Posts filed under ‘FIEBRE en el POST-VIAJE’

False-Positive Rapid Malaria Antigen Test Result in a Returned Traveler

Journal of Clinical Microbiology August 2017 V.55 N.8 P.2294-2297

The Brief Case

Kristle L. Haberichter, Paul C. Johnson, Paul J. Chittick, Peter Millward, Barbara Robinson-Dunn, and Bobby L. Boyanton Jr.

A previously healthy 43-year-old female presented to her primary care physician with a 13-day history of recurrent nightly fevers (100°F to 101°F), nonproductive cough, and respiratory congestion. She was prescribed azithromycin, albuterol, and benzonatate. She presented to the emergency center 2 days later without improvement and at that time reported night sweats. She had recently traveled to Thailand, Laos, Cambodia, and the United Arab Emirates. The nightly fevers began 11 days after returning home. She acknowledged being bitten by mosquitoes throughout her travels and did not take malaria prophylaxis.

A previously healthy 43-year-old female presented to her primary care physician with a 13-day history of recurrent nightly fevers (100°F to 101°F), nonproductive cough, and respiratory congestion. She was prescribed azithromycin, albuterol, and benzonatate. She presented to the emergency center 2 days later without improvement and at that time reported night sweats. She had recently traveled to Thailand, Laos, Cambodia, and the United Arab Emirates. The nightly fevers began 11 days after returning home. She acknowledged being bitten by mosquitoes throughout her travels and did not take malaria prophylaxis….

PDF

http://jcm.asm.org/content/55/8/2294.full.pdf+html

 

 

Journal of Clinical Microbiology August 2017 V.55 N.8 P.2560-2561

Closing the Brief Case: False-Positive Rapid Malaria Antigen Test Result in a Returned Traveler

Kristle L. Haberichter, Paul C. Johnson, Paul J. Chittick, Peter Millward, Barbara Robinson-Dunn, and Bobby L. Boyanton Jr.

aDepartment of Pathology and Laboratory Medicine, Beaumont Health, Royal Oak, Michigan, USA

bDepartment of Infectious Disease, Beaumont Health, Royal Oak, Michigan, USA

cOakland University William Beaumont School of Medicine, Rochester, Michigan, USA

ANSWERS TO SELF-ASSESSMENT QUESTIONS

PDF

http://jcm.asm.org/content/55/8/2560.full.pdf+html

July 26, 2017 at 9:23 am

Sexual transmission of American trypanosomiasis in humans: a new potential pandemic route for Chagas parasites

Memórias do Instituto Oswaldo Cruz June 2017 V.112 N.6

Perla F Araujo1, Adriana B Almeida1, Carlos F Pimentel1, Adriano R Silva1, Alessandro Sousa1, Sebastião A Valente2,

Vera C Valente2, Manuela M Britto1, Ana C Rosa1, Rozeneide M Alves1, Luciana Hagström1, Antonio RL Teixeira1  *  +

1Universidade de Brasília, Faculdade de Medicina, Laboratório Multidisciplinar de Pesquisa em Doença de Chagas, Brasília, DF, Brasil

2Instituto Evandro Chagas, Belém, PA, Brasil

BACKGROUND

The Trypanosoma cruzi infection endemic in Latin America has now spread to several countries across four continents; this endemic involves triatomine vector-free protists. We hypothesised that the sexual transmission of T. cruzi contributes to the ongoing spread of Chagas disease.

OBJECTIVES

A short-term longitudinal study was conducted to evaluate this hypothesis.

METHODS

The study population comprised 109 subjects from four families, among whom 21 had been diagnosed with acute Chagas disease by direct parasitological analysis. Blood mononuclear cells and serum samples were obtained from each study subject once per year for three consecutive years. Enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence serological examinations were used to detect specific T. cruzi antibodies. Polymerase chain reaction of T. cruzi DNA revealed 188-nucleotide bands, which hybridised to a specific radiolabelled probe and were confirmed by cloning and sequencing.

