Archive for July 12th, 2009
Tick-borne encephalitis virus – a review of an emerging zoonosis
Journal of General Virology August 2009 V.90 N.8 p.1781-1794
Review
K. L. Mansfield1, N. Johnson1, L. P. Phipps1, J. R. Stephenson2, A. R. Fooks1 and T. Solomon3
1 Rabies and Wildlife Zoonoses Group, Veterinary Laboratories Agency, Woodham Lane, New Haw, Surrey, UK
2 Health Protection Agency, London, UK
3 Brain Infections Group, Divisions of Neurological Science and Medical Microbiology, University of Liverpool, Liverpool, UK
During the last 30 years, there has been a continued increase in human cases of tick-borne encephalitis (TBE) in Europe, a disease caused by tick-borne encephalitis virus (TBEV). TBEV is endemic in an area ranging from northern China and Japan, through far-eastern Russia to Europe, and is maintained in cycles involving Ixodid ticks (Ixodes ricinus and Ixodes persulcatus) and wild vertebrate hosts. The virus causes a potentially fatal neurological infection, with thousands of cases reported annually throughout Europe. TBE has a significant mortality rate depending upon the strain of virus or may cause long-term neurological/neuropsychiatric sequelae in people affected. In this review, we comprehensively reviewed TBEV, its epidemiology and pathogenesis, the clinical manifestations of TBE, along with vaccination and prevention. We also discuss the factors which may have influenced an apparent increase in the number of reported human cases each year, despite the availability of effective vaccines.
abstract
http://vir.sgmjournals.org/cgi/content/abstract/90/8/1781
http://vir.sgmjournals.org/cgi/reprint/90/8/1781
* * *
Add comment July 12, 2009
Forever Unprepared — The Predictable Unpredictability of Pathogens
N Engl J of Medicine July 9, 2009 V.361 N.2 p.120-121
Perspective
Kent A. Sepkowitz, M.D.
abstract
http://content.nejm.org/cgi/content/short/361/2/120?query=TOC
Add comment July 12, 2009
Geographic Dependence, Surveillance, and Origins of the 2009 Influenza A (H1N1) Virus
N Engl J of Medicine July 9, 2009 V.361 N.2 p.115-119
Perspective
Vladimir Trifonov, Ph.D., Hossein Khiabanian, Ph.D., and Raul Rabadan, Ph.D.
abstract
http://content.nejm.org/cgi/content/full/361/2/115?query=TOC
Add comment July 12, 2009
Managing and Reducing Uncertainty in an Emerging Influenza Pandemic
N Engl J of Medicine July 9, 2009 V.361 N.2 p.112-115
Perspective
Marc Lipsitch, D.Phil., Steven Riley, D.Phil., Simon Cauchemez, Ph.D., Azra C. Ghani, Ph.D., and Neil M. Ferguson, D.Phil.
abstract
http://content.nejm.org/cgi/content/full/361/2/112?query=TOC
Add comment July 12, 2009
Update on Avian Influenza A H5N1 Virus Infection in Humans
N Engl J of Medicine Jan.17, 2008 V.358 N.3 p.261-273
Review Article
Current Concepts
Writing Committee of the Second World Health Organization Consultation on Clinical Aspects of Human Infection with Avian Influenza A (H5N1) Virus
Full Text
http://content.nejm.org/cgi/content/full/358/3/261
Add comment July 12, 2009
Efficacy and Safety of the Oral Neuraminidase Inhibitor Oseltamivir in Treating Acute Influenza
JAMA Feb.23, 2000 V.283 N.8 p.1016-1024
A Randomized Controlled Trial
John J. Treanor, MD; Frederick G. Hayden, MD; Peter S. Vrooman, MD; Rick Barbarash, PharmD; Robert Bettis, MD; Dennis Riff, MD; Sudeep Singh, MD; Nelson Kinnersley; Penelope Ward, MD; Roger G. Mills, MD; for the US Oral Neuraminidase Study Group
University of Rochester, Rochester, NY (Dr Treanor); University of Virginia, Charlottesville (Dr Hayden); PW Clinical Research, Winston-Salem, NC (Dr Vrooman); Hill Top Research, St Louis, Mo (Dr Barbarash); Edmonds Family Medicine Clinic, Edmonds, Wash (Dr Bettis); Advanced Clinical Research Institute, Anaheim, Calif (Dr Riff); SARC Research Center, Fresno, Calif (Dr Singh); Roche Global Development, Welwyn, England (Mr Kinnersley and Dr Ward); and Gilead Sciences, Foster City, Calif (Dr Mills).
