Rationale:Dengue fever is a viral infection that is spread through the bites of infected female Aedes mosquitos.It can cause life threatening complications,including dengue haemorrhagic fever(DHF)and dengue shock synd...Rationale:Dengue fever is a viral infection that is spread through the bites of infected female Aedes mosquitos.It can cause life threatening complications,including dengue haemorrhagic fever(DHF)and dengue shock syndrome.Patient concerns:A 15-year-old male presented with fever and petechiae and later developed hemoptysis.Diagnosis:Dengue fever with DHF with diffuse alveolar hemorrhage.Interventions:Invasive ventilation with high positive end expiratory pressure,multiple transfusions of packed red blood cells,fresh frozen plasma,single donor platelets and inotropic support Outcomes:The patient was stabilized and discharged on minimal supplemental oxygen.Lessons:Diffuse alveolar hemorrhage,although very rare,should be considered in a patient with dengue who presents with hemoptysis.The treatment is directed at providing respiratory and circulatory support,and preventing the progression of microcirculation damage.展开更多
Aedes-borne diseases remain a public health challenge for many countries globally. The extent of spread of invasive species of Aedes mosquitoes and risk of transmission of the diseases especially around the point of e...Aedes-borne diseases remain a public health challenge for many countries globally. The extent of spread of invasive species of Aedes mosquitoes and risk of transmission of the diseases especially around the point of entry of goods such as ports is not well known in Ghana. This study investigated the ecology, distribution and risk of transmission of viral haemorrhagic fevers by Aedes mosquitoes around the port areas of Tema, Southern Ghana. The mosquitoes from this study were collected using human landing catches, ovitraps and larval collections for a period of six months. A total of 1092 containers were inspected in both seasons and of these, 237 (21.7%) were positive for mosquito larvae or pupae in rainy season while 181 (16.6%) were positive in dry season. A total of 6498 mosquitoes were collected and identified morphologically using taxonomic keys. 6038 (92.9%) were Aedes aegypti, 337 (5.2%) were Culex spp. and 123 (1.9%) were Anopheles gambiae. The Ae. aegypti larvae were found breeding in a series of water-holding containers which included disposed plastic containers, earthenware pots, car tyres, plastic barrels, plastic basins, buckets, metal drums, jerrycans and poly tank. A high proportion of Aedes aegypti eggs were found in the ovitraps during the rainy season than in the dry season in the study sites. Ae. aegypti was the most common mosquitoes biting mostly outdoors (65.6%) with more bites occurring in the rainy season (63.6%) in the two residential sites (Tema Community One and Tema New Town). The risk of transmission of viral haemorrhagic fever in the study sites was assessed using House Index, Container Index, Breteau Index and was found to be higher in Tema New town area with seasonal variations within the sites. The man-vector contact rates for the two residential sites were also found to be higher in rainy season than the dry season. These observations indicate that the risk of transmission of viral haemorrhagic fevers in the study areas is high especially in the rainy season. The implications of the findings in the formulation of future vector control programmes around the port areas in the country are discussed in the paper.展开更多
Haemorrhagic fever with renal syndrome (HFRS) is a worldwide epidemic plaguing over thirty nations. This disease has spread across 26 provinces, cities and autonomous regions of China with an annual onsets number ...Haemorrhagic fever with renal syndrome (HFRS) is a worldwide epidemic plaguing over thirty nations. This disease has spread across 26 provinces, cities and autonomous regions of China with an annual onsets number of more than a hundred thousand and a mortality rate of 5% to 15%, accounting for over 80% of cases in the world, and threatening the safety and health of Chinese people. 1 Analysis of serum samples over recent years indicates that the plagued areas are expanding. Instead of a single type Ⅰ or Ⅱ strain, each area now has a combination with one type predominant. 2 These demographic changes revealed a shortcoming of the monovalent vaccine in use, urging China to develop a purified bivalent vaccine based on monovalent one. This research on clinical observation and immunization effects led to a purified bivalent vaccine manufactured by Changchun Institute of Biological Products, China from primary cultured hamster kidney cells.展开更多