RESULTS

Three independent assessments at different time points revealed T. cruzi nuclear DNA footprints in 76% (83/109) of the study population with active infection. In contrast, the ELISA and indirect immunofluorescence assays detected the T. cruzi antibody in 28.4% (31/109) of the study samples. Moreover, the semen from 82.6% (19/23) of subjects people revealed harboured the 188- bp base pair T. cruzi footprint. Interestingly, the ejaculates of nuclear DNA-positive Chagas patient transmitted the T. cruzi upon peritoneal injection or infusion in the vagina of mice, and amastigotes were detected in the skeletal muscle, myocardium, vas deferens, and uterine tube.

MAIN CONCLUSIONS

T. cruzi infections can be transmitted from females or males to naïve mates through intercourse, and progeny showed discrepancies between the ratios of nuclear DNA footprints and specific antibody that can be explained by the tolerance attained during early embryo growth. Additional studies are needed to develop drugs to eradicate the infections. Additionally, the importance of a vigorous education, information, and communication program to prevent sexually transmitted Chagas disease in humans cannot be underemphasised.

PDF

http://www.scielo.br/pdf/mioc/v112n6/0074-0276-mioc-112-6-0437.pdf

July 14, 2017 at 8:23 am

Epidemiology of human plague in the United States, 1900-2012.

Emerg Infect Dis. 2015 Jan;21(1):16-22.

Kugeler KJ, Staples JE, Hinckley AF, Gage KL, Mead PS.

Abstract

We summarize the characteristics of 1,006 cases of human plague occurring in the United States over 113 years, beginning with the first documented case in 1900.

Three distinct eras can be identified on the basis of the frequency, nature, and geographic distribution of cases. During 1900-1925, outbreaks were common but were restricted to populous port cities.

During 1926-1964, the geographic range of disease expanded rapidly, while the total number of reported cases fell. During 1965-2012, sporadic cases occurred annually, primarily in the rural Southwest.

Clinical and demographic features of human illness have shifted over time as the disease has moved from crowded cities to the rural West.

These shifts reflect changes in the populations at risk, the advent of antibiotics, and improved detection of more clinically indistinct forms of infection.

Overall, the emergence of human plague in the United States parallels observed patterns of introduction of exotic plants and animals.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4285253/pdf/14-0564.pdf

June 29, 2017 at 8:17 am

Gentamicin and tetracyclines for the treatment of human plague: review of 75 cases in new Mexico, 1985-1999.

Clin Infect Dis. MARCH 2004 Mar 1;38(5):663-9.

Boulanger LL1, Ettestad P, Fogarty JD, Dennis DT, Romig D, Mertz G.

Author information

1 Department of Internal Medicine, Division of Infectious Diseases, University of New Mexico, Albuquerque, NM, USA. lucyjohn@hotmail.com

Abstract

Streptomycin, an antimicrobial with limited availability, is the treatment of choice for plague, a fulminating and potentially epidemic disease that poses a bioterrorism concern. We evaluated the efficacy of gentamicin and tetracyclines for treating human plague. A medical record review was conducted on all 75 patients with plague who were reported in New Mexico during 1985-1999. Fifty patients were included in an analysis that compared streptomycin-treated patients (n=14) with those treated with gentamicin and/or a tetracycline (n=36). The mean numbers of fever days, hospital days, and complications and the number of deaths did not differ between patients treated with streptomycin and those treated with gentamicin. One patient who received tetracycline alone experienced a serious complication. Gentamicin alone or in combination with a tetracycline was as efficacious as streptomycin for treating human plague. The efficacy of a tetracycline alone could not be determined from the study.

