostic clue for FMF. PMID:23521609

  1. Viral Hemorrhagic Fever Cases in the Country of Georgia: Acute Febrile Illness Surveillance Study Results

    PubMed Central

    Kuchuloria, Tinatin; Imnadze, Paata; Chokheli, Maiko; Tsertsvadze, Tengiz; Endeladze, Marina; Mshvidobadze, Ketevan; Clark, Danielle V.; Bautista, Christian T.; Fadeel, Moustafa Abdel; Pimentel, Guillermo; House, Brent; Hepburn, Matthew J.; Wölfel, Silke; Wölfel, Roman; Rivard, Robert G.

    2014-01-01

    Minimal information is available on the incidence of Crimean–Congo hemorrhagic fever (CCHF) virus and hantavirus infections in Georgia. From 2008 to 2011, 537 patients with fever ≥ 38°C for ≥ 48 hours without a diagnosis were enrolled into a sentinel surveillance study to investigate the incidence of nine pathogens, including CCHF virus and hantavirus. Of 14 patients with a hemorrhagic fever syndrome, 3 patients tested positive for CCHF virus immunoglobulin M (IgM) antibodies. Two of the patients enrolled in the study had acute renal failure. These 2 of 537 enrolled patients were the only patients in the study positive for hantavirus IgM antibodies. These results suggest that CCHF virus and hantavirus are contributing causes of acute febrile syndromes of infectious origin in Georgia. These findings support introduction of critical diagnostic approaches and confirm the need for additional surveillance in Georgia. PMID:24891463

  2. A retrospective analysis of dengue fever case management and frequency of co-morbidities associated with deaths

    PubMed Central

    2014-01-01

    Background Dengue epidemic in Lahore (2011) resulted in hundreds of deaths and affected thousands. As most of the studies were focused on its diagnosis and treatment, scanty data is available on associated diseases/co-morbidities in these patients that could have contributed to a higher mortality. There were no local guidelines available on recording, reporting and management of these co-morbidities. The objective of this study was to analyze the initial presentations of dengue cases and to estimate the frequency of co-morbidities in dengue patients. Methods Data of 556 dengue cases was retrieved from 2 major public sector tertiary-care hospitals for patients who were admitted during 2011 epidemic and a case record analysis was done. Data was retrieved from patient’s information reports which included demography, signs and symptoms and the laboratory investigations. In addition verbal autopsy of deceased cases was also done from their relatives using standardized WHO verbal autopsy form after making modifications as per needed. Results Of 556 cases studied, 390 (70%) were males. The mean age was 36 years and 30% of the cases were between 20-29 years. Average duration of the hospital stay was 6 days. Out of the total, 435 (78%) were dengue fever (DF) cases followed by dengue hemorrhagic fever (DHF) in 95 (17%) and dengue shock syndrome (DSS) in 26 (4%) cases. A total of 40 cases died and among them 17 were diagnosed with DSS, 13 DF and 10 DHF. Further the verbal autopsy from relatives of deceased cases showed 29 (60%) deceased had co-morbid diseases which included hypertension, diabetes etc. DSS was common in patients who had hypertension (27) either alone or associated with other illnesses. Conclusions Co-morbidities with dengue infection were seen in 60% deceased cases indicating the reasons for high dengue related complications and death. PMID:24690140

  3. Dengue Fever

    MedlinePlus

    ... away from areas that have a dengue fever epidemic, the risk of contracting dengue fever is small for international travelers./p> Reviewed by: Elana Pearl Ben-Joseph, ... Nile Virus First Aid: Vomiting Are Insect Repellents With DEET ...

  4. Rheumatic fever

    MedlinePlus

    ... an ASO test) Complete blood count (CBC) Electrocardiogram (EKG) Sedimentation rate (ESR -- a test that measures inflammation ... criteria include: Fever High ESR Joint pain Abnormal EKG You'll likely be diagnosed with rheumatic fever ...

  5. Dengue Fever

    MedlinePlus

    ... Search Button Leading research to understand, treat, and prevent infectious, immunologic, and allergic diseases NIAID Home Health & ... NIAID News & Events Volunteer NIAID > Health & Research Topics > Dengue Fever > Understanding Dengue Fever Understanding Cause Transmission Symptoms ...

  6. Valley Fever

    MedlinePlus

    Valley Fever is a disease caused by a fungus (or mold) called Coccidioides. The fungi live in the soil ... from person to person. Anyone can get Valley Fever. But it's most common among older adults, especially ...

  7. [A case of Behçet disease developing recurrent ischemic stroke with fever and scrotal ulcers].

    PubMed

    Koike, Yuka; Sakai, Naoko; Umeda, Yoshitaka; Umeda, Maiko; Oyake, Mutsuo; Fujita, Nobuya

    2015-01-01

    A 30-year-old man, who was diagnosed with Behçet disease at 10 years of age, was hospitalized because of transient right hemiparesis after presenting with high fever and scrotal ulcers. Brain MRI revealed ischemic lesions in the area supplied by the anterior cerebral arteries. Analysis of cerebrospinal fluid (CSF) showed pleocytosis and a high interleukin-6 (IL-6) concentration (668 pg/ml). The patient was diagnosed with acute ischemic stroke associated with exacerbation of Behçet disease. After initiation of corticosteroid therapy, his clinical symptoms improved, and the CSF IL-6 concentration decreased. One year later, the patient developed high fever and scrotal ulcers after the onset of transient left upper limb plegia. Brain MRI showed an acute ischemic lesion in the right putamen, and CSF analysis showed an elevated IL-6 concentration (287 pg/ml). Brain CT angiography revealed stenosis of the left anterior cerebral artery and occlusion of the right anterior cerebral artery, which had been well visualized one year previously. Involvement of the intracranial cerebral arteries in Behçet disease is extremely rare. To the best of our knowledge, this is the first case report of a patient with recurrent symptomatic ischemic stroke associated with high fever and scrotal ulcers, which suggests exacerbation of Behçet disease. PMID:26103818

  8. Q fever.

    PubMed

    Tissot-Dupont, Hervé; Raoult, Didier

    2008-09-01

    Q fever is a worldwide zoonosis caused by the pathogen Coxiella burnetii causing acute and chronic clinical manifestations. The name "Q fever" derives from "Query fever" and was given in 1935 following an outbreak of febrile illness in an abattoir in Queensland, Australia. C burnetii is considered a potential agent of bioterrorism (class B by the Centers for Disease Control). PMID:18755387

  9. Chronic recurrent multifocal Q fever osteomyelitis in children: a case report and review of the literature: Retracted.

    PubMed

    Cano, Carlos; Alonso, Laura; Rendón, Diego A; García, Francisco J; Pescador, David; Blanco, Juan F

    2014-12-01

    Q fever is a common worldwide zoonosis that is often difficult to diagnose because of its variety and the fact that its clinical symptoms are highly unspecific. We present a rare case of chronic multifocal osteomyelitis caused by Coxiella burnetti in a 2-year-old girl, which has recurred on many occasions, although the patient is under treatment with the most widely accepted approaches from other studies. A systemic review of the little published literature on this patients shows that there is no universal consensus with regard to the most adequate treatment. PMID:25144884

  10. [Case of polymer fume fever with interstitial pneumonia caused by inhalation of polytetrafluoroethylene (Teflon)].

    PubMed

    Son, Masami; Maruyama, Eiichi; Shindo, Yuichiro; Suganuma, Nobukazu; Sato, Shinji; Ogawa, Masahiro

    2006-07-01

    A 30-year old man was admitted to our hospital with cough, slight fever, and dyspnea that he had developed several hours after inhaling the fumes produced from a Teflon-coated pan, after evaporation of the water in the pan. Chest radiography revealed diffuse infiltrations, and a computed tomography (CT) scan revealed patchy interstitial shadows in both lungs. In pulmonary function tests, the diffusing capacity of the lungs showed a moderate decrease. Leukocytosis and slight hypoxemia were observed. The patient recovered clinically in a few days without any specific treatment. We speculated that the pulmonary problems in this patient may have been induced by the products of thermal degradation of Teflon that were present in the fumes. When Teflon is heated, the fumes generated cause an influenza like syndrome (polymer fume fever) or cause severe toxic effects such as pulmonary edema, pneumonitis, and death in the exposed individual. PMID:16922460

  11. The world first two cases of severe fever with thrombocytopenia syndrome: An epidemiological study in Nagasaki, Japan.

    PubMed

    Kurihara, Shintaro; Satoh, Akira; Yu, Fuxun; Hayasaka, Daisuke; Shimojima, Masayuki; Tashiro, Masato; Saijo, Tomomi; Takazono, Takahiro; Imamura, Yoshifumi; Miyazaki, Taiga; Tsukamoto, Misuzu; Yanagihara, Katsunori; Mukae, Hiroshi; Saijo, Masayuki; Morita, Kouichi; Kohno, Shigeru; Izumikawa, Koichi

    2016-07-01

    Severe fever with thrombocytopenia syndrome (SFTS) caused by the SFTS virus (SFTSV), a novel phlebovirus belonging to the family Bunyaviridae, was reported in China for the first time in 2009. We observed two cases where the SFTSV was isolated for the first time in Nagasaki, Japan, in 2005. Two males in their 60s, a farmer and a hunter, respectively, living in Nagasaki developed SFTS during the same period. The patients developed similar clinical symptoms and signs, such as fever, loss of consciousness, and multiple organ dysfunction. The farmer died and the hunter survived. A retrospective diagnosis of SFTS was made in 2013, and genetic analysis revealed that the patients were infected with different SFTSV strains. Retrospective analysis of cytokine production in non-fatal case revealed interleukin (IL)-6, IL-8 and interferon-γ level of acute phase was low and could be potential prognostic factors. As there are no epidemiological studies of positive rate of SFTSV antibody in people living in endemic areas in Japan, a field study was performed. Volunteers at high risk for tick bites, such as hunters, farmers, and soldiers, were recruited in 6 regions, including the areas where the SFTS cases occurred. Three hundred and twenty six volunteers in Nagasaki prefecture were examined and none of these tested positive for the SFTSV antibody. Our data indicates that the risk for SFTSV infection is not high in Nagasaki prefecture. Further collection of blood samples from endemic areas is warranted for the prevention of SFTSV infection. PMID:27142979

  12. The incidence of scarlet fever.

    PubMed Central

    Perks, E. M.; Mayon-White, R. T.

    1983-01-01

    This study attempted to find the incidence of scarlet fever in the Oxford region, including the proportion of patients from whom Streptococcus pyogenes could be isolated. General practitioners collected throat swabs from patients with suspected scarlet fever. The swabs were examined for viral and bacterial pathogens. Children admitted to hospital were used as controls. Twenty-five of 105 patients with suspected scarlet fever grew Str. pyogenes; M type 4 was the commonest type. The clinical diagnosis of scarlet fever was not always confirmed by throat culture. The annual incidence of scarlet fever was estimated to be 0.3 cases per 1000 per year. PMID:6358344

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

    NASA Astrophysics Data System (ADS)

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

    2012-04-01

    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

  14. El Niño Southern Oscillation and vegetation dynamics as predictors of dengue fever cases in Costa Rica.

    PubMed

    Fuller, D O; Troyo, A; Beier, J C

    2009-03-01

    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. PMID:19763186

  15. El Niño Southern Oscillation and vegetation dynamics as predictors of dengue fever cases in Costa Rica

    NASA Astrophysics Data System (ADS)

    Fuller, D. O.; Troyo, A.; Beier, J. C.

    2009-01-01

    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.

  16. Using Modelling to Disentangle the Relative Contributions of Zoonotic and Anthroponotic Transmission: The Case of Lassa Fever

    PubMed Central

    Lo Iacono, Giovanni; Cunningham, Andrew A.; Fichet-Calvet, Elisabeth; Garry, Robert F.; Grant, Donald S.; Khan, Sheik Humarr; Leach, Melissa; Moses, Lina M.; Schieffelin, John S.; Shaffer, Jeffrey G.; Webb, Colleen T.; Wood, James L. N.

    2015-01-01

    Background Zoonotic infections, which transmit from animals to humans, form the majority of new human pathogens. Following zoonotic transmission, the pathogen may already have, or may acquire, the ability to transmit from human to human. With infections such as Lassa fever (LF), an often fatal, rodent-borne, hemorrhagic fever common in areas of West Africa, rodent-to-rodent, rodent-to-human, human-to-human and even human-to-rodent transmission patterns are possible. Indeed, large hospital-related outbreaks have been reported. Estimating the proportion of transmission due to human-to-human routes and related patterns (e.g. existence of super-spreaders), in these scenarios is challenging, but essential for planned interventions. Methodology/Principal Findings Here, we make use of an innovative modeling approach to analyze data from published outbreaks and the number of LF hospitalized patients to Kenema Government Hospital in Sierra Leone to estimate the likely contribution of human-to-human transmission. The analyses show that almost of the cases at KGH are secondary cases arising from human-to-human transmission. However, we found much of this transmission is associated with a disproportionally large impact of a few individuals (‘super-spreaders’), as we found only of human cases result in an effective reproduction number (i.e. the average number of secondary cases per infectious case) , with a maximum value up to . Conclusions/Significance This work explains the discrepancy between the sizes of reported LF outbreaks and a clinical perception that human-to-human transmission is low. Future assessment of risks of LF and infection control guidelines should take into account the potentially large impact of super-spreaders in human-to-human transmission. Our work highlights several neglected topics in LF research, the occurrence and nature of super-spreading events and aspects of social behavior in transmission and detection. PMID:25569707

  17. Lymphoproliferation in captive wild ruminants affected with malignant catarrhal fever: 25 cases (1977-1985).

    PubMed

    Blake, J E; Nielsen, N O; Heuschele, W P

    1990-04-01

    The severity of lymphoproliferative disease associated with malignant catarrhal fever was extremely variable among 25 animals at the San Diego Wild Animal Park. Severe lymphoproliferative disease was seen in 3 of 10 Formosan Sika deer (Cervus nippon taiouanus), 3 of 6 Indian Axis deer (Cervus a axis), 3 of 6 Barasingha deer (Cervus d duvauceli), and 1 of 3 Nilgai (Boselaphus tragocamelus). Two Sika deer and 2 Barasingha deer had lesions morphologically indistinguishable from lymphosarcoma. Our findings were consistent with the hypothesis that alcelaphine herpesvirus-1 has oncogenic potential. PMID:2329087

  18. The biogeography of viral emergence: rice yellow mottle virus as a case study.

    PubMed

    Pinel-Galzi, Agnès; Traoré, Oumar; Séré, Yacouba; Hébrard, Eugénie; Fargette, Denis

    2015-02-01

    Rice yellow mottle virus (RYMV) exemplifies the key role in plant virus emergence of the early steps of crop extension and intensification in traditional agriculture. In East Africa, RYMV emerged in the 19(th) century after rice intensification along the Indian Ocean coast, and later spread inland concomitantly with rice introduction. In West Africa, the contrasted history of rice cultivation among regions differently shaped RYMV populations. A biogeographical approach - which jointly considers the spatial distribution of the virus and its hosts over time - was applied to reach these conclusions. We linked the evolution of RYMV over the past two centuries to a geographical map of the history of rice cultivation in Africa. PMID:25544357

  19. Sensitivity and uncertainty in crop water footprint accounting: a case study for the Yellow River Basin

    NASA Astrophysics Data System (ADS)

    Zhuo, L.; Mekonnen, M. M.; Hoekstra, A. Y.