Background:In recent years there have been reports of viral haemorrhagic fever(VHF)epidemics in sub-Saharan Africa where malaria is endemic.VHF and malaria have overlapping clinical presentations making diferential di...Background:In recent years there have been reports of viral haemorrhagic fever(VHF)epidemics in sub-Saharan Africa where malaria is endemic.VHF and malaria have overlapping clinical presentations making diferential diagno‑sis a challenge.The objective of this study was to determine the prevalence of selected zoonotic VHFs and malaria co-infections among febrile patients seeking health care in Tanzania.Methods:This facility-based cross-sectional study was carried out between June and November 2018 in Buhigwe,Kalambo,Kyela,Kilindi,Kinondoni,Kondoa,Mvomero,and Ukerewe districts in Tanzania.The study involved febrile patients seeking health care from primary healthcare facilities.Blood samples were collected and tested for infections due to malaria,Crimean-Congo haemorrhagic fever(CCHF),Ebola virus disease(EVD),Marburg virus disease(MVD),Rift Valley fever(RVF)and yellow fever(YF).Malaria infections were tested using rapid diagnostics tests while exposure to VHFs was determined by screening for immunoglobulin M antibodies using commercial enzyme-linked immuno‑sorbent assays.The Chi-square test was used to compare the proportions.Results:A total of 308 participants(mean age=35±19 years)were involved in the study.Of these,54(17.5%)had malaria infection and 15(4.8%)were positive for IgM antibodies against VHFs(RVF=8;CCHF=2;EBV=3;MBV=1;YF=1).Six(1.9%)individuals had both VHF(RVF=2;CCHF=1;EVD=2;MVD=1)and malaria infections.The highest co-infection prevalence(0.6%)was observed among individuals aged 46‒60 years(P<0.05).District was signifcantly associated with co-infection(P<0.05)with the highest prevalence recorded in Buhigwe(1.2%)followed by Kinondoni(0.9%)districts.Headache(100%)and muscle,bone,back and joint pains(83.3%)were the most signifcant complaints among those infected with both VHFs and malaria(P=0.001).Conclusions:Co-infections of VHF and malaria are prevalent in Tanzania and afect more the older than the younger population.Since the overlapping symptoms in co-infected individuals may challenge accurate diagnosis,adequate laboratory diagnosis should be emphasized in the management of febrile illnesses.展开更多
Background:Crimean-Congo haemorrhagic fever(CCHF)is a potentially fatal disease endemic in Pakistan.The causative virus is transmitted by the bite of Hyalomma ticks or by contact with infected blood or tissue.First ca...Background:Crimean-Congo haemorrhagic fever(CCHF)is a potentially fatal disease endemic in Pakistan.The causative virus is transmitted by the bite of Hyalomma ticks or by contact with infected blood or tissue.First cases of the disease were reported in Pakistan in 1976 but regular outbreaks have been observed since the year 2000.A huge agricultural base with more than 175 million livestock,the concomitant presence of Hyalomma ticks and a lack of precautionary measures to prevent transmission lead to a considerable risk for exposed populations to contract CCHF in Pakistan.At the same time,secondary cases contracted by nosocomial transmission are reported from hospitals.Case presentation:Here we present an outbreak of CCHF with four of six patients succumbing to the disease before the suspicion for CCHF was raised.Importantly,the main clinical features of these cases were gastrointestinal symptoms without any clinical signs of bleeding.Only the last two patients in this outbreak presented with typical signs of bleeding disorder and were then confirmed being infected by CCHF.Confirmation of diagnosis was done at the National Institute of Health by real-time RT-PCR.Conclusions:This case series highlights the importance of early clinical suspicion for CCHF in exposed individuals and the need for improved precautionary measures against the spread of CCHF within the Pakistani population and hospitals.展开更多
After the first secondarily-transmitted ebola case in Spain, a wave of divergent opinions flooded mass and sanitary media. Very few of these opinions, however, came from experts on epidemiology or hemorrhagic fevers. ...After the first secondarily-transmitted ebola case in Spain, a wave of divergent opinions flooded mass and sanitary media. Very few of these opinions, however, came from experts on epidemiology or hemorrhagic fevers. This observational study aimed to assess the specific knowledge of Primary Care physicians and nurses about ebola and hemorrhagic fevers by means of analyzing the results obtained from a 5-item self-reported questionnaire dealing on hemorrhagic fevers basic knowledge. Validity and reliability of questionnaire were confirmed by a pilot study. The participants were 138 family doctors and nurses from the 64 public Primary Care centers sited in the North Metropolitan Area of Barcelona (1,400,000 inhab;Catalonia, Spain) taking part