Archive for April 7, 2014

Notes from the field: Heartland virus disease – United States, 2012-2013.

MMWR Morb Mortal Wkly Rep. 2014 Mar 28;63(12):270-1.

Pastula DM, Turabelidze G, Yates KF, Jones TF, Lambert AJ, Panella AJ, Kosoy OI, Velez JO, Fisher M, Staples E; EIS officer, CDC.


Heartland virus is a newly identified phlebovirus that was first isolated from two northwestern Missouri farmers hospitalized with fever, leukopenia, and thrombocytopenia in 2009.

Based on the patients’ clinical findings and their reported exposures, the virus was suspected to be transmitted by ticks.

After this discovery, CDC worked with state and local partners to define the ecology and modes of transmission of Heartland virus, develop diagnostic assays, and identify additional cases to describe the epidemiology and clinical disease.

From this work, it was learned that Heartland virus is found in the Lone Star tick (Amblyomma americanum).

Six additional cases of Heartland virus disease were identified during 2012-2013; four of those patients were hospitalized, including one with comorbidities who died.

PDF (see p.270)

April 7, 2014 at 8:48 am

Chikungunya virus infection: an overview.

New Microbiol. 2013 Jul;36(3):211-27.

Caglioti C1, Lalle E, Castilletti C, Carletti F, Capobianchi MR, Bordi L.

Laboratory of Virology, “L. Spallanzani” National Institute for Infectious Diseases, Rome, Italy.


Chikungunya virus (CHIKV) is a mosquito-transmitted alphavirus belonging to the Togaviridae family, first isolated in Tanzania in 1952.

The main vectors are mosquitoes from the Aedes species.

Recently, the establishment of an envelope mutation increased infectivity for A. albopictus. CHIKV has recently re-emerged causing millions of infections in countries around the Indian Ocean characterized by climate conditions favourable to high vector density.

Importation of human cases to European regions with high density of suitable arthropod vectors (such as A. albopictus) may trigger autochthonous outbreaks.

The clinical signs of CHIKV infection include non-specific flu-like symptoms, and a characteristic rash accompanied by joint pain that may last for a long time after the resolution of the infection.

The death rate is not particularly high, but excess mortality has been observed in concomitance with large CHIKV outbreaks. Deregulation of innate defense mechanisms, such as cytokine inflammatory response, may participate in the main clinical signs of CHIKV infection, and the establishment of persistent (chronic) disease.

There is no specific therapy, and prevention is the main countermeasure. Prevention is based on insect control and in avoiding mosquito bites in endemic countries.

Diagnosis is based on the detection of virus by molecular methods or by virus culture on the first days of infection, and by detection of an immune response in later stages.

CHIKV infection must be suspected in patients with compatible clinical symptoms returning from epidemic/endemic areas.

Differential diagnosis should take into account the cross-reactivity with other viruses from the same antigenic complex (i.e. O’nyong-nyong virus).


April 7, 2014 at 8:45 am

Chikungunya and the eye – A review.

J Ophthalmic Inflamm Infect. 2013 Feb 11;3(1):35.

Mahendradas P1, Avadhani K, Shetty R.

1Narayana Nethralaya Post Graduate Institute of Ophthalmology, 121/C, Chord Road, Rajaji Nagar 1st ‘R’ Block, Bangalore, 560010, India.


Chikungunya is a self-limited, systemic viral infection that has been a major health problem since the past few years.

Ocular manifestations of the disease have become more prevalent in the recent years. Currently, there is neither a specific treatment nor vaccine available for chikungunya fever.

This review highlights the current understanding on the pathogenesis, systemic changes with an emphasis on ocular findings, laboratory investigations, and prevention and treatment of this disease.


April 7, 2014 at 8:42 am


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