    2014-01-01

    Water Footprint Assessment is a quickly growing field of research, but as yet little attention has been paid to the uncertainties involved. This study investigates the sensitivity of water footprint estimates to changes in important input variables and quantifies the size of uncertainty in water footprint estimates. The study focuses on the green (from rainfall) and blue (from irrigation) water footprint of producing maize, soybean, rice, and wheat in the Yellow River Basin in the period 1996-2005. A grid-based daily water balance model at a 5 by 5 arcmin resolution was applied to compute green and blue water footprints of the four crops in the Yellow River Basin in the period considered. The sensitivity and uncertainty analysis focused on the effects on water footprint estimates at basin level (in m3 t-1) of four key input variables: precipitation (PR), reference evapotranspiration (ET0), crop coefficient (Kc), and crop calendar. The one-at-a-time method was carried out to analyse the sensitivity of the water footprint of crops to fractional changes of individual input variables. Uncertainties in crop water footprint estimates were quantified through Monte Carlo simulations. The results show that the water footprint of crops is most sensitive to ET0 and Kc, followed by crop calendar and PR. Blue water footprints were more sensitive to input variability than green water footprints. The smaller the annual blue water footprint, the higher its sensitivity to changes in PR, ET0, and Kc. The uncertainties in the total water footprint of a crop due to combined uncertainties in climatic inputs (PR and ET0) were about ±20% (at 95% confidence interval). The effect of uncertainties in ET0 was dominant compared to that of precipitation. The uncertainties in the total water footprint of a crop as a result of combined key input uncertainties were on average ±26% (at 95% confidence level). The sensitivities and uncertainties differ across crop types, with highest sensitivities

  20. Sensitivity and uncertainty in crop water footprint accounting: a case study for the Yellow River basin

    NASA Astrophysics Data System (ADS)

    Zhuo, L.; Mekonnen, M. M.; Hoekstra, A. Y.

    2014-06-01

    Water Footprint Assessment is a fast-growing field of research, but as yet little attention has been paid to the uncertainties involved. This study investigates the sensitivity of and uncertainty in crop water footprint (in m3 t-1) estimates related to uncertainties in important input variables. The study focuses on the green (from rainfall) and blue (from irrigation) water footprint of producing maize, soybean, rice, and wheat at the scale of the Yellow River basin in the period 1996-2005. A grid-based daily water balance model at a 5 by 5 arcmin resolution was applied to compute green and blue water footprints of the four crops in the Yellow River basin in the period considered. The one-at-a-time method was carried out to analyse the sensitivity of the crop water footprint to fractional changes of seven individual input variables and parameters: precipitation (PR), reference evapotranspiration (ET0), crop coefficient (Kc), crop calendar (planting date with constant growing degree days), soil water content at field capacity (Smax), yield response factor (Ky) and maximum yield (Ym). Uncertainties in crop water footprint estimates related to uncertainties in four key input variables: PR, ET0, Kc, and crop calendar were quantified through Monte Carlo simulations. The results show that the sensitivities and uncertainties differ across crop types. In general, the water footprint of crops is most sensitive to ET0 and Kc, followed by the crop calendar. Blue water footprints were more sensitive to input variability than green water footprints. The smaller the annual blue water footprint is, the higher its sensitivity to changes in PR, ET0, and Kc. The uncertainties in the total water footprint of a crop due to combined uncertainties in climatic inputs (PR and ET0) were about ±20% (at 95% confidence interval). The effect of uncertainties in ET0was dominant compared to that of PR. The uncertainties in the total water footprint of a crop as a result of combined key input

  1. Identification of dengue fever cases in Houston, Texas, with evidence of autochthonous transmission between 2003 and 2005.

    PubMed

    Murray, Kristy O; Rodriguez, Liliana F; Herrington, Emily; Kharat, Vineetkumar; Vasilakis, Nikolaos; Walker, Christopher; Turner, Cynthia; Khuwaja, Salma; Arafat, Raouf; Weaver, Scott C; Martinez, Diana; Kilborn, Cindy; Bueno, Rudy; Reyna, Martin

    2013-12-01

    Houston, Texas, maintains an environment conducive to dengue virus (DENV) emergence; however, surveillance is passive and diagnostic testing is not readily available. To determine if DENV is present in the area, we tested 3768 clinical specimens (2138 cerebrospinal fluid [CSF] and 1630 serum) collected from patients with suspected mosquito-borne viral disease between 2003 and 2005. We identified 47 immunoglobulin M (IgM)-positive dengue cases, including two cases that were positive for viral RNA in serum for dengue serotype 2. The majority of cases did not report any history of travel outside the Houston area prior to symptom onset. The epidemic curve suggests an outbreak occurred in 2003 with continued low-level transmission in 2004 and 2005. Chart abstractions were completed for 42 of the 47 cases; 57% were diagnosed with meningitis and/or encephalitis, and 43% met the case definition for dengue fever. Two of the 47 cases were fatal, including one with illness compatible with dengue shock syndrome. Our results support local transmission of DENV during the study period. These findings heighten the need for dengue surveillance in the southern United States. PMID:24107180

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

    PubMed Central

    2011-01-01

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

  3. Lassa hemorrhagic fever in a late term pregnancy from northern Sierra Leone with a positive maternal outcome: case report.

    PubMed

    Branco, Luis M; Boisen, Matt L; Andersen, Kristian G; Grove, Jessica N; Moses, Lina M; Muncy, Ivana J; Henderson, Lee A; Schieffellin, John S; Robinson, James E; Bangura, James J; Grant, Donald S; Raabe, Vanessa N; Fonnie, Mbalu; Zaitsev, Eleina M; Sabeti, Pardis C; Garry, Robert F

    2011-01-01

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

  4. Pox-like lesions and haemorrhagic fever in two concurrent cases in the Central African Republic: case investigation and management in difficult circumstances

    PubMed Central

    Froeschl, Guenter; Kayembe, Pitchou Kasongo

    2015-01-01

    Cases of monkeypox in humans are frequently reported from the Democratic Republic of Congo. The few reports from the Central African Republic have been limited to cases in the far South closely bordering the Congos. Team members of an international medical organisation have suspected clinically two human cases of MPX, associated with clinical signs of coagulopathy and haemorrhage in the North of the country. Key findings were history of a squirrel, fever and vesicular dermal eruptions. Subsequently patients developed profuse epistaxis and hematemesis, associated with clinical signs of shock. Both patients were isolated and treated symptomatically. Samples were sent to a regional reference laboratory, who initially issued a confirmation of the suspected diagnosis of MPX in both cases. The result was later revised, and additional analyses of samples could not confirm the diagnosis. PMID:26664524

  5. Dengue hemorrhagic fever

    MedlinePlus

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

  6. Cotton Fever: Does the Patient Know Best?

    PubMed

    Xie, Yingda; Pope, Bailey A; Hunter, Alan J

    2016-04-01

    Fever and leukocytosis have many possible etiologies in injection drug users. We present a case of a 22-year-old woman with fever and leukocytosis that were presumed secondary to cotton fever, a rarely recognized complication of injection drug use, after an extensive workup. Cotton fever is a benign, self-limited febrile syndrome characterized by fevers, leukocytosis, myalgias, nausea and vomiting, occurring in injection drug users who filter their drug suspensions through cotton balls. While this syndrome is commonly recognized amongst the injection drug user population, there is a paucity of data in the medical literature. We review the case presentation and available literature related to cotton fever. PMID:26105678

  7. Bichat guidelines for the clinical management of haemorrhagic fever viruses and bioterrorism-related haemorrhagic fever viruses.

    PubMed

    Bossi, Philippe; Tegnell, Anders; Baka, Agoritsa; Van Loock, Frank; Hendriks, Jan; Werner, Albrecht; Maidhof, Heinrich; Gouvras, Georgios

    2004-12-01

    Haemorrhagic fever viruses (HFVs) are a diverse group of viruses that cause a clinical disease associated with fever and bleeding disorder. HFVs that are associated with a potential biological threat are Ebola and Marburg viruses (Filoviridae), Lassa fever and New World arenaviruses (Machupo, Junin, Guanarito and Sabia viruses) (Arenaviridae), Rift Valley fever (Bunyaviridae) and yellow fever, Omsk haemorrhagic fever, and Kyanasur Forest disease (Flaviviridae). In terms of biological warfare concerning dengue, Crimean-Congo haemorrhagic fever and Hantaviruses, there is not sufficient knowledge to include them as a major biological threat. Dengue virus is the only one of these that cannot be transmitted via aerosol. Crimean-Congo haemorrhagic fever and the agents of haemorrhagic fever with renal syndrome appear difficult to weaponise. Ribavirin is recommended for the treatment and the prophylaxis of the arenaviruses and the bunyaviruses, but is not effective for the other families. All patients must be isolated and receive intensive supportive therapy. PMID:15677844

  8. Education Fever and the East Asian Fertility Puzzle: A case study of low fertility in South Korea.

    PubMed

    Anderson, Thomas; Kohler, Hans-Peter

    2013-05-01

    Fertility throughout East Asia has fallen rapidly over the last five decades and is now below the replacement rate of 2.1 in every country in the region. Using South Korea as a case study, we argue that East Asia's ultra-low fertility rates can be partially explained by the steadfast parental drive to have competitive and successful children. Parents throughout the region invest large amounts of time and money to ensure that their children are able to enter prestigious universities and obtain top jobs. Accordingly, childrearing has become so expensive that the average couple cannot afford to have more than just one or two children. The trend of high parental investment in child education, also known as 'education fever', exemplifies the notion of 'quality over quantity' and is an important contributing factor to understanding low-fertility in East Asia. PMID:24883076

  9. Distribution of phthalate esters in topsoil: a case study in the Yellow River Delta, China.

    PubMed

    Hongjun, Yang; Wenjun, Xie; Qing, Liu; Jingtao, Liu; Hongwen, Yu; Zhaohua, Lu

    2013-10-01

    The Yellow River Delta (YRD) is a typical agricultural and petrochemical industrial area of China. To assess the current status of phthalate esters (PAEs) of soil residues, soil samples (0∼20 cm) (n = 82) were collected in Bincheng District, at the geographic center of the YRD. PAEs were detected in all topsoil samples analyzed, which indicated that PAEs are ubiquitous environmental contaminants. Concentrations of 11 PAEs are in the range of 0.794∼19.504 μg g(-1), with an average value of 2.975 μg g(-1). It was presented that PAEs pollution in this area was weak and monotonously increasing along the rural-urban gradient. Higher concentrations were observed from roadsides (and/or gutters), densely anthropogenic activities areas (such as the urbanization and industrialization), and agriculture influence district, which mainly originated from construction waste, municipal sewage, agricultural waste and pesticide, discarded plastic effusion and atmospheric depositions. Concentrations of PAEs were weakly positivity correlated with soil organic carbon content and pH, which suggested both of them can affect the distribution of PAEs. The concentration of di (2-ethylhexyl) phthalate and di-n-butyl phthalate dominated in the 11 PAEs, with the average values of 0.735 and 1.915 μg g(-1), respectively, and accounted for 92.1 % of the whole PAEs' concentrations. No significant differences of PAE congeneric profiles were observed between our work and others previously reported, which is consistent with the use of similar commercial PAEs around the world. PMID:23609921

  10. The Impact of Integrated Community Case Management of Childhood Diseases Interventions to Prevent Malaria Fever in Children Less than Five Years Old in Bauchi State of Nigeria

    PubMed Central

    Abegunde, Dele; Orobaton, Nosa

    2016-01-01

    Background Malaria accounts for about 300,000 childhood deaths and 30% of under-five year old mortality in Nigeria annually. We assessed the impact of intervention strategies that integrated Patent Medicines Vendors into community case management of childhood-diseases, improved access to artemisinin combination therapy (ACT) and distributed bed nets to households. We explored the influence of household socioeconomic characteristics on the impact of the interventions on fever in the under-five year olds in Bauchi State Nigeria. Methods A cross-sectional case-controlled, interventional study, which sampled 3077 and 2737 under-5 year olds from 1,588 and 1601 households in pre- and post-intervention periods respectively, was conducted from 2013 to 2015. Difference-in-differences and logistic regression analyses were performed to estimate the impact attributable to the interventions: integrated community case management of childhood illness which introduced trained public and private sector health providers and the possession of nets on the prevalence of fever. Results Two-week prevalence of fever among under-fives declined from 56.6% at pre-intervention to 42.5% at post-intervention. Fever-prevention fraction attributable to nets was statistically significant (OR = 0.217, 95% CI: 0.08–0.33). Children in the intervention group had significantly fewer incidence of fever than children in the control group had (OR = 0.765, 95% CI: 0.67–0.87). Although being in the intervention group significantly provided 23.5% protection against fever (95% CI: 0.13–0.33), the post-intervention likelihood of fever was also significantly less than at pre-intervention (OR = 0.57, 95% CI: 0.50–0.65). The intervention protection fraction against fever was statistically significant at 43.4% (OR = 0.434, 95% CI: 0.36–0.50). Logistic regression showed that the odds of fever were lower in households with nets (OR = 0.72, 95% CI: 0.60–0.88), among children whose mothers had higher

  11. Treatment of a patient with severe hemorrhagic fever accompanied by infection with methicillinresistant Staphylococcus aureus, Acinetobacter baumannii, aspergillus and mucor: a case report.

    PubMed

    Zhang, Di; Wang, Xue; Lv, Jing; Dong, Yalin

    2015-12-01

    A 40-year-old Korean man developed hemorrhagic fever in Xi'an, which is one of the main endemic areas for this illness in China. According to the local epidemiological situation, his condition could have been due to hantavirus infection, but this was not confirmed. He presented with the typical symptoms of hemorrhagic fever and rapidly progressed to a severe multisystem illness. The clinical situation deteriorated rapidly after admission, and he became coinfected with methicillin-resistant Staphylococcus aureus, Acinetobacter baumannii, aspergillus, and mucor. The patient was successfully treated with appropriate fluid infusion, hemodynamic support, continuous renal replacement therapy, liver protectants, and antibacterials. This case indicates that the choice of antimicrobials and the required dose are crucial issues, and that the vaccination campaign for hemorrhagic fever in Xi'an needs greater attention. PMID:26521926

  12. Rheumatic Fever

    MedlinePlus

    ... always tell your doctor or dentist about your history of rheumatic fever before you have a surgical or dental procedure. Such procedures may cause bacteria to enter the bloodstream and infect your heart ...

  13. Lassa Fever

    MedlinePlus

    ... an acute viral illness that occurs in west Africa. The illness was discovered in 1969 when two ... Lassa fever is endemic in parts of west Africa including Sierra Leone, Liberia, Guinea and Nigeria; however, ...