PDF

https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/cid/38/5/10.1086/381545/2/38-5-663.pdf?Expires=1498827128&Signature=LoBuf2os660n~z7jhBjm5hWOK27YiZe~p108SitqKZHdaaz90DyfMMZwRNA6Kk6RfuSBseh4I0cfwycZFhOO1oPeANkLDzIKvLRe~uSLvkrJTiMmHWdV84wps9iOAhhbQKAR1FQ~peXBdVoBGtGklZtqKPHsh1~Np1m9MOyPgU4yxS9VXWdWr8bsOYJI4GwX65zQE3M1n~UgnMWsR-70pbMr3b9inZB7psk~EeDAX-C10beelBpxjwksBqp2AKGT~fsTYufj8h80NeWgaWOJs6XsSjd3iPK0hQwEsfozZCvpH-V7KS7fDd2XGc8RgbOoi28nRn96JeNircd-3Qo~Vw__&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q

June 29, 2017 at 8:15 am

Modelling the effects of global climate change on Chikungunya transmission in the 21st century

Scientific Reports 7, Article number: 3813 (2017)

Nils B. Tjaden, Jonathan E. Suk, Dominik Fischer, Stephanie M. Thomas, Carl Beierkuhnlein & Jan C. Semenza

The arrival and rapid spread of the mosquito-borne viral disease Chikungunya across the Americas is one of the most significant public health developments of recent years, preceding and mirroring the subsequent spread of Zika.

Globalization in trade and travel can lead to the importation of these viruses, but climatic conditions strongly affect the efficiency of transmission in local settings.

In order to direct preparedness for future outbreaks, it is necessary to anticipate global regions that could become suitable for Chikungunya transmission.

Here, we present global correlative niche models for autochthonous Chikungunya transmission. These models were used as the basis for projections under the representative concentration pathway (RCP) 4.5 and 8.5 climate change scenarios. In a further step, hazard maps, which account for population densities, were produced. The baseline models successfully delineate current areas of active Chikungunya transmission.

Projections under the RCP 4.5 and 8.5 scenarios suggest the likelihood of expansion of transmission-suitable areas in many parts of the world, including China, sub-Saharan Africa, South America, the United States and continental Europe.

The models presented here can be used to inform public health preparedness planning in a highly interconnected world…..

PDF

https://www.nature.com/articles/s41598-017-03566-3.pdf

June 28, 2017 at 7:48 am

Persistent Arthralgia Associated Chikungunya Virus Outbreak, US Virgin Islands, December 2014–February 2016

Emerging Infectious Diseases. April 2017 V.23 N.4 P.673-676.

Leora R. Feldstein, Ali Rowhani-Rahbar, J. Erin Staples, Marcia R. Weaver, M. Elizabeth Halloran, Esther M. Ellis

Author affiliations: Fred Hutchinson Cancer Research Center, Seattle, Washington, USA (L.R. Feldstein, M.E. Halloran); University of Washington, Seattle (A. Rowhani-Rahbar, M.R. Weaver, M.E. Halloran); Centers for Disease Control and Prevention, Fort Collins, Colorado, USA (J.E. Staples); US Virgin Islands Department of health, Saint Croix, US Virgin Islands (E.M. Ellis)

After the 2014–2015 outbreak of chikungunya virus in the US Virgin Islands, we compared the prevalence of persistent arthralgia among case-patients and controls. Prevalence was higher in case-patients than controls 6 and 12 months after disease onset. Continued vaccine research to prevent acute illness and long-term sequelae is essential.

PDF

https://wwwnc.cdc.gov/eid/article/23/4/pdfs/16-1562.pdf

June 27, 2017 at 5:37 pm

El virus Zika es más dañino para el embarazo de lo que se pensaba

25/05/2017 – La infección por el ZIKV pasa eficientemente de un mono embarazado a su feto, propagando daño inflamatorio a través de los tejidos que sostienen al feto y al sistema nervioso en desarrollo del feto, y sugiere una amenaza más amplia en embarazos humanos de lo que generalmente se aprecia.

Se infectaron cuatro monos macacos rhesus embarazados en el Centro Nacional de Investigación de Primates de Wisconsin con una dosis de ZIKV similar a la que se transferiría a través de una picadura de mosquito y se encontró evidencia de que el virus estaba presente en el feto de cada mono.

Se trata de un nivel elevado –100% de exposición– del virus al feto, junto