in training-the-trainers ebola workshops. Overall, there were 117 (84.8%) respondents out from 138 workshop participants;of them were physicians 61 (51.2%). The main age was 46.7 (8.8) years;stating previous specific knowledge on hemorrhagic fevers 39 (33.3%). On the whole, up to 92 (78.6%) of respondents shown a poor knowledge. Previous specific formation was significantly and independently associated with having proper knowledge (p < 0.001);OR = 8.6 (CI 95%: 3.199 - 23.623). In summary, confusion that accompanied the single secondary-transmitted ebola case in Spain could probably be explained by the existence of a serious gap on hemorrhagic fevers knowledge. More accurate, scientific and formally-presented information should be provided to Primary Care physicians and nurses.展开更多
文摘Rationale:Dengue fever is a viral infection that is spread through the bites of infected female Aedes mosquitos.It can cause life threatening complications,including dengue haemorrhagic fever(DHF)and dengue shock syndrome.Patient concerns:A 15-year-old male presented with fever and petechiae and later developed hemoptysis.Diagnosis:Dengue fever with DHF with diffuse alveolar hemorrhage.Interventions:Invasive ventilation with high positive end expiratory pressure,multiple transfusions of packed red blood cells,fresh frozen plasma,single donor platelets and inotropic support Outcomes:The patient was stabilized and discharged on minimal supplemental oxygen.Lessons:Diffuse alveolar hemorrhage,although very rare,should be considered in a patient with dengue who presents with hemoptysis.The treatment is directed at providing respiratory and circulatory support,and preventing the progression of microcirculation damage.
文摘Aedes-borne diseases remain a public health challenge for many countries globally. The extent of spread of invasive species of Aedes mosquitoes and risk of transmission of the diseases especially around the point of entry of goods such as ports is not well known in Ghana. This study investigated the ecology, distribution and risk of transmission of viral haemorrhagic fevers by Aedes mosquitoes around the port areas of Tema, Southern Ghana. The mosquitoes from this study were collected using human landing catches, ovitraps and larval collections for a period of six months. A total of 1092 containers were inspected in both seasons and of these, 237 (21.7%) were positive for mosquito larvae or pupae in rainy season while 181 (16.6%) were positive in dry season. A total of 6498 mosquitoes were collected and identified morphologically using taxonomic keys. 6038 (92.9%) were Aedes aegypti, 337 (5.2%) were Culex spp. and 123 (1.9%) were Anopheles gambiae. The Ae. aegypti larvae were found breeding in a series of water-holding containers which included disposed plastic containers, earthenware pots, car tyres, plastic barrels, plastic basins, buckets, metal drums, jerrycans and poly tank. A high proportion of Aedes aegypti eggs were found in the ovitraps during the rainy season than in the dry season in the study sites. Ae. aegypti was the most common mosquitoes biting mostly outdoors (65.6%) with more bites occurring in the rainy season (63.6%) in the two residential sites (Tema Community One and Tema New Town). The risk of transmission of viral haemorrhagic fever in the study sites was assessed using House Index, Container Index, Breteau Index and was found to be higher in Tema New town area with seasonal variations within the sites. The man-vector contact rates for the two residential sites were also found to be higher in rainy season than the dry season. These observations indicate that the risk of transmission of viral haemorrhagic fevers in the study areas is high especially in the rainy season. The implications of the findings in the formulation of future vector control programmes around the port areas in the country are discussed in the paper.
文摘Haemorrhagic fever with renal syndrome (HFRS) is a worldwide epidemic plaguing over thirty nations. This disease has spread across 26 provinces, cities and autonomous regions of China with an annual onsets number of more than a hundred thousand and a mortality rate of 5% to 15%, accounting for over 80% of cases in the world, and threatening the safety and health of Chinese people. 1 Analysis of serum samples over recent years indicates that the plagued areas are expanding. Instead of a single type Ⅰ or Ⅱ strain, each area now has a combination with one type predominant. 2 These demographic changes revealed a shortcoming of the monovalent vaccine in use, urging China to develop a purified bivalent vaccine based on monovalent one. This research on clinical observation and immunization effects led to a purified bivalent vaccine manufactured by Changchun Institute of Biological Products, China from primary cultured hamster kidney cells.