  14. Typhoid fever

    MedlinePlus

    ... most commonly caused due to a bacteria called Salmonella typhi ( S typhi ). Causes S typhi is spread through contaminated ... as food handlers. Alternative Names Enteric fever Images Salmonella typhi organism Fly Digestive system organs References Harris ...

  15. Dengue fever

    MedlinePlus

    ... by the bite of mosquitoes, most commonly the mosquito Aedes aegypti , which is found in tropic and ... Clothing, mosquito repellent, and netting can help reduce the risk of mosquito bites that can spread dengue fever and ...

  16. Hay Fever

    MedlinePlus

    ... 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 ...

  17. Q Fever

    PubMed Central

    Maurin, M.; Raoult, D.

    1999-01-01

    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. PMID:10515901

  18. Q fever — a review

    PubMed Central

    Marrie, Thomas J.

    1990-01-01

    Q or “query” fever is a zoonosis caused by the organism Coxiella burnetii. Cattle, sheep and goats are the most common reservoirs of this organism. The placenta of infected animals contains high numbers (up to 109/g) of C. burnetii. Aerosols occur at the time of parturition and man becomes infected following inhalation of the microorganism. The spectrum of illness in man is wide and consists of acute and chronic forms. Acute Q fever is most often a self-limited flu-like illness but may include pneumonia, hepatitis, or meningoencephalitis. Chronic Q fever almost always means endocarditis and rarely osteomyelitis. Chronic Q fever is not known to occur in animals other than man. An increased abortion and stillbirth rate are seen in infected domestic ungulates. Four provinces (Nova Scotia, New Brunswick, Ontario and Alberta) reported cases of Q fever in 1989. A vaccine for Q fever has recently been licensed in Australia. ImagesFigure 1. PMID:17423643

  19. Dengue and Dengue Hemorrhagic Fever

    PubMed Central

    Gubler, Duane J.

    1998-01-01

    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. PMID:9665979

  20. Remote Sensing in a Changing Climate and Environment: the Rift Valley Fever Case

    NASA Astrophysics Data System (ADS)

    Tourre, Y. M.; Lacaux, J.-P.; Vignolles, C.; Lafaye, M.

    2012-07-01

    Climate and environment are changing rapidly whilst global population already reached 7 billions people. New public health challenges are posed by new and re-emerging diseases. Innovation is a must i.e., 1) using high resolution remote sensing, 2) re-invent health politics and trans-disciplinary management. The above are part of the 'TransCube Approach' i.e., Transition, Translation, and Transformation. The new concept of Tele-epidemiology includes such approach. A conceptual approach (CA) associated with Rift Valley Fever (RVF) epidemics in Senegal is presented. Ponds are detected using high-resolution SPOT-5 satellite images and radar data from space. Data on rainfall events obtained from the Tropical Rainfall Measuring Mission (NASA/JAXA) are combined with in-situ data. Localization of vulnerable and parked hosts (obtained from QuickBird satellite) is also used. The dynamic spatio-temporal distribution and aggressiveness of RVF mosquitoes, are based on total rainfall amounts, ponds' dynamics and entomological observations. Detailed risks maps (hazards + vulnerability) in real-time are expressed in percentages of parks where animals are potentially at risks. This CA which simply relies upon rainfall distribution from space, is meant to contribute to the implementation of the RVF early warning system (RVFews). It is meant to be applied to other diseases and elsewhere. This is particularly true in new places where new vectors have been rapidly adapting (such as Aedes albopictus) whilst viruses (such as West Nile and Chikungunya,) circulate from constantly moving reservoirs and increasing population.

  1. Six Cases of Paratyphoid Fever Due to Salmonella Paratyphi A in Travelers Returning from Myanmar Between July 2014 and August 2015.

    PubMed

    Katanami, Yuichi; Kutsuna, Satoshi; Morita, Masatomo; Izumiya, Hidemasa; Ohnishi, Makoto; Yamamoto, Kei; Takeshita, Nozomi; Hayakawa, Kayoko; Kanagawa, Shuzo; Kato, Yasuyuki; Ohmagari, Norio

    2016-09-01

    We report six cases of Salmonella enterica serotype Paratyphi A infections in travelers returning from Myanmar. In 2015, 31 cases of paratyphoid fever were reported in Japan, and 54.8% of those traveled to Myanmar. Among them, six patients presented to our hospital. They had traveled to Myanmar from July 2014 to August 2015 for business purposes. All six isolates were phage type 1, and they were resistant to nalidixic acid. PMID:27352874

  2. Recurrent Fever in Children

    PubMed Central

    Torreggiani, Sofia; Filocamo, Giovanni; Esposito, Susanna

    2016-01-01

    Children presenting with recurrent fever may represent a diagnostic challenge. After excluding the most common etiologies, which include the consecutive occurrence of independent uncomplicated infections, a wide range of possible causes are considered. This article summarizes infectious and noninfectious causes of recurrent fever in pediatric patients. We highlight that, when investigating recurrent fever, it is important to consider age at onset, family history, duration of febrile episodes, length of interval between episodes, associated symptoms and response to treatment. Additionally, information regarding travel history and exposure to animals is helpful, especially with regard to infections. With the exclusion of repeated independent uncomplicated infections, many infective causes of recurrent fever are relatively rare in Western countries; therefore, clinicians should be attuned to suggestive case history data. It is important to rule out the possibility of an infectious process or a malignancy, in particular, if steroid therapy is being considered. After excluding an infectious or neoplastic etiology, immune-mediated and autoinflammatory diseases should be taken into consideration. Together with case history data, a careful physical exam during and between febrile episodes may give useful clues and guide laboratory investigations. However, despite a thorough evaluation, a recurrent fever may remain unexplained. A watchful follow-up is thus mandatory because new signs and symptoms may appear over time. PMID:27023528

  3. Recurrent Fever in Children.

    PubMed

    Torreggiani, Sofia; Filocamo, Giovanni; Esposito, Susanna

    2016-01-01

    Children presenting with recurrent fever may represent a diagnostic challenge. After excluding the most common etiologies, which include the consecutive occurrence of independent uncomplicated infections, a wide range of possible causes are considered. This article summarizes infectious and noninfectious causes of recurrent fever in pediatric patients. We highlight that, when investigating recurrent fever, it is important to consider age at onset, family history, duration of febrile episodes, length of interval between episodes, associated symptoms and response to treatment. Additionally, information regarding travel history and exposure to animals is helpful, especially with regard to infections. With the exclusion of repeated independent uncomplicated infections, many infective causes of recurrent fever are relatively rare in Western countries; therefore, clinicians should be attuned to suggestive case history data. It is important to rule out the possibility of an infectious process or a malignancy, in particular, if steroid therapy is being considered. After excluding an infectious or neoplastic etiology, immune-mediated and autoinflammatory diseases should be taken into consideration. Together with case history data, a careful physical exam during and between febrile episodes may give useful clues and guide laboratory investigations. However, despite a thorough evaluation, a recurrent fever may remain unexplained. A watchful follow-up is thus mandatory because new signs and symptoms may appear over time. PMID:27023528

  4. Fever in the tropics: aetiology and case-fatality - a prospective observational study in a tertiary care hospital in South India

    PubMed Central

    2013-01-01

    Background The objective of this study was to describe aetiology and case fatality of fever among inpatients in a tertiary care hospital in South India. Methods This was an observational, prospective study conducted in a tertiary care hospital in Vellore, Tamil Nadu, India. Between July 2nd 2007 and August 2nd in 2007, adult patients admitted to the hospital with temperature ≥ 38.0°C were included consecutively and followed during the hospitalisation period. Demographic and clinical data were collected and analysed for each patient. Associations were sought between death and various clinical and demographic variables. Results One hundred patients were included, 61 male and 39 female. Mean age was 37.5 (range: 16 to 84) years. Mean fever duration was 5.4 (range: 0.1 to 42.9) weeks. The following infectious aetiologies were recorded: tuberculosis (19%), lower respiratory infection (11%) including three with sepsis, urinary tract infection (10%) including three with E. coli sepsis, Plasmodium falciparum malaria (5%) including three patients with mixed P. vivax infection, scrub typhus (5%), typhoid fever (4%), cryptococcal meningitis (4%) including three HIV positive patients, endocarditis (3%) including two patients with Staphylococcus aureus sepsis, spleen abscess (2%), amoebic liver abscess (2%), sepsis undefined focus (1%), HIV infection (1%), hepatitis B (1%), rubella (1%), peritonitis (1%) and cholecystitis (1%). Non-infectious causes of fever were diagnosed in 15%, including systemic lupus erythematosus in four and malignancy in six patients. Cause of fever remained unknown in 13%. Case fatality during hospitalisation was 7% (7/100). Six of those who died were male. Five fatalities had bacterial sepsis, one spleen abscess and malignancy, and one had lymphomalignant disorder. Diabetes and increasing age were significant risk factors for fatal outcome in unadjusted analyses, but only increasing age was a risk factor for death in adjusted analysis

  5. [Economic evaluation of cases of dengue fever attributed to the disaster of 2011 in Nova Friburgo (State of Rio de Janeiro/Brazil)].

    PubMed

    Pereira, Carlos Alexandre Rodrigues; Barata, Martha Macedo de Lima; Hoelz, Melania de Paulo Cariello; Medeiros, Viviane Nunes Lopes Oliveira; Marincola, Felipe de Carvalho Vommaro; Costa Neto, Cristina; Marinho, Diana Pinheiro; Oliveira, Teresa Vieira Dos Santos; Trigo, Aline Guimarães Monteiro; Medeiros, Thiago Klein de

    2014-09-01

    The prospects outlined in climate scenarios produced for Brazil indicate a probable increase in the number of extreme hydrometeorological events in the coming years. Therefore, a study of the health scourges that may intensify due to these events is important. The scope of this article is to estimate the cost represented by the cases of dengue fever attributed to the 2011 disaster in Nova Friburgo (RJ). There were 1,356 suspected cases of dengue fever, 937 of which were confirmed. The total cost of the disease may have been between R$66,000 and R$499,000 taking the minimum salary as a benchmark, with approximately 70% of this amount being among the confirmed cases. The disaster caused extensive changes in the city's environment which, together with the urban sanitation and clearing up process that occurred in the post-event period, led to an increase in the number of potential mosquito breeding sites, facilitating their proliferation and increasing the number of cases of dengue fever. This was a disease that in the decade prior to the disaster recorded few cases of the disease in the municipality. This illustrates the potential of events like the one that occurred in 2011 in Nova Friburgo may have on the increase in the number of cases, and consequently on the cost of the disease. PMID:25184576

  6. Cholestatic presentation of yellow phosphorus poisoning.

    PubMed

    Lakshmi, C P; Goel, Amit; Basu, Debdatta

    2014-01-01

    Yellow phosphorus, a component of certain pesticide pastes and fireworks, is well known to cause hepatotoxicity. Poisoning with yellow phosphorus classically manifests with acute hepatitis leading to acute liver failure which may need liver transplantation. We present a case of yellow phosphorus poisoning in which a patient presented with florid clinical features of cholestasis highlighting the fact that cholestasis can rarely be a presenting feature of yellow phosphorus hepatotoxicity. PMID:24554916

  7. Scenario-based decision making in water resource management: A case study in the Yellow River Delta

    NASA Astrophysics Data System (ADS)

    Dong, Congli; Schoups, Gerrit; van de Giesen, Nick

    2013-04-01

    Decision making in water resource management encounters difficulties due to uncertainties about the future. Scenarios are useful to explore uncertainties and inform decision makers to take actions. Scenarios are originally used to describe the future states in the form of storylines. These are then supplemented with numerical information from model predictions and expert judgement. Probabilities are attached to scenarios to encourage the specific explanation of the assumptions and expectations behind the storylines, and communicate the possibility of each scenario. Bayesian probability offers a prior probability on the basis of available knowledge and beliefs at the presence of uncertainties, and allows for updating to the posterior probability as new evidence arises. Bayesian rules are also applicable for decision making given the existing probabilistic scenarios. Decisions can be ranked according to their performance on the utility function given each possible scenario. A case study is provided to find an optimal solution to alleviate the water stress problem in the Yellow River Delta for the next 30 years. Scenarios of water availability and water demand are developed for the planning period. In order to make decisions rationally, cost-benefit analysis is used to evaluate the performance of viable decisions given the probabilistic scenarios. Key word: Scenarios, Water Management, Uncertainty, Decision making, Bayesian approach

  8. First report of Q fever in Oman.

    PubMed Central

    Scrimgeour, E. M.; Johnston, W. J.; Al Dhahry, S. H.; El-Khatim, H. S.; John, V.; Musa, M.

    2000-01-01

    Although serologic evidence suggests the presence of Q fever in humans and animals in Saudi Arabia and the United Arab Emirates, acute Q fever has not been reported on the Arabian Peninsula. We report the first two cases of acute Q fever in Oman. PMID:10653575

  9. [Differential diagnostic and therapeutic aspects of Q-fever in a male prisoner. Case report].

    PubMed

    Vanya, Melinda; Szili, Károly; Zámolyi, Szilvia; Magyar, Hajnalka; Kőrösi, Gábor; Benkő, Árpád; Hornyák, Anna; Hegedűs, Zsolt; György, Lajos

    2015-05-01

    The authors describe the case of a 46-year-old man, who developed atypical pneumonia caused by Coxiella burnetii. Chest X-ray revealed interstitial pneumonia. Western blot and ELISA test were positive for Coxiella burnetii antibody. After treatment with doxycyclin and amoxicillin supplemented with vitamin B6 for 10 days, the patient displayed a clinical improvement. The authors conclude that in cases with atypical pneumonia, Coxiella burnetii antibody as well as other bacterial or viral antibodies should be determined. PMID:26042781

  10. Yellow nails following hemodialysis in chronic renal failure: is it yellow nail syndrome or a variant?

    PubMed

    Mehta, Vandana; Vasanth, Vani; Balachandran, C

    2008-01-01

    Yellow nail syndrome (YNS) is triad of yellow nails, lymphedema, and respiratory tract involvement. The exact pathogenesis of nail changes in YNS is unknown. We present a case of yellow nails and localized lymphedema secondary to artificial AV fistula in a 55-year-old chronic renal failure patient on hemodialysis for 5 years. To the best of our knowledge, this is the first case of yellow nail syndrome reported in association with artificial AV fistula. PMID:19094857

  11. Dengue fever (image)

    MedlinePlus

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

  12. Rat-bite fever

    MedlinePlus

    Streptobacillary fever; Streptobacillosis; Haverhill fever; Epidemic arthritic erythema; Spirillary fever; Sodoku ... Rat-bite fever can be caused by 2 different bacteria, Streptobacillus moniliformis or Spirillum minus. Both of these are found in ...

  13. Durable Regression of Primary Cutaneous B-Cell Lymphoma Following Fever-inducing Mistletoe Treatment: Two Case Reports

    PubMed Central

    Lace, Aija; Fonseca, Maria P.; von Laue, Broder H.; Geider, Stefan; Kienle, Gunver S.