Context Previous studies have shown oseltamivir, a neuraminidase inhibitor, to be effective in preventing influenza and treating experimental influenza.
Objective To evaluate the efficacy and safety of oseltamivir in the treatment of naturally acquired influenza infection.
Design Randomized, placebo-controlled, double-blind study conducted January through March 1998.
Setting Sixty primary care and university health centers throughout the United States.
Participants A total of 629 healthy nonimmunized adults aged 18 to 65 years with febrile respiratory illness of no more than 36 hours’ duration with temperature of 38°C or more plus at least 1 respiratory symptom and 1 constitutional symptom.
Interventions Individuals were randomized to 1 of 3 treatment groups with identical appearing pills: oral oseltamivir phosphate, 75 mg twice daily (n = 211) or 150 mg (n = 209) twice daily, or placebo (n = 209).
Main Outcome Measures Duration and severity of illness in individuals infected with influenza.
Results Two individuals withdrew before receiving medication and were excluded from further analyses. A total of 374 individuals (59.6%) were infected with influenza. Their duration of illness was reduced by more than 30% with both oseltamivir, 75 mg twice daily (median, 71.5 hours; P<.001), and oseltamivir, 150 mg twice daily (median, 69.9 hours; P = .006), compared with placebo (median, 103.3 hours). Severity of illness was reduced by 38% (median score, 597 score-hours; P<.001) with oseltamivir, 75 mg twice daily, and by 35% (median score, 626 score-hours; P<.001) with oseltamivir, 150 mg twice daily, vs placebo (median score, 963 score-hours). Oseltamivir treatment reduced the duration of fever and oseltamivir recipients returned to usual activities 2 to 3 days earlier than placebo recipients (P<=.05). Secondary complications such as bronchitis and sinusitis occurred in 15% of placebo recipients compared with 7% of combined oseltamivir recipients (P = .03). Among all 629 subjects, oseltamivir reduced illness duration (76.3 hours and 74.3 hours for 75 mg and 150 mg, respectively, vs 97.0 hours for placebo; P = .004 for both comparisons) and illness severity (686 score-hours and 629 score-hours for 75 mg and 150 mg, respectively, vs 887 score-hours for placebo; P<.001 for both comparisons). Nausea and vomiting occurred more frequently in both oseltamivir groups (combined, 18.0% and 14.1%, respectively; P = .002) than in the placebo group (7.4% and 3.4%; P<.001).
Conclusions Our data suggest that oral oseltamivir treatment reduces the duration and severity of acute influenza in healthy adults and may decrease the incidence of secondary complications.
Add comment July 12, 2009
Intensive-Care Patients With Severe Novel Influenza A (H1N1) Virus Infection Michigan, June 2009
MMWR Dispatch July 10, 2009 V.58 Dispatch p.1-4
Since April 26, communitywide transmission of novel influenza A (H1N1) virus has occurred in Michigan, with 655 probable and confirmed cases reported as of June 18. This report summarizes the clinical characteristics of a series of 10 patients with novel influenza A (H1N1) virus infection and acute respiratory distress syndrome at a tertiary-care intensive care unit in Michigan. Of the 10 patients, nine were obese (body mass index [BMI] >30), including seven who were extremely obese (BMI >40); five had pulmonary emboli; and nine had multiorgan dysfunction syndrome. Three patients died. Clinicians should be aware of the potential for severe complications of novel influenza A (H1N1) virus infection, particularly in extremely obese patients.
Full Text
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58d0710a1.htm?s_cid=mm58d0710a1_e
http://www.cdc.gov/mmwr/PDF/wk/mm58d0710.pdf
* * *
Add comment July 12, 2009