文摘Background:In recent years there have been reports of viral haemorrhagic fever(VHF)epidemics in sub-Saharan Africa where malaria is endemic.VHF and malaria have overlapping clinical presentations making diferential diagno‑sis a challenge.The objective of this study was to determine the prevalence of selected zoonotic VHFs and malaria co-infections among febrile patients seeking health care in Tanzania.Methods:This facility-based cross-sectional study was carried out between June and November 2018 in Buhigwe,Kalambo,Kyela,Kilindi,Kinondoni,Kondoa,Mvomero,and Ukerewe districts in Tanzania.The study involved febrile patients seeking health care from primary healthcare facilities.Blood samples were collected and tested for infections due to malaria,Crimean-Congo haemorrhagic fever(CCHF),Ebola virus disease(EVD),Marburg virus disease(MVD),Rift Valley fever(RVF)and yellow fever(YF).Malaria infections were tested using rapid diagnostics tests while exposure to VHFs was determined by screening for immunoglobulin M antibodies using commercial enzyme-linked immuno‑sorbent assays.The Chi-square test was used to compare the proportions.Results:A total of 308 participants(mean age=35±19 years)were involved in the study.Of these,54(17.5%)had malaria infection and 15(4.8%)were positive for IgM antibodies against VHFs(RVF=8;CCHF=2;EBV=3;MBV=1;YF=1).Six(1.9%)individuals had both VHF(RVF=2;CCHF=1;EVD=2;MVD=1)and malaria infections.The highest co-infection prevalence(0.6%)was observed among individuals aged 46‒60 years(P<0.05).District was signifcantly associated with co-infection(P<0.05)with the highest prevalence recorded in Buhigwe(1.2%)followed by Kinondoni(0.9%)districts.Headache(100%)and muscle,bone,back and joint pains(83.3%)were the most signifcant complaints among those infected with both VHFs and malaria(P=0.001).Conclusions:Co-infections of VHF and malaria are prevalent in Tanzania and afect more the older than the younger population.Since the overlapping symptoms in co-infected individuals may challenge accurate diagnosis,adequate laboratory diagnosis should be emphasized in the management of febrile illnesses.
文摘Background:Crimean-Congo haemorrhagic fever(CCHF)is a potentially fatal disease endemic in Pakistan.The causative virus is transmitted by the bite of Hyalomma ticks or by contact with infected blood or tissue.First cases of the disease were reported in Pakistan in 1976 but regular outbreaks have been observed since the year 2000.A huge agricultural base with more than 175 million livestock,the concomitant presence of Hyalomma ticks and a lack of precautionary measures to prevent transmission lead to a considerable risk for exposed populations to contract CCHF in Pakistan.At the same time,secondary cases contracted by nosocomial transmission are reported from hospitals.Case presentation:Here we present an outbreak of CCHF with four of six patients succumbing to the disease before the suspicion for CCHF was raised.Importantly,the main clinical features of these cases were gastrointestinal symptoms without any clinical signs of bleeding.Only the last two patients in this outbreak presented with typical signs of bleeding disorder and were then confirmed being infected by CCHF.Confirmation of diagnosis was done at the National Institute of Health by real-time RT-PCR.Conclusions:This case series highlights the importance of early clinical suspicion for CCHF in exposed individuals and the need for improved precautionary measures against the spread of CCHF within the Pakistani population and hospitals.
文摘After the first secondarily-transmitted ebola case in Spain, a wave of divergent opinions flooded mass and sanitary media. Very few of these opinions, however, came from experts on epidemiology or hemorrhagic fevers. This observational study aimed to assess the specific knowledge of Primary Care physicians and nurses about ebola and hemorrhagic fevers by means of analyzing the results obtained from a 5-item self-reported questionnaire dealing on hemorrhagic fevers basic knowledge. Validity and reliability of questionnaire were confirmed by a pilot study. The participants were 138 family doctors and nurses from the 64 public Primary Care centers sited in the North Metropolitan Area of Barcelona (1,400,000 inhab;Catalonia, Spain) taking part in training-the-trainers ebola workshops. Overall, there were 117 (84.8%) respondents out from 138 workshop participants;of them were physicians 61 (51.2%). The main age was 46.7 (8.8) years;stating previous specific knowledge on hemorrhagic fevers 39 (33.3%). On the whole, up to 92 (78.6%) of respondents shown a poor knowledge. Previous specific formation was significantly and independently associated with having proper knowledge (p < 0.001);OR = 8.6 (CI 95%: 3.199 - 23.623). In summary, confusion that accompanied the single secondary-transmitted ebola case in Spain could probably be explained by the existence of a serious gap on hemorrhagic fevers knowledge. More accurate, scientific and formally-presented information should be provided to Primary Care physicians and nurses.