    2012-01-01

    Background: Mistletoe is a complementary cancer treatment that is widely used, usually in addition to and alongside recommended conventional cancer therapy. However, little is known about its use, effectiveness, and safety in the treatment of cutaneous lymphoma. Case Report: Two patients with primary cutaneous B-cell lymphoma (pT2bcNxM0 follicle center and pT2ac-NxM0 marginal zone) either declined or postponed recommended conventional treatment and received high-dose, fever-inducing mistletoe treatment; a combination of intratumoral, subcutaneous, and intravenous application was given; and one patient also underwent whole-body hyperthermia. The lymphoma regressed over a period of 12 and 8 months, respectively, and after administration of a cumulative dose of 12.98 g and 4.63 g mistletoe extract, respectively. The patients are in remission to date, 3.5 years after commencement of treatment. Neither patient received conventional cancer treatment during the entire observation period. PMID:24278797

  14. “Tazomoka Is Not a Problem”. Local Perspectives on Malaria, Fever Case Management and Bed Net Use in Madagascar

    PubMed Central

    Raboanary, Emma; Kesteman, Thomas; Piola, Patrice; Randrianarivelojosia, Milijaona; Rogier, Christophe

    2016-01-01

    Background Although its incidence has been decreasing during the last decade, malaria is still a major public health issue in Madagascar. The use of Long Lasting Insecticidal Nets (LLIN) remains a key malaria control intervention strategy in Madagascar, however, it encounters some obstacles. The present study aimed to explore the local terminology related to malaria, information channels about malaria, attitude towards bed nets, and health care seeking practices in case of fever. This article presents novel qualitative findings about malaria. Until now, no such data has been published for Madagascar. Methods A comparative qualitative study was carried out at four sites in Madagascar, each differing by malaria epidemiology and socio-cultural background of the populations. Seventy-one semi-structured interviews were conducted with biomedical and traditional caregivers, and members of the local population. In addition, observations of the living conditions and the uses of bed net were conducted. Results Due to the differences between local and biomedical perspectives on malaria, official messages did not have the expected impact on population in terms of prevention and care seeking behaviors. Rather, most information retained about malaria was spread through informal information circulation channels. Most interviewees perceived malaria as a disease that is simple to treat. Tazomoka (“mosquito fever”), the Malagasy biomedical word for malaria, was not used by populations. Tazo (“fever”) and tazomahery (“strong fever”) were the terms more commonly used by members of the local population to refer to malaria related symptoms. According to local perceptions in all areas, tazo and tazomahery were not caused by mosquitos. Each of these symptoms required specific health recourse. The usual fever management strategies consisted of self-medication or recourse to traditional and biomedical caregivers. Usage of bed nets was intermittent and was not directly linked to

  15. A Historical Look at the First Reported Cases of Lassa Fever: IgG Antibodies 40 Years After Acute Infection

    PubMed Central

    Bond, Nell; Schieffelin, John S.; Moses, Lina M.; Bennett, Andrew J.; Bausch, Daniel G.

    2013-01-01

    Lassa fever is an acute and sometimes severe viral hemorrhagic illness endemic in West Africa. One important question regarding Lassa fever is the duration of immunoglobulin G (IgG) antibody after infection. We were able to locate three persons who worked in Nigeria dating back to the 1940s, two of whom were integrally involved in the early outbreaks and investigations of Lassa fever in the late 1960s, including the person from whom Lassa virus was first isolated. Two persons had high titers of Lassa virus-specific IgG antibody over 40 years after infection, indicating the potential for long-term duration of these antibodies. One person was likely infected in 1952, 17 years before the first recognized outbreak. We briefly recount the fascinating stories of these three pioneers and their important contribution to our understanding of Lassa fever. PMID:23390223

  16. A Historical Look at the First Reported Cases of Lassa Fever: IgG Antibodies 40 Years After Acute Infection.

    PubMed

    Bond, Nell; Schieffelin, John S; Moses, Lina M; Bennett, Andrew J; Bausch, Daniel G

    2012-12-31

    Lassa fever is an acute and sometimes severe viral hemorrhagic illness endemic in West Africa. One important question regarding Lassa fever is the duration of immunoglobulin G (IgG) antibody after infection. We were able to locate three persons who worked in Nigeria dating back to the 1940s, two of whom were integrally involved in the early outbreaks and investigations of Lassa fever in the late 1960s, including the person from whom Lassa virus was first isolated. Two persons had high titers of Lassa virus-specific IgG antibody over 40 years after infection, indicating the potential for long-term duration of these antibodies. One person was likely infected in 1952, 17 years before the first recognized outbreak. We briefly recount the fascinating stories of these three pioneers and their important contribution to our understanding of Lassa fever. PMID:23277481

  17. A historical look at the first reported cases of Lassa fever: IgG antibodies 40 years after acute infection.

    PubMed

    Bond, Nell; Schieffelin, John S; Moses, Lina M; Bennett, Andrew J; Bausch, Daniel G

    2013-02-01

    Lassa fever is an acute and sometimes severe viral hemorrhagic illness endemic in West Africa. One important question regarding Lassa fever is the duration of immunoglobulin G (IgG) antibody after infection. We were able to locate three persons who worked in Nigeria dating back to the 1940s, two of whom were integrally involved in the early outbreaks and investigations of Lassa fever in the late 1960s, including the person from whom Lassa virus was first isolated. Two persons had high titers of Lassa virus-specific IgG antibody over 40 years after infection, indicating the potential for long-term duration of these antibodies. One person was likely infected in 1952, 17 years before the first recognized outbreak. We briefly recount the fascinating stories of these three pioneers and their important contribution to our understanding of Lassa fever. PMID:23390223

  18. Orchid Fever

    ERIC Educational Resources Information Center

    Oliver, Phillip

    2004-01-01

    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…

  19. Dengue Fever

    Technology Transfer Automated Retrieval System (TEKTRAN)

    “Dengue Fever” will be included in “Health Information for International Travel, 2007-2008” which will be published by the U.S. Centers for Disease Control and Prevention. Dengue and dengue hemorrhagic fever are viral diseases transmitted by Aedes mosquitoes. The disease is found in tropical and s...

  20. Hemorrhagic fever with renal syndrome in Montenegro.

    PubMed

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

    2008-09-01

    The objective of the study was to analyze the epidemiological features of hemorrhagic fever with renal syndrome (HFRS) in Montenegro. The study included 169 cases of HFRS diagnosed in the period between 1995 and 2005 according to the clinical symptoms and serological confirmation. For the analysis of the demographic characteristics of the cases, as well as of the chronological and topographical features of the disease, a descriptive epidemiological method was employed. The average incidence rate in the observed period was 2.6 per 100,000. In the observed period, 8 people died; the average case fatality rate was 4.8% (range: 0.1-15%). Among the diseased persons, 116 were males and 53 were females; most of the cases were adults. The greatest number of HFRS cases occurred during the summer months. The highest incidence rates were registered in the northeastern, rural part of the country. The most frequent type of hantaviruses in Montenegro were Dobrava-Belgrade and Hantaan, carried by rodent species, i.e., the yellow-neck mouse and the striped-field mouse. It is likely that HFRS in Montenegro will become more common in the near future, unless public health control measures are taken. PMID:18806348

  1. Q fever.

    PubMed Central

    Reimer, L G

    1993-01-01

    Q fever is an acute febrile illness first described in 1935 and now seen in many parts of the world. Human infection follows exposure to animals, especially domestic livestock. Recent outbreaks in metropolitan areas have implicated cats as the carrier of disease to humans. The etiologic agent, Coxiella burnetti, belongs to the family Rickettsiaceae, although it has distinct genetic characteristics and modes of transmission. Most recent attention has been focused on a number of large outbreaks of Q fever associated with medical research involving pregnant sheep. Although most infections are self-limited, some patients require prolonged treatment. Recent vaccines have had encouraging success in the prevention of disease in individuals at high risk of exposure. PMID:8358703

  2. Zika fever.

    PubMed

    Martínez de Salazar, Pablo; Suy, Anna; Sánchez-Montalvá, Adrián; Rodó, Carlota; Salvador, Fernando; Molina, Israel

    2016-04-01

    Zika fever is an arboviral systemic disease that has recently become a public health challenge of global concern after its spread through the Americas. This review highlights the current understanding on Zika virus epidemiology, its routes of transmission, clinical manifestations, diagnostic tests, and the current management, prevention and control strategies. It also delves the association between zika infection and complications, such as microencephaly or Guillem-Barré syndrome. PMID:26993436

  3. The importance of molecular tools in classical biological control of weeds: Two case studies with yellow starthistle candidate biological agents

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Molecular analyses may play a primary role in the process of host-specificity evaluation at species and population levels; here are reported two examples of their application with new candidate biocontrol agents for yellow starthistle (YST). Ceratapion basicorne is a root-crown boring weevil that sh...

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

    NASA Astrophysics Data System (ADS)

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

    2008-02-01

    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.

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

    PubMed

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

    2008-02-01

    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

  6. Calculation of the Average Cost per Case of Dengue Fever in Mexico Using a Micro-Costing Approach

    PubMed Central

    2016-01-01

    Introduction The increasing burden of dengue fever (DF) in the Americas, and the current epidemic in previously unaffected countries, generate major costs for national healthcare systems. There is a need to quantify the average cost per DF case. In Mexico, few data are available on costs, despite DF being endemic in some areas. Extrapolations from studies in other countries may prove unreliable and are complicated by the two main Mexican healthcare systems (the Secretariat of Health [SS] and the Mexican Social Security Institute [IMSS]). The present study aimed to generate specific average DF cost-per-case data for Mexico using a micro-costing approach. Methods Expected medical costs associated with an ideal management protocol for DF (denoted ´ideal costs´) were compared with the medical costs of current treatment practice (denoted ´real costs´) in 2012. Real cost data were derived from chart review of DF cases and interviews with patients and key personnel from 64 selected hospitals and ambulatory care units in 16 states for IMSS and SS. In both institutions, ideal and real costs were estimated using the program, actions, activities, tasks, inputs (PAATI) approach, a micro-costing technique developed by us. Results Clinical pathways were obtained for 1,168 patients following review of 1,293 charts. Ideal and real costs for SS patients were US$165.72 and US$32.60, respectively, in the outpatient setting, and US$587.77 and US$490.93, respectively, in the hospital setting. For IMSS patients, ideal and real costs were US$337.50 and US$92.03, respectively, in the outpatient setting, and US$2,042.54 and US$1,644.69 in the hospital setting. Conclusions The markedly higher ideal versus real costs may indicate deficiencies in the actual care of patients with DF. It may be necessary to derive better estimates with micro-costing techniques and compare the ideal protocol with current practice when calculating these costs, as patients do not always receive optimal care

  7. Rhombencephalitis associated with Dengue fever.

    PubMed

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

    2016-05-01

    Dengue infection is gradually disseminating throughout the world in alarming proportions. It is a arbovirus infection,transmitted by aedes mosquitoes. It is a multi-systemic disorder associated with varied neurological complications. There is increased trend of development of neurological complications in dengue fever. The neurological complications arising due to dengue infection can be categorized into central and neuromuscular complications. The central nervous system disorders reported with dengue fever are encephalopathy,encephalitis and myelitis.Here we report a case of rhombencephalitis associated with dengue fever. The literature does not mention rhombencephalitis occurring with dengue illness. PMID:27015434

  8. [Persistent fever of dental origin].

    PubMed

    Pernice, L; Ribault, J Y; Fourestier, J; Gacon, J; Quilichini, R; Aubert, L; Chaffanjon, P; Roubaudi, G

    1990-01-01

    Based on 5 cases of unexplained prolonged fever, the authors stress the need to systematically look for a dental focus of infection. They discuss the difficulties in determining the site of the probable causal focus and stress the uncertain pathogenic relationship between the dental focus of infection and the fever. The extraction of infected teeth leads to a cure, however, the functional disadvantages of multiple extractions need to be carefully taken into account. PMID:2130447

  9. Q fever in Bulgaria and Slovakia.

    PubMed Central

    Serbezov, V. S.; Kazár, J.; Novkirishki, V.; Gatcheva, N.; Kovácová, E.; Voynova, V.

    1999-01-01

    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. PMID:10341175

  10. Chronic Q Fever in the United States

    PubMed Central

    Karakousis, Petros C.; Trucksis, Michele; Dumler, J. Stephen

    2006-01-01

    Infections due to Coxiella burnetii, the causative agent of Q fever, are uncommon in the United States. Cases of chronic Q fever are extremely rare and most often manifest as culture-negative endocarditis in patients with underlying valvular heart disease. We describe a 31-year-old farmer from West Virginia with a history of congenital heart disease and recurrent fevers for 14 months who was diagnosed with Q fever endocarditis based on an extremely high antibody titer against Coxiella burnetii phase I antigen. Despite treatment with doxycycline, he continued to have markedly elevated Coxiella burnetii phase I antibody titers for 10 years after the initial diagnosis. To our knowledge, this case represents the longest follow-up period for a patient with chronic Q fever in the United States. We review all cases of chronic Q fever reported in the United States and discuss important issues pertaining to epidemiology, diagnosis, and management of this disease. PMID:16757641

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

    PubMed

    2007-02-01

    In mid-December 2006, several unexplained fatalities associated with fever and generalized bleeding were reported to the Kenya Ministry of Health (KMOH) from Garissa District in North Eastern Province (NEP). By December 20, a total of 11 deaths had been reported. Of serum samples collected from the first 19 patients, Rift Valley fever (RVF) virus RNA or immunoglobulin M (IgM) antibodies against RVF virus were found in samples from 10 patients; all serum specimens were negative for yellow fever, Ebola, Crimean-Congo hemorrhagic fever, and dengue viruses. The outbreak was confirmed by isolation of RVF virus from six of the specimens. Humans can be infected with RVF virus from bites of mosquitoes or other arthropod vectors that have fed on animals infected with RVF virus, or through contact with viremic animals, particularly livestock. Reports of livestock deaths and unexplained animal abortions in NEP provided further evidence of an RVF outbreak. On December 20, an investigation was launched by KMOH, the Kenya Field Epidemiology and Laboratory Training Program (FELTP), the Kenya Medical Research Institute (KEMRI), the Walter Reed Project of the U.S. Army Medical Research Unit, CDC-Kenya's Global Disease Detection Center, and other partners, including the World Health Organization (WHO) and Médecins Sans Frontières (MSF). This report describes the findings from that initial investigation and the control measures taken in response to the RVF outbreak, which spread to multiple additional provinces and districts, resulting in 404 cases with 118 deaths as of January 25, 2007. PMID:17268404

  12. Case Report: An Outbreak of Food-Borne Typhoid Fever Due to Salmonella enterica Serotype Typhi in Japan Reported for the First Time in 16 Years.

    PubMed

    Kobayashi, Tetsuro; Kutsuna, Satoshi; Hayakawa, Kayoko; Kato, Yasuyuki; Ohmagari, Norio; Uryu, Hideko; Yamada, Ritsuko; Kashiwa, Naoyuki; Nei, Takahito; Ehara, Akihito; Takei, Reiko; Mori, Nobuaki; Yamada, Yasuhiro; Hayasaka, Tomomi; Kagawa, Narito; Sugawara, Momoko; Suzaki, Ai; Takahashi, Yuno; Nishiyama, Hiroyuki; Morita, Masatomo; Izumiya, Hidemasa; Ohnishi, Makoto

    2016-02-01

    For the first time in 16 years, a food-borne outbreak of typhoid fever due to Salmonella enterica serotype Typhi was reported in Japan. Seven patients consumed food in an Indian buffet at a restaurant in the center of Tokyo, while one was a Nepali chef in the restaurant, an asymptomatic carrier and the implicated source of this outbreak. The multiple-locus variable-number tandem repeat analysis showed 100% consistency in the genomic sequence for five of the eight cases. PMID:26621565

  13. Lassa fever vaccine.

    PubMed

    Fisher-Hoch, Susan P; McCormick, Joseph B

    2004-04-01

    Lassa fever remains a serious challenge to public health in West Africa threatening both local residents in rural areas and those who serve them, particularly medical care providers. Given the ecology of the rodent host and conditions in the endemic area, a vaccine is mandatory for control. The challenge is to overcome the scientific, political and economic obstacles to producing a human use vaccine candidate. There are some scientific issues to resolve. It is known that the G-protein confers protection but we do not know its duration. If the N-protein is also included there may be a better duration of protection but it is unclear whether the N-protein as a vaccine may possibly enhance the infection. The original vaccinia vector must be replaced by new vectors, chimeras or by delivering DNA in some format. A live vaccine is attractive because it can confer protection in a single shot. A killed vaccine is more stable, particularly for distribution in the tropics but usually requires repeated shots. For practical reasons a live vaccine format should probably be pursued, which could then be combined with a yellow fever vaccine, using the same cold chains, since this disease occupies the same endemic areas in West Africa. Lassa vaccine initiatives have suffered from a lack of funding in the past but bioterrorism has brought new resources to Lassa virus science. Adequate funding and applications of new vaccine technologies give hope that we may soon see a vaccine in clinical trials. However, the difficulty of conducting trials in endemic areas and lack of political stability remain serious problems. PMID:15056044

  14. Clinical Profile of Concurrent Dengue Fever and Plasmodium vivax Malaria in the Brazilian Amazon: Case Series of 11 Hospitalized Patients

    PubMed Central

    Magalhães, Belisa M. L.; Alexandre, Márcia A. A.; Siqueira, André M.; Melo, Gisely C.; Gimaque, João B. L.; Bastos, Michele S.; Figueiredo, Regina M. P.; Carvalho, Ricardo C.; Tavares, Michel A.; Naveca, Felipe G.; Alonso, Pedro; Bassat, Quique; Lacerda, Marcus V. G.; Mourão, Maria P. G.

    2012-01-01

    Malaria and dengue fever are the most prevalent vector-borne diseases worldwide. This study aims to describe the clinical profile of patients with molecular diagnosis of concurrent malaria and dengue fever in a tropical-endemic area. Eleven patients with concurrent dengue virus (DENV) and Plasmodium vivax infection are reported. Similar frequencies of DENV-2, DENV-3, and DENV-4 were found, including DENV-3/DENV-4 co-infection. In eight patients, the World Health Organization (WHO) criteria for severe malaria could be fulfilled (jaundice being the most common). Only one patient met severe dengue criteria, but warning signs were present in 10. Syndromic surveillance systems must be ready to identify this condition to avoid misinterpretation of severity attributed to a single disease. PMID:23033396

  15. Early detection of circulating anodic antigen (CAA) in a case of acute schistosomiasis mansoni with Katayama fever.

    PubMed

    Gundersen, S G; Ravn, J; Haagensen, I

    1992-01-01

    A 34-year-old male developed acute Katayama fever with fever, diarrhoea, joint pains, headache, urticarial rash and eosinophilia 18 days after falling into and spending 15 min in the water during water-skiing in the outlet of the Volta river. Low anti-schistosomal antibody titres were found by the immunofluorescence assay after 4 weeks, and the first Schistosoma mansoni eggs were found in faeces after 6 weeks. Both symptoms and eosinophilia increased the first days after treatment with oxamniquine, after which he improved gradually. Examination of frozen sera by the newly developed Magnetic Beads Antigen Capture-EIA (MBAC-EIA) later demonstrated a peak in schistosomal circulating anodic antigen (CAA) levels of diagnostic significance already 4 weeks after he was infected. PMID:1411323

  16. Prevention of lassa Fever in Nigeria.

    PubMed

    Inegbenebor, Ute; Okosun, John; Inegbenebor, Josephine

    2010-01-01

    Although specific treatment is available for Lassa fever, early diagnosis is still difficult in most Nigerian primary and secondary health centers. This study was carried out to compare the case-fatality rates of Lassa fever and other medical diseases commonly seen in adult medical wards, to determine the community habits that make Lassa fever endemic in Edo Central District of Nigeria, with the aim of prescribing preventive measures for its control in Nigeria. The records of 908 inpatients in the adult medical wards of Irrua Specialist Teaching Hospital, Irrua and responses from respondents interviewed by trained interviewers on their knowledge, attitudes and practices pertaining to Lassa fever were used for this study. The case-fatality rate of Lassa fever in this center was 28%. Cultural factors and habits were found to favor endemicity of Lassa fever in Edo Central District of Nigeria. Preventive measures were prescribed for families and communities. PMID:19712954

  17. Insights into Borrelia miyamotoi infection from an untreated case demonstrating relapsing fever, monocytosis and a positive C6 Lyme serology.

    PubMed

    Sudhindra, Praveen; Wang, Guiqing; Schriefer, Martin E; McKenna, Donna; Zhuge, Jian; Krause, Peter J; Marques, Adriana R; Wormser, Gary P

    2016-09-01

    We describe a patient from the United States with PCR- and serology-confirmed Borrelia miyamotoi infection who recovered without antibiotics. Our findings suggest that B. miyamotoi infection may cause relapsing fever, blood monocytosis and antibody reactivity to the C6 peptide. Further studies are required to better define the spectrum of clinical and laboratory findings for this emerging tick-transmitted infection. PMID:27412815

  18. Clinical Case of the Month: A 49-Year-Old Man with Fever, Headache and Leg Weakness.

    PubMed

    Cardinale, Jeffrey P; Gentile, Oliver O; Reddy, Laya M; Tran, Trung N; Avalos, Joseph A; Lopez, Fred A

    2015-01-01

    A 49-year-old man with an unremarkable past medical history presented to an outside hospital with a five-day history of fever, left leg weakness, myalgia and headache. The patient reported that the illness started as a fever and sore throat and he was originally diagnosed with streptococcal pharyngitis and prescribed antibiotics. The day after his initial diagnosis, his fever had progressed to include a headache, myalgia, a rash on his upper torso and right shoulder and sudden-onset left leg weakness with preserved sensation. With progressively worsening symptoms, he eventually presented to a local emergency department (ED), five days after his symptoms first started. He was experiencing continued left leg weakness, an inability to ambulate, persistent fevers to 103ºF, muscle aches, an intense band-like headache and confusion. The patient denied neck stiffness, photophobia, loss of sensation or any additional muscle weakness. He denied any recent travel aside from work, any sick contacts, recent tick/insect bites, history of sexually transmitted diseases or contact with animals. He reported no history of illicit drug use as well as no recent weight loss, trauma or radiation exposure. The patient had approximately a 10-pack-year tobacco smoking history. For the last ten years he drank about a six-pack of beer daily while onshore (roughly two weeks out of every month). He works on an offshore oil platform. He was not taking any home medications besides his recently prescribed antibiotics. He lived alone at home in a moderately rural area of South Louisiana. His family history was non-contributory. PMID:26741691

  19. Psychogenic fever, functional fever, or psychogenic hyperthermia?

    PubMed Central

    Olivier, Berend

    2015-01-01

    Psychogenic fever reflects a phenomenon where core body temperature is high (up to 41°C) or low-grade high (37–38°C) during either acute or chronic stress. Underlying mechanisms are distinct from infection-induced fever and involve the central and sympathetic nervous systems. Psychogenic fever appears a complex psychological, physiological and endocrinological phenomenon.

  20. Beyond the superficial: Coccidioides immitis fungaemia in a man with fever, fatigue and skin nodules: a case of an emerging and evolving pathogen

    PubMed Central

    Langelier, Charles; Baxi, Sanjiv M; Iribarne, Daniela; Chin-Hong, Peter

    2014-01-01

    Coccidioidomycosis is an insidious fungal disease, endemic to arid regions of the Americas, which is becoming more frequently recognised worldwide. While most infections resemble a mild respiratory illness, a subset of cases progress to severe pneumonia or systemic dissemination. Here, we describe a case of disseminated coccidioidomycosis in a 54-year-old immunocompetent African-American man with geographic and demographic risk factors for Coccidiodes acquisition who presented with 2 months of fevers, fatigue, weight loss and painful skin lesions. Blood count and serum chemistry studies initially demonstrated leukocytosis, anaemia, hyponatraemia and acute renal failure. Chest imaging revealed numerous small pulmonary nodules and skin biopsy, serological studies and blood cultures eventually confirmed disseminated infection with Coccidioides immitis. This case highlights important features regarding the risk factors, spectrum of clinical findings, evaluation and treatment of coccidioidomycosis relevant to providers in endemic areas and throughout the world. PMID:25228676

  1. Pregnancy Outcome in Relation to Treatment of Murine Typhus and Scrub Typhus Infection: A Fever Cohort and a Case Series Analysis

    PubMed Central

    McGready, Rose; Prakash, John Antony Jude; Benjamin, Santosh Joseph; Watthanaworawit, Wanitda; Anantatat, Tippawan; Tanganuchitcharnchai, Ampai; Ling, Clare L.; Tan, Saw Oo; Ashley, Elizabeth A.; Pimanpanarak, Mupawjay; Blacksell, Stuart D.; Day, Nicholas P.; Singhasivanon, Pratap; White, Nicholas J.; Nosten, François; Paris, Daniel H.

    2014-01-01

    Background There is a paucity of published reports on pregnancy outcome following scrub and murine typhus despite these infections being leading causes of undifferentiated fever in Asia. This study aimed to relate pregnancy outcome with treatment of typhus. Methodology/Principal Findings Data were analyzed from: i) pregnant women with a diagnosis of scrub and/or murine typhus from a fever cohort studies; ii) case series of published studies in PubMed using the search terms “scrub typhus” (ST), “murine typhus” (MT), “Orientia tsutsugamushi”, “Rickettsia tsutsugamushi”, “Rickettsia typhi”, “rickettsiae”, “typhus”, or “rickettsiosis”; and “pregnancy”, until February 2014 and iii) an unpublished case series. Fever clearance time (FCT) and pregnancy outcome (miscarriage and delivery) were compared to treatment. Poor neonatal outcome was a composite measure for pregnancies sustained to 28 weeks or more of gestation ending in stillbirth, preterm birth, or delivery of a growth restricted or low birth weight newborn. Results There were 26 women in the fever cohort. MT and ST were clinically indistinguishable apart from two ST patients with eschars. FCTs (median [range] hours) were 25 [16–42] for azithromycin (n = 5), 34 [20–53] for antimalarials (n = 5) and 92 [6–260] for other antibiotics/supportive therapy (n = 16). There were 36.4% (8/22) with a poor neonatal outcome. In 18 years, 97 pregnancies were collated, 82 with known outcomes, including two maternal deaths. Proportions of miscarriage 17.3% (14/81) and poor neonatal outcomes 41.8% (28/67) were high, increasing with longer FCTs (p = 0.050, linear trend). Use of azithromycin was not significantly associated with improved neonatal outcomes (p = 0.610) Conclusion The published ST and MT world literature amounts to less than 100 pregnancies due to under recognition and under diagnosis. Evidence supporting the most commonly used treatment, azithromycin, is

  2. Immunological features underlying viral hemorrhagic fevers.

    PubMed

    Messaoudi, Ilhem; Basler, Christopher F

    2015-10-01

    Several enveloped RNA viruses of the arenavirus, bunyavirus, filovirus and flavivirus families are associated with a syndrome known as viral hemorrhagic fever (VHF). VHF is characterized by fever, vascular leakage, coagulation defects and multi organ system failure. VHF is currently viewed as a disease precipitated by viral suppression of innate immunity, which promotes systemic virus replication and excessive proinflammatory cytokine responses that trigger the manifestations of severe disease. However, the mechanisms by which immune dysregulation contributes to disease remain poorly understood. Infection of nonhuman primates closely recapitulates human VHF, notably Ebola and yellow fever, thereby providing excellent models to better define the immunological basis for this syndrome. Here we review the current state of our knowledge and suggest future directions that will better define the immunological mechanisms underlying VHF. PMID:26163194

  3. Bridging Epidemiology and Remote Sensing: A Case Study of Dengue Fever and Land Use and Land Cover Change in Roatán, Honduras

    NASA Astrophysics Data System (ADS)

    Tuholske, C.; Brooks, T.

    2015-12-01

    Dengue fever is one of the fastest spreading infectious diseases in Latin America and the Caribbean. As part of a yearlong epidemiological study of dengue, this paper takes the first step to model the relationship between the urban/built environment and incidents of dengue fever in Roatán, Honduras. Roatán has experienced an 80-fold increase in annual tourists since the 1990s, with over 1.2 million people now visiting the island yearly. In tandem, the Caribbean island's population has exploded from fewer than 13,000 people in the 1970s to over 100,000 people today. Using broadband remote sensed satellite imagery, this paper maps and measures how this massive influx of tourists and population has altered the island's landscape. Results from a decision tree classifying technique applied to a Landsat 5 Thematic Mapper (TM) image from 1985 and Landsat 8 Operational Land Imager (OLI) image from 2014 suggest a rapid pace of urbanization; built and impervious surface has increased over 300% in the last 30 years. Emerging research suggests, similar to other mosquito-borne diseases, a correlation between built environment and risk to dengue because of the increase in stagnate water that serve as disease-host reservoirs. This remote sensing analysis will be integrated with georeferenced household level data of cases of dengue collected during a year-long cross-sectional study of dengue patients in Roatán. The result will be to model the relationship between dengue fever and urban/built environment.

  4. Successful treatment with humanized anti-interleukin-6 receptor antibody (tocilizumab) in a case of AA amyloidosis complicated by familial Mediterranean fever.

    PubMed

    Hamanoue, Satoshi; Suwabe, Tatsuya; Hoshino, Junichi; Sumida, Keiichi; Mise, Koki; Hayami, Noriko; Sawa, Naoki; Takaichi, Kenmei; Fujii, Takeshi; Ohashi, Kenichi; Yazaki, Masahide; Ikeda, Shuichi; Ubara, Yoshifumi

    2016-07-01

    Familial Mediterranean fever (FMF) is a well-known cause of secondary AA amyloidosis. Colchicine is generally considered to be the most effective treatment for FMF and FMF-associated amyloidosis, but the management of patients who are refractory to colchicine remains controversial. We encountered a 51-year-old Japanese man with suspected FMF, who had periodic fever with abdominal pain, polyarthritis, and nephropathy (serum creatinine of 1.9 mg/dL and 24-h protein excretion of 3.8 g). FMF was diagnosed by mutation analysis of the Mediterranean fever (MEFV) gene, which revealed that the patient was compound heterozygous for the marenostrin/pyrin variant E148Q/M694I. AA amyloidosis was diagnosed by renal and gastric biopsy. Colchicine was administered, but his arthritis persisted, and serum creatinine increased to 2.4 mg/dL. Therefore, a humanized anti-interleukin-6 receptor antibody (tocilizumab) was administered at a dose of 8 mg/kg on a monthly basis. Both arthritis and abdominal pain subsided rapidly, and C-reactive protein (CRP) decreased from 2.5 to 0.0 mg/dL. After 2 years, his serum creatinine was decreased to 1.5 mg/dL and proteinuria was improved to 0.3 g daily. In addition, repeat gastric biopsy showed a marked decrease of AA amyloidosis. This case suggests that tocilizumab could be a new therapeutic option for patients with FMF-associated AA amyloidosis if colchicine is not effective. PMID:25619282

  5. Rocky Mountain spotted fever in Argentina

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Cases of epidemic typhus have been documented in Argentina since 1919; however, no confirmed reports of spotted fever rickettsiosis were described in this country until 1999. We describe the first molecular confirmation of Rickettsia rickettsii, the etiologic agent of Rocky Mountain spotted fever (R...

  6. Rocky Mountain Spotted Fever in Argentina

    Technology Transfer Automated Retrieval System (TEKTRAN)

    We describe the first molecular confirmation of Rickettsia rickettsii, the cause of Rocky Mountain spotted fever (RMSF), from a tick vector, Amblyomma cajennense, and from a cluster of fatal spotted fever cases in Argentina. Questing A. cajennense ticks were collected at or near sites of presumed or...

  7. Q Fever Chronic Osteomyelitis in Two Children.

    PubMed

    Costa, Beatriz; Morais, Andreia; Santos, Ana Sofia; Tavares, Delfin; Seves, Graça; Gouveia, Catarina

    2015-11-01

    We report 2 cases of chronic Q fever osteomyelitis in 10- and 5-year-old girls who presented with distal right femoral and left parasternal granulomatous osteomyelitis, respectively. Both were treated with ciprofloxacin and rifampin with good response. Q fever osteomyelitis is a challenging diagnosis in children, and the choice of antimicrobial treatment is difficult because of limited available data. PMID:26226441

  8. Clinical Case of the Month: A 48-Year-Old Man With Fever and Abdominal Pain of One Day Duration.

    PubMed

    Yu, Mary; Tadin, David; Conrad, Erich J; Lopez, Fred A

    2015-01-01

    A 48-year-old man residing in a mental health department inpatient program with a history of schizoaffective disorder presented to the emergency department with a chief complaint of fever and intense abdominal pain for one day. The patient stated he initially fell in the shower and afterwards experienced back pain. He was transferred to an acute care unit within the facility for further evaluation. The facility physician noted that the patient had a mild temperature elevation and abdominal rigidity on exam. At that time, he was given two doses of benztropine intramuscularly, and transferred to our hospital for further evaluation. The patient exhibited fever, diffuse abdominal pain and a nonproductive cough, but denied chills, dysuria, urinary frequency, hematuria, weakness, diarrhea, melena or hematochezia. He did have a one-week history of constipation for which he was given sodium phosphate enemas, magnesium citrate and docusate sodium, eventually resulting in a bowel movement. He also complained of new onset dysphagia. There were no recent changes to his medications, which included clonazepam, divalproex sodium extended release, olanzapine and risperidone. He denied use of tobacco, alcohol or illicit drugs. PMID:27159603

  9. Management of acute childhood fevers.

    PubMed

    Teuten, Polly; Paul, Siba Prosad; Heaton, Paul Anthony

    2015-01-01

    Feverish illnesses commonly affect children and are the second most frequent reason for a child to be admitted to hospital. Most cases are viral in origin, usually with a good prognosis. Fever can be caused by severe and rapidly progressive illness which needs urgent referral to hospital for potentially life-saving treatment, and community practitioners must be able to identify such cases showing 'red flag'features. The fear of serious disease among parents and carers may result in 'fever phobia' leading to minor illnesses being managed inappropriately. Community practitioners are well placed to reassure and support families, and to provide education regarding the facts about fever, the appropriate use of antipyretic medication, how to avoid dehydration, and the beneficial role of immunisation in preventing infection. PMID:26387247

  10. African tick-bite fever: a new entity in the differential diagnosis of multiple eschars in travelers. Description of five cases imported from South Africa to Switzerland.

    PubMed

    Althaus, Fabrice; Greub, Gilbert; Raoult, Didier; Genton, Blaise

    2010-09-01

    African tick-bite fever (ATBF) is a newly described spotted fever rickettsiosis that frequently presents with multiple eschars in travelers returning from sub-Saharan Africa and, to a lesser extent, from the West Indies. It is caused by the bite of an infected Amblyomma tick, whose hunting habits explain the typical presence of multiple inoculation skin lesions and the occurrence of clustered cases. The etiological agent of ATBF is Rickettsia africae, an emerging tick-borne pathogenic bacterium. We describe herein a cluster of five cases of ATBF occurring in Swiss travelers returning from South Africa. The co-incidental infections in these five patients and the presence of multiple inoculation eschars, two features pathognomonic of this rickettsial disease, suggested the diagnosis of ATBF. Indeed, the presence of at least one inoculation eschar is observed in 53-100% of cases and multiple eschars in 21-54%. Two patients presented regional lymphadenitis and one a mild local lymphangitis. Though a cutaneous rash is described in 15-46% of cases, no rash was observed in our series. ATBF was confirmed by serology. Thus, ATBF has recently emerged as one of the most important causes of flu-like illness in travelers returning from Southern Africa. The presence of one or multiple eschars of inoculation is an important clinical clue to the diagnosis. It can be confirmed by serology or by PCR of a biopsy of the eschar. Culture can also be done in reference laboratories. Dermatologists and primary care physicians should know this clinical entity, since an inexpensive and efficient treatment is available. PMID:20233665

  11. [Maculopathy and dengue fever].

    PubMed

    Jellab, B; Fardeau, C; Lehoang, P

    2013-01-01

    The authors report a case of a 20 year old female who presented a bilateral decrease in vision. Detailed history revealed that 15 days before the onset of symptoms, the patient presented a dengue fever during her stay in Martinique. On initial examination, the fundus exam revealed a bilateral loss of foveal reflection. The optical coherence tomography demonstrated the macular edema and the dengue serology was postive. The patient received an interferon2a-based therapy. The macular edema disappeared and we noticed a partial but fast improvement of visual acuity 12 days after the treatment initiation. PMID:24923080

  12. 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

    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

    2012-01-01

    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

  13. Fever,Weight Loss and Early Satiety due to Gastric Inflammatory Myofibroblastic Tumor; Case Report and Literature Review.

    PubMed

    Mohammad Hoseini-Azar, Mohammadreza; Mokhtare, Marjan; Zare-Mirzaie, Ali; Gholami, Abbas; Agah, Shahram; Ghafoori, Seyed Mohammad Sadegh

    2016-04-01

    Gastric inflammatory myofibroblastic tumor (IMT) is a rare tumor with and unpredictable prognosis usually find in young adults. We present an 18-yearold man with gastric IMT. He complained of epigastric pain, intermittent fever and night sweating associated with weight loss since two years ago. Physical examination showed anemic and cachestic features with mild abdominal tenderness in palpitation as well as an abdominal mass in epigastrium. Abdominal CT scan revealed a huge mass that was arising from the stomach. Upper endoscopy revealed a submucosal lesion in fundus of stomach of approximately 8cm. Endoscopic ultrasound showed a large sub-mucosal non homogenous fundal mass with areas of calcification. The patient underwent laparoscopic partial gastrectomy. Histopathologyand immunohistochemistryevaluation revealed an IMT. PMID:27252821

  14. Fever,Weight Loss and Early Satiety due to Gastric Inflammatory Myofibroblastic Tumor; Case Report and Literature Review

    PubMed Central

    Mohammad Hoseini-Azar, Mohammadreza; Mokhtare, Marjan; Zare-Mirzaie, Ali; Gholami, Abbas; Agah, Shahram; Ghafoori, Seyed Mohammad Sadegh

    2016-01-01

    Gastric inflammatory myofibroblastic tumor (IMT) is a rare tumor with and unpredictable prognosis usually find in young adults. We present an 18-yearold man with gastric IMT. He complained of epigastric pain, intermittent fever and night sweating associated with weight loss since two years ago. Physical examination showed anemic and cachestic features with mild abdominal tenderness in palpitation as well as an abdominal mass in epigastrium. Abdominal CT scan revealed a huge mass that was arising from the stomach. Upper endoscopy revealed a submucosal lesion in fundus of stomach of approximately 8cm. Endoscopic ultrasound showed a large sub-mucosal non homogenous fundal mass with areas of calcification. The patient underwent laparoscopic partial gastrectomy. Histopathologyand immunohistochemistryevaluation revealed an IMT. PMID:27252821

  15. Rat Bite Fever Resembling Rheumatoid Arthritis.

    PubMed

    Akter, Ripa; Boland, Paul; Daley, Peter; Rahman, Proton; Al Ghanim, Nayef

    2016-01-01

    Rat bite fever is rare in Western countries. It can be very difficult to diagnose as blood cultures are typically negative and a history of rodent exposure is often missed. Unless a high index of suspicion is maintained, the associated polyarthritis can be mistaken for rheumatoid arthritis. We report a case of culture-positive rat bite fever in a 46-year-old female presenting with fever and polyarthritis. The clinical presentation mimicked rheumatoid arthritis. Infection was complicated by discitis, a rare manifestation. We discuss the diagnosis and management of this rare zoonotic infection. We also review nine reported cases of rat bite fever, all of which had an initial presumptive diagnosis of a rheumatological disorder. Rat bite fever is a potentially curable infection but can have a lethal course if left untreated. PMID:27366177

  16. Rat Bite Fever Resembling Rheumatoid Arthritis

    PubMed Central

    Akter, Ripa; Boland, Paul; Daley, Peter; Rahman, Proton; Al Ghanim, Nayef

    2016-01-01

    Rat bite fever is rare in Western countries. It can be very difficult to diagnose as blood cultures are typically negative and a history of rodent exposure is often missed. Unless a high index of suspicion is maintained, the associated polyarthritis can be mistaken for rheumatoid arthritis. We report a case of culture-positive rat bite fever in a 46-year-old female presenting with fever and polyarthritis. The clinical presentation mimicked rheumatoid arthritis. Infection was complicated by discitis, a rare manifestation. We discuss the diagnosis and management of this rare zoonotic infection. We also review nine reported cases of rat bite fever, all of which had an initial presumptive diagnosis of a rheumatological disorder. Rat bite fever is a potentially curable infection but can have a lethal course if left untreated. PMID:27366177

  17. Dengue fever: a Wikipedia clinical review.

    PubMed

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

    2014-01-01

    Dengue fever, also known as breakbone fever, is a mosquito-borne infectious tropical disease caused by the dengue virus. Symptoms include fever, headache, muscle and joint pains, and a characteristic skin rash that is similar to measles. In a small proportion of cases, the disease develops into life-threatening dengue hemorrhagic fever, which results in bleeding, thrombocytopenia, and leakage of blood plasma, or into dengue shock syndrome, in which dangerously low blood pressure occurs. Treatment of acute dengue fever is supportive, with either oral or intravenous rehydration for mild or moderate disease and use of intravenous fluids and blood transfusion for more severe cases. Along with attempts to eliminate the mosquito vector, work is ongoing to develop a vaccine and medications targeted directly at the virus. PMID:25426178

  18. Blackwater fever in children, Burundi.

    PubMed

    Gobbi, Federico; Audagnotto, Sabrina; Trentini, Laura; Nkurunziza, Innocent; Corachan, Manuel; Di Perri, Giovanni

    2005-07-01

    Blackwater fever is characterized by acute intravascular hemolysis with hemoglobinuria in patients with Plasmodium falciparum malaria. Its pathogenesis and management are still debated. Nine cases of this syndrome occurred in 2003 at Kiremba Hospital in Burundi in children receiving multiple quinine treatments. PMID:16022794

  19. Unusual Presentation of Anaplastic Large Cell Lymphoma with Clinical Course Mimicking Fever of Unknown Origin and Sepsis: Autopsy Study of Five Cases

    PubMed Central

    Mosunjac, Marina B.; Sundstrom, J. Bruce; Mosunjac, Mario I.

    2008-01-01

    Aim To describe a subset of cases with the unusual clinical and histomorphological presentation of anaplastic large cell lymphoma (ALCL) mimicking fever of unknown origin (FUO) and sepsis. Methods A pathology database was searched using full term Systematized Nomenclature of Medicine codes for ALCL to identify 23ALCL cases from the period 1999-2006. Of those, five cases that did not have a correct premortem diagnosis were further analyzed to elucidate the reasons for delayed and incorrect pre-mortem diagnosis. The analyzed data included clinical presentation, duration of symptoms, duration of hospital stay, premortem presumed cause of death, white blood cell count, platelet count, anion gap and blood pH, liver enzymes (alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, alkaline phosphatase), lactate, coagulation tests (prothrombin time, partial thromboplastin time, fibrinogen, D-dimers), microbiology cultures, and radiology and surgical pathology reports. Autopsy reports were reviewed for description of major gross findings, initial clinical diagnosis, and cause of death. Results Five fatal and pre-mortem unrecognized ALCL cases were characterized by rapid decline, with histologic findings showing predominantly extranodal involvement, intravascular lymphomatosis, and hemophagocytosis. The cases were also characterized by unusual clinical manifestations including a FUO, sepsis, and disseminated intravascular coagulation-like picture, lactic acidosis, hepatosplenomegaly, and absence of significant peripheral adenopathy. Conclusions There is a distinct group of ALCLs with unique and specific clinical, gross autopsy, and histopathologic findings. Recognition of this clinical variant may facilitate early detection and potentially timely diagnosis and therapy. PMID:18925700

  20. Severe toxicity of skin rash, fever and diarrhea associated with imatinib: case report and review of skin toxicities associated with tyrosine kinase inhibitors

    PubMed Central

    Huang, Xuan; Patel, Samir; Ahmed, Nasir; Seiter, Karen; Liu, Delong

    2008-01-01

    Chronic myeloid leukemia (CML) is characterized by a Philadelphia chromosome which contains an oncogene, bcr-abl. This oncogene encodes a tyrosine kinase which is constitutively activated. Imatinib, a tyrosine kinase inhibitor (TKI), has been widely used in the treatment of CML. Dasatinib and nilotinib were recently approved for the treatment of CML. Other TKIs, such as bosutinib, erlotinib, and sunitinib, are under study for the treatment of CML as well as other hematologic and solid malignancies. Skin rash has been reported as one of the most common side effects of the TKIs. Here we present a case of severe skin rash together with unusual symptoms of high fever and diarrhea induced by imatinib in a CML patient. The dermatologic toxicities from a variety of tyrosine kinase inhibitors are reviewed and general principles of management are also discussed. PMID:19920908

  1. Fever in a traveler returning from the Amazon. Do not forget hepatitis A.

    PubMed

    Cunha, Burke A; Teper, Rina Seerke; Raza, Muhammad

    2016-01-01

    Travelers returning from the tropics with fever remain a diagnostic challenge. Fever and chills suggest malaria, but may be present in dengue, chikungunya and influenza, and splenomegaly favors malaria or typhoid fever. In terms of laboratory tests, leukopenia suggests dengue fever, chikungunya fever or influenza. Atypical lymphocytes are present in malaria, dengue fever, chikungunya fever and influenza HAV, but not typhoid fever. Thrombocytopenia is profound in dengue fever, is also present in influenza and malaria. Mildly increased serum transaminases are common in malaria, typhoid fever, dengue fever, chikungunya fever and influenza while very high serum transaminases point to HAV. We present a case of a young woman traveler returning from the Amazon with splenomegaly, leukopenia, atypical lymphocytes, elevated LDH and minimally elevated serum transaminases who was found to have acute hepatitis A infection. PMID:27051578

  2. Rocky Mountain spotted fever

    MedlinePlus

    Rocky Mountain spotted fever is a disease caused by a type of bacteria carried by ticks. ... Rocky Mountain spotted fever is caused by the bacteria Rickettsia rickettsii (R. Rickettsii) , which is carried by ticks. The ...

  3. Viral Hemorrhagic Fevers

    MedlinePlus

    ... Fever with Renal Syndrome Hendra Virus Disease Kyasanur Forest Disease Lassa Fever Lymphocytic Choriomeningitis (LCM) Marburg Hemorrhagic ... the rodent species carrying several of the New World arenaviruses, live in geographically restricted areas. Therefore, the ...

  4. Colorado tick fever

    MedlinePlus

    ... immediately by using tweezers, pulling carefully and steadily. Insect repellent may be helpful. Alternative Names Mountain tick fever; ... chap 51. Read More Acute Encephalitis Fever Incidence Insect bites and stings Update Date 12/7/2014 Updated by: Jatin ...

  5. Rocky Mountain spotted fever

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/000654.htm Rocky Mountain spotted fever To use the sharing features on this page, please enable JavaScript. Rocky Mountain spotted fever is a disease caused by a ...

  6. Haemorrhagic Fevers, Viral

    MedlinePlus

    ... fever, dengue, Omsk haemorrhagic fever, Kyasanur forest disease). Ebola virus disease outbreak in West Africa in 2014-2015 All information on Ebola virus disease Ebola features map Dashboard - Progress update ...

  7. Rat-bite fever

    MedlinePlus

    ... infection. Symptoms due to Streptobacillus moniliformis may include: Chills Fever Joint pain, redness, or swelling Rash Symptoms due to Spirillum minus may include: Chills Fever Open sore at the site of the ...

  8. Unusual Presentation of Dengue Fever Leading to Unnecessary Appendectomy

    PubMed Central

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

    2015-01-01

    Dengue fever is the most important arbovirus illness with an estimated incidence of 50–100 million cases per year. The common symptoms of dengue include fever, rash, malaise, nausea, vomiting, and musculoskeletal pain. Dengue fever may present as acute abdomen leading to diagnostic dilemma. The acute surgical complications of dengue fever include acute pancreatitis, acute acalculous cholecystitis, nonspecific peritonitis, and acute appendicitis. We report a case of dengue fever that mimicked acute appendicitis leading to unnecessary appendectomy. A careful history examination for dengue-related signs, and serial hemogram over the first 3-4 days of disease may prevent unnecessary appendectomy. PMID:26167314

  9. Unusual Presentation of Dengue Fever Leading to Unnecessary Appendectomy.

    PubMed

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

    2015-01-01

    Dengue fever is the most important arbovirus illness with an estimated incidence of 50-100 million cases per year. The common symptoms of dengue include fever, rash, malaise, nausea, vomiting, and musculoskeletal pain. Dengue fever may present as acute abdomen leading to diagnostic dilemma. The acute surgical complications of dengue fever include acute pancreatitis, acute acalculous cholecystitis, nonspecific peritonitis, and acute appendicitis. We report a case of dengue fever that mimicked acute appendicitis leading to unnecessary appendectomy. A careful history examination for dengue-related signs, and serial hemogram over the first 3-4 days of disease may prevent unnecessary appendectomy. PMID:26167314

  10. Groundwater flow and geochemistry in the lower reaches of the Yellow River: a case study in Shandang Province, China

    NASA Astrophysics Data System (ADS)

    Chen, J. Y.; Tang, C. Y.; Sakura, Y.; Kondoh, A.; Shen, Y. J.

    2002-08-01

    Water samples were collected from the Yellow River and from wells for chemical and isotopic measurement in the counties of Yucheng and Qihe, to which 6-9×108 m3 of water is diverted annually from the Yellow River. A zone of high electrical conductivity (EC) in groundwater corresponds well on the regional scale with a ridge in groundwater level, which is the main flow path through the region, but has a low gradient. The zone of highest EC along this ridge occurs at a position with the lowest ground altitude in the study area. The unique characteristic of the groundwater is the linear relationship among the principal anions as the result of mixing. The mixing effect is confirmed by its isotopic signature, which was then used to calculate the contributions from three sources: rainfall, old water, and diverted water with an average mixing rate of 18, 17, and 65%, respectively. As an indicator of water movement, Cl- content varies across a wide range in the profile from 30-10 m with a maximum concentration at about 1.2 m depth. Concentrations are relatively stable at about 2 m, which is the average boundary of the saturated and unsaturated zone. The water from the Yellow River has proved to be dominant in mixing in the aquifer in terms of groundwater flow and geochemistry. Résumé. En vue d'analyses chimiques et isotopiques, des échantillons d'eau ont été prélevés sur le Fleuve Jaune et dans des puits des comtés de Yucheng et Qihe, où l'on prélève sur le fleuve 6-9×108 m3. Une zone de forte conductivité électrique dans la nappe correspond bien, à l'échelle régionale, avec une crête piézométrique liée au principal canal traversant la région, mais avec une faible pente. La zone de plus fortes conductivités le long de cette crête se situe là où l'altitude est la plus basse dans la région. La caractéristique remarquable de la nappe est la relation linéaire entre les principaux anions, résultant d'un mélange. L'effet de mélange est confirm

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

    PubMed Central

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

    2009-01-01

    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. PMID:20052381

  12. Fever management: Evidence vs current practice

    PubMed Central

    El-Radhi, A Sahib Mehdi

    2012-01-01

    Fever is a very common complaint in children and is the single most common non-trauma-related reason for a visit to the emergency department. Parents are concerned about fever and it’s potential complications. The biological value of fever (i.e., whether it is beneficial or harmful) is disputed and it is being vigorously treated with the belief of preventing complications such as brain injury and febrile seizures. The practice of alternating antipyretics has become widespread at home and on paediatric wards without supporting scientific evidence. There is still a significant contrast between the current concept and practice, and the scientific evidence. Why is that the case in such a common complaint like fever The article will discuss the significant contrast between the current concepts and practice of fever management on one hand, and the scientific evidence against such concepts and practice. PMID:25254165

  13. [A mild blackwater fever].

    PubMed

    Bouldouyre, M-A; Dia, D; Carmoi, T; Fall, K Ba; Chevalier, B; Debonne, J-M

    2006-06-01

    We report a highly probable case of moderately severe blackwater fever. A French woman, living in Guinea Bissau, was used to taking self-medication halofantrine for malaria. On this occasion, she felt unusual chills and pyrexia after a non documented bout of malaria, followed by nausea, then jaundice with dark-red urines despite another treatment with halofantrine. A sepsis was eliminated by two negatives thick peripheral blood drop examinations. Hemolysis was noted with 8.1 g/dl of hemoglobin, Coombs positive, and LDH at 1,452 IU/l, associated to renal failure with 34 ml per minute of clearance. The outcome was favourable with rehydration. Blackwater fever has been described with the three aminoalcohols, but mainly in severe presentations. Clinicians are not familiar with this disease, even though it has major therapeutic implications: quinine, halofantrine, and mefloquine become strictly contra-indicated. Moderate forms may be unknown, and this observation should be taken into account to prevent mistreatment in future patients. PMID:16806779

  14. Typhoid and paratyphoid fever.

    PubMed

    Bhan, M K; Bahl, Rajiv; Bhatnagar, Shinjini

    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 to fluoroquinolones despite disc sensitivity. Developments are being made in our understanding of the molecular pathogenesis, and genomic and proteomic studies reveal the possibility of new targets for diagnosis and treatment. Further, we review guidelines for use of diagnostic tests and for selection of antimicrobials in varying clinical situations. The importance of safe water, sanitation, and immunisation in the presence of increasing antibiotic resistance is paramount. Routine immunisation of school-age children with Vi or Ty21a vaccine is recommended for countries endemic for typhoid. Vi vaccine should be used for 2-5 year-old children in highly endemic settings. PMID:16125594

  15. Serodiagnosis of Acute Typhoid Fever in Nigerian Pediatric Cases by Detection of Serum IgA and IgG Against Hemolysin E and Lipopolysaccharide.

    PubMed

    Davies, D Huw; Jain, Aarti; Nakajima, Rie; Liang, Li; Jasinskis, Algis; Supnet, Medalyn; Felgner, Philip L; Teng, Andy; Pablo, Jozelyn; Molina, Douglas M; Obaro, Stephen K

    2016-08-01

    Inexpensive, easy-to-use, and highly sensitive diagnostic tests are currently unavailable for typhoid fever. To identify candidate serodiagnostic markers, we have probed microarrays displaying the full Salmonella enterica serovar Typhi (S. Typhi) proteome of 4,352 different proteins + lipopolysaccharides (LPSs), with sera from Nigerian pediatric typhoid and other febrile cases, Nigerian healthy controls, and healthy U.S. adults. Nigerian antibody profiles were broad (∼500 seropositive antigens) and mainly low level, with a small number of stronger "hits," whereas the profile in U.S. adults was < 1/5 as broad, consistent with endemic exposure in Nigeria. Nigerian profiles were largely unaffected by clinical diagnosis, although the response against t1477 (hemolysin E) consistently emerged as stronger in typhoid cases. The response to LPS was also a strong discriminator of healthy controls and typhoid, although LPS did not discriminate between typhoid and nontyphoidal Salmonella (NTS) disease. As a first step toward the development of a point-of-care diagnostic, t1477 and LPS were evaluated on immunostrips. Both provided good discrimination between healthy controls and typhoid/NTS disease. Such a test could provide a useful screen for salmonellosis (typhoid and NTS disease) in suspected pediatric cases that present with undefined febrile disease. PMID:27215295

  16. Q fever in maritime Canada.

    PubMed Central

    Marrie, T. J.; Haldane, E. V.; Noble, M. A.; Faulkner, R. S.; Lee, S. H.; Gough, D.; Meyers, S.; Stewart, J.

    1982-01-01

    Only nine cases of Q fever were recorded in Canada in the 20 years prior to 1978. In the 18 months from August 1979 to January 1981 the disease was diagnosed serologically in six patients from the Maritime provinces. All were epidemiologically unrelated and none had been exposed to animals. Five had pneumonia and one had chronic Q fever with probable prosthetic valve endocarditis. Three of the five pneumonia patients presented with signs and symptoms of an acute lower respiratory tract infection and were indistinguishable clinically from other patients with atypical pneumonias. The other two with pneumonia presented with nonresolving pulmonary infiltrates and complained of decreased energy. Four of the five pneumonia patients responded well to treatment with erythromycin; the fifth required two courses of tetracycline. The patient with chronic Q fever had a large amount of cryoglobulins in his serum and evidence of immune complex disease. These cases indicate that Q fever should be considered as a possible cause of atypical pneumonia in Canada. Images FIG. 1 FIG. 2 FIG. 3 PMID:7074457

  17. [A case of HIV-1 and HHV-8-associated Castleman disease with a relapsing high fever and lymphoadenopathy].

    PubMed

    Minami, Rumi; Yamamoto, Masahiro

    2006-07-01

    A 48-year-old man infected with an HIV-1 experienced intermittent bouts of fever, lymphadenopathy, elevated CRP level, and thrombocytopenia, each lasting about 2 weeks, and recurring at 2-3 month intervals. His CD4 count was about 500/microL, and he had never received antiretroviral therapy (ART). In March 2005, he experienced the same symptoms, accompanied by liver damage, splenomegaly, pleural fluid, and a high serum soluble IL-2 receptor level. Examination of a cervical lymph node specimen resulted in a diagnosis of Castleman disease, plasma cell type. Immunohistochemical studies confirmed the presence of HHV-8 and Ebstein-Barr virus (EBV). Since the plasma HHV-8 DNA and serum IL-6 were elevated during the flare-up, were negative between episodes, he was treated with ART to control the Castleman disease. He remained asymptomatic for 3 months, but, similar symptoms recurred with a high level of HHV-8 DNA in his PBMCs. Oral valganciclovir was them started at 1,800 mg twice daily, and his symptoms immediately improved. The HHV-8 DNA level in the PBMCs decreased markedly over the course of 4 weeks, and valganciclovir was discontinued. One week later, he experienced another flare-up, and was successfully treated with 10 days of valganciclovir 1,800 mg, followed by maintenance with valganciclovir 900 mg. ART was discontinued, because the valganciclovir plus ART caused severe fatigue. No subsequent flare-ups have been observed, and, no HHV-8 DNA has been detected in his PBMCs. Castleman disease is an unusual complication in patients with HIV-1 and HHV-8 infection, but it should be included in the differential diagnosis of patients who exhibit a relapsing systemic inflammatory syndrome and lymphoadenopathy. Further study is needed to determine the appropriate usage and timing of the anti-HHV-8 and HIV-1 medication. PMID:16922487

  18. Acute Q fever in southern Taiwan: atypical manifestations of hyperbilirubinemia and prolonged fever.

    PubMed

    Chang, Ko; Lee, Nan-Yao; Chen, Yen-Hsu; Lee, Hsin-Chun; Lu, Po-Liang; Chang, Chia-Ming; Wu, Chi-Jung; Chen, Tun-Chieh; Hsieh, Hsiao-Chen; Ko, Wen-Chien

    2008-02-01

    The clinical information of acute Q fever in Taiwan was limited. A clinical study of 109 adults with serologically documented acute Q fever in the past decade (1994-2005) at 3 referral hospitals in southern Taiwan was reported. Their clinical manifestations, laboratory findings, and clinical outcomes were analyzed. Males predominated (98, 90%). There is a significant correlation between monthly average temperature and case numbers of acute Q fever (r = 0.74, P = 0.006). Fever (99%), chills (69%), and headache (45%) were the common symptoms, and relative bradycardia (44/60, 73 %) was often noted. Acute hepatitis, defined as either serum aspartate aminotransferase >or=60 IU/L or alanine aminotransferase >or=78 IU/L, was found in 88 (85%) cases, and more than one-third (31/87, 36%) had hyperbilirubinemia (serum total bilirubin >or=1.4 mg/dL) at initial presentation. The intervals between initiation of appropriate therapy to defervescence were longer in patients with hyperbilirubinemia than those without hyperbilirubinemia, irrespective of tetracycline or fluoroquinolone therapy. Of note, 8 (7.3%) cases experienced a prolonged period of fever (>28 days). In southern Taiwan, the predominant presentation of acute Q fever is acute febrile illness with hepatitis with or without jaundice. Acute Q fever should be added to the list of differential diagnoses of patients with fever, headache, relative bradycardia, elevated serum aminotransferase levels, or prolongation of activated partial thromboplastin time, irrespective of jaundice. PMID:17949935

  19. Association between sequence variations of the Mediterranean fever gene and the risk of migraine: a case-control study.

    PubMed

    Coşkun, Salih; Varol, Sefer; Özdemir, Hasan H; Çelik, Sercan Bulut; Balduz, Metin; Camkurt, Mehmet Akif; Çim, Abdullah; Arslan, Demet; Çevik, Mehmet Uğur

    2016-01-01

    Migraine pathogenesis involves a complex interaction between hormones, neurotransmitters, and inflammatory pathways, which also influence the migraine phenotype. The Mediterranean fever gene (MEFV) encodes the pyrin protein. The major role of pyrin appears to be in the regulation of inflammation activity and the processing of the cytokine pro-interleukin-1β, and this cytokine plays a part in migraine pathogenesis. This study included 220 migraine patients and 228 healthy controls. Eight common missense mutations of the MEFV gene, known as M694V, M694I, M680I, V726A, R761H, K695R, P369S, and E148Q, were genotyped using real-time polymerase chain reaction with 5' nuclease assays, which include sequence specific primers, and probes with a reporter dye. When mutations were evaluated separately among the patient and control groups, only the heterozygote E148Q carrier was found to be significantly higher in the control group than in the patient group (P=0.029, odds ratio [95% confidence interval] =0.45 [0.21-0.94]). In addition, the frequency of the homozygote and the compound heterozygote genotype carrier was found to be significantly higher in patients (n=8, 3.6%) than in the control group (n=1, 0.4%) (P=0.016, odds ratio [95% confidence interval] =8.57 [1.06-69.07]). However, there was no statistically significant difference in the allele frequencies of MEFV mutations between the patients and the healthy control group (P=0.964). In conclusion, the results of the present study suggest that biallelic mutations in the MEFV gene could be associated with a risk of migraine in the Turkish population. Moreover, MEFV mutations could be related to increased frequency and short durations of migraine attacks (P=0.043 and P=0.021, respectively). Future studies in larger groups and expression analysis of MEFV are required to clarify the role of the MEFV gene in migraine susceptibility. PMID:27621632

  20. Knowledge and behavior in an animal disease outbreak - Evidence from the item count technique in a case of African swine fever in Madagascar.

    PubMed

    Randrianantoandro, Tiana N; Kono, Hiroichi; Kubota, Satoko

    2015-03-01

    Pig production in Madagascar is not sufficient for domestic consumption. Unfortunately, African swine fever (ASF), which is a severe disease, is endemic in Madagascar and constitutes a constant threat for farmers. Therefore, ASF must be eradicated in order to guarantee the development of pig production. One of the main strategies in controlling ASF is stamping out which requires the farmers' collaboration in reporting cases or suspected cases. The objective of this study was to estimate the proportion of farmers who knowingly sell ASF-infected meat without reporting. Since selling ASF-infected meat is prohibited by the government, we used the item count technique (ICT), an indirect questioning technique appropriate for measuring the proportion of people engaged in sensitive behavior, for one subsample, while another subsample was asked directly whether they sell ASF-infected meat. Based on the ICT, approximately 73.2% of farmers who have experienced ASF sell the ASF-infected meat. This estimate was not statistically different from that obtained by direct questioning. In the 28% of interviewed farmers who believe ASF can affect humans, the ICT yielded a higher estimate than did direct questioning, indicating that pig farmers who sell ASF-infected meat hide that fact because of their belief that infected meat might harm human consumers, not because of the law. The ICT was thus a suitable technique to address the problem of sensitive behavior. In the case of ASF outbreaks, the Malagasy government should enforce the law more strictly and provide compensation as incentive for reporting cases. PMID:25591977

  1. Systematic Epstein-Barr virus-positive T-cell lymphoproliferative disease presenting as a persistent fever and cough: a case report

    PubMed Central

    2014-01-01

    Introduction Systemic Epstein-Barr virus-positive T-cell lymphoproliferative childhood disease is an extremely rare disorder and classically arises following primary acute or chronic active Epstein-Barr virus infection. It is characterized by clonal proliferation of Epstein-Barr virus-infected T-cells with an activated cytotoxic phenotype. This disease has a rapid clinical course and is more frequent in Asia and South America, with relatively few cases being reported in Western countries. The clinical and pathological features of the disease overlap with other conditions including infectious mononucleosis, chronic active Epstein-Barr virus infection, hemophagocytic lymphohistiocytosis and natural killer cell malignancies. We describe the rare case of systemic Epstein-Barr virus-positive T-cell lymphoproliferative childhood disease in a 16-year-old Malay boy. Case presentation He presented with a six-month history of fever and cough, with pulmonary and mediastinal lymphadenopathy and severe pancytopenia. Medium- to large-sized, CD8+ and Epstein-Barr virus-encoded RNA-positive atypical lymphoid cells were present in the bone marrow aspirate. He subsequently developed fatal virus-associated hemophagocytic syndrome and died due to sepsis and multiorgan failure. Conclusions Although systemic Epstein-Barr virus-positive T-cell lymphoproliferative childhood disease is a disorder which is rarely encountered in clinical practice, our case report underlines the importance of a comprehensive diagnostic approach in the management of this disease. A high level of awareness of the disease throughout the diagnosis process for young patients who present with systemic illness and hemophagocytic syndrome may be of great help for the clinical diagnosis of this disease. PMID:25163591

  2. Barley Yellow Dwarf Virus

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Barley yellow dwarf (BYD) is the most widespread and economically important virus disease of cereals. The viruses causing BYD were initially grouped based on common biological properties, including persistent and often strain-specific transmission by aphids and induction of yellowing symptoms. The...

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

    PubMed Central

    Honarmand, Hamidreza

    2012-01-01

    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. PMID:23213331

  4. Q Fever: an old but still a poorly understood disease.

    PubMed

    Honarmand, Hamidreza

    2012-01-01

    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. PMID:23213331

  5. [Fever in returning travelers].

    PubMed

    Burchard, G

    2014-03-01

    Travel-related illness is most often due to gastrointestinal, febrile, and dermatologic diseases. Fever in a returned traveler demands prompt attention because it may be a manifestation of an infection that could be rapidly progressive and lethal. The approach to the febrile patient should be stepwise and consider travel and exposure history. Malaria is the most common cause of fever in patients returning from Sub-Saharan Africa, whereas dengue is more frequent in travelers from other tropical and subtropical areas. Other serious diseases are typhoid and paratyphoid fever, amebic liver abscess, visceral leishmaniasis, leptospirosis and-rarely-viral hemorrhagic fevers. PMID:24557143

  6. Moxalactam in the treatment of typhoid fever.

    PubMed Central

    Uwaydah, M; Vartivarian, S; Shatila, S; Raad, I; Harakeh, H; Nassar, N T

    1986-01-01

    Moxalactam therapy was evaluated in 25 patients with typhoid fever. A satisfactory initial response was observed in all cases. Treatment for 3 days resulted in a much higher relapse rate (three of five patients) than did treatment for 5 days (one of nine patients). None of the 11 patients treated for 10 to 11 days relapsed. Moxalactam is effective in typhoid fever, but its use is better restricted to special indications. PMID:3532946

  7. An Unusual Manifestation of Q Fever: Peritonitis.

    PubMed

    Yılmaz, Gülden; Öztürk, Bengi; Memikoğlu, Osman; Coşkun, Belgin; Yalçı, Aysun; Metin, Özge; Ünal, Hatice; Kurt, Halil

    2015-01-01

    Q fever has rarely been reported and can be difficult to diagnose, especially in immunocompromised patients. In the present report, we describe an unusual case of Q fever that presented as peritonitis and was treated with long-term combination therapy with doxycycline, ciprofloxacin and rifampicin for five weeks in a patient who had been on peritoneal dialysis for six years due to hypertensive nephropathy. PMID:25899561

  8. Non-destructive identification of green and yellow pigments: the case of some Sicilian Renaissance glazed pottery

    NASA Astrophysics Data System (ADS)

    Crupi, V.; Majolino, D.; Venuti, V.; Barone, G.; Mazzoleni, P.; Pezzino, A.; La Russa, M. F.; Ruffolo, S. A.; Bardelli, F.

    2010-09-01

    Selected decorated Renaissance ceramic fragments, found during the excavation of a Sicilian archaeological site (Caltagirone, Sicily, South Italy), have been studied by combining scanning electron microscopy (SEM), energy-dispersive X-ray spectrometry (EDS), and X-ray absorbance spectroscopy (XAS). The study was aimed at providing microchemical and microstructural characterization of the colored glazed coatings in order to elucidate the nature of the pigments in the decorative layers, and in the glaze itself. From the obtained results, the general perspective has been the identification of information to be used for a reliable recognition of the production techniques. In particular, XAS measurements, performed using synchrotron radiation (SR) as the source at the Cu K-edge, in the case of green decorations, provided structural information of the oxidation states and the local chemical environment of copper (neighboring atoms and bond distances).

  9. Nasal NK/T cell lymphoma presents with long-term nasal blockage and fever: a rare case report and literature review

    PubMed Central

    Zou, Hai; Pan, Ke-Hua; Wu, Liang; Pan, Hong-Ying; Ding, Ya-Hui; Zheng, Ming-Hua

    2016-01-01

    NK/T cell lymphoma (NKTCL) is a common disease which is a threat to human health. Nasal NKTCL is a rare but serious type of systemic lymphoma because of its high mortality rate and serious complications. In this case report, we describe a male who presented with nasal blockage in the right side, a fever of one month duration and a soy-like, painless and gradually increasing mass in the right submandibular region due to nasal NKTCL. The patient had no significant medical history and the initial clinical symptoms were nasal blockage. Contrast computed tomography showed that the nasopharyngeal mucosa was thickened and that the celiac and retroperitoneal lymphaden was intumescent. Finally a biopsy, guided by nasal endoscopy and examined using flow cytometry confirmed a diagnosis of NKTCL. Nasal NKTCL is rare and has no unique characteristics at first presentation, such as epidemiology and obvious clinical manifestation. As no effective therapy is currently available for this disease, early diagnosis and therapy of nasal NKTCL remains challenging. PMID:26885897

  10. 9 CFR 96.2 - Prohibition of casings due to African swine fever and bovine spongiform encephalopathy.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Meat Inspection Act (21 U.S.C. 601 et seq.) and regulations under the Act (9 CFR, chapter III, part 327... Drug Administration at 21 CFR 589.2000 may be imported. (2) Casings that are derived from bovines that... Safety and Inspection Service at 9 CFR 310.22 and the Food and Drug Administration at 21 CFR 189.5....

  11. 9 CFR 96.2 - Prohibition of casings due to African swine fever and bovine spongiform encephalopathy.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... et seq.) and regulations under the Act (9 CFR, chapter III, part 327), including requirements that... Drug Administration at 21 CFR 589.2000 may be imported. (2) Casings that are derived from bovines that... Safety and Inspection Service at 9 CFR 310.22 and the Food and Drug Administration at 21 CFR 189.5....

  12. 9 CFR 96.2 - Prohibition of casings due to African swine fever and bovine spongiform encephalopathy.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Meat Inspection Act (21 U.S.C. 601 et seq.) and regulations under the Act (9 CFR, chapter III, part 327... Drug Administration at 21 CFR 589.2000 may be imported. (2) Casings that are derived from bovines that... Safety and Inspection Service at 9 CFR 310.22 and the Food and Drug Administration at 21 CFR 189.5....

  13. 9 CFR 96.2 - Prohibition of casings due to African swine fever and bovine spongiform encephalopathy.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... et seq.) and regulations under the Act (9 CFR, chapter III, part 327), including requirements that... Drug Administration at 21 CFR 589.2000 may be imported. (2) Casings that are derived from bovines that... Safety and Inspection Service at 9 CFR 310.22 and the Food and Drug Administration at 21 CFR 189.5....

  14. 9 CFR 96.2 - Prohibition of casings due to African swine fever and bovine spongiform encephalopathy.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... et seq.) and regulations under the Act (9 CFR, chapter III, part 327), including requirements that... Drug Administration at 21 CFR 589.2000 may be imported. (2) Casings that are derived from bovines that... Safety and Inspection Service at 9 CFR 310.22 and the Food and Drug Administration at 21 CFR 189.5....

  15. A renal transplant recipient with delayed gastric emptying in amyloidosis due to familial Mediterranean fever improved with erythromycin: a case report.

    PubMed

    Saglam, F; Celik, A; Cavdar, C; Sifil, A; Atila, K; Kaya, G C; Bora, S; Gulay, H; Camsari, T

    2008-01-01

    Patients with systemic amyloidosis often have symptoms related to impared gastrointestinal motility due to delayed gastric emptying, which results from autonomic nerve or smooth muscle infiltration with amyloid. There is no current report about gastric delaying secondary to amyloidosis due to familial Mediterranean fever. In this report, we have described a renal transplant recipient with delayed gastric emptying secondary to amyloidosis due to familial Mediterranean fever, which improved with erithromycin treatment. PMID:18261613

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

    NASA Astrophysics Data System (ADS)

    Yong, Benny; Samat, Nor Azah

    2016-02-01

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

  17. Rat-bite fever.

    PubMed

    van Nood, E; Peters, S H A

    2005-09-01

    A 23-year-old woman presented with fever, arthralgias and a skin rash. She possessed nine pet rats, and denied that she had been bitten. Blood culture was positive for Streptobacillus moniliformis, which can cause rat-bite fever. The patient fully recovered after treatment with clarithromycin. PMID:16186643

  18. Rift Valley Fever Virus

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Rift Valley fever virus (RVFV) is a mosquito-transmitted virus or arbovirus that is endemic in sub-Saharan Africa. In the last decade, Rift Valley fever (RVF) outbreaks have resulted in loss of human and animal life, as well as had significant economic impact. The disease in livestock is primarily a...

  19. Typhoid fever and invasive nontyphoid salmonellosis, Malawi and South Africa.

    PubMed

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

    2010-09-01

    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. PMID:20735930

  20. Typhoid Fever and Invasive Nontyphoid Salmonellosis, Malawi and South Africa

    PubMed Central

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

    2010-01-01

    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. PMID:20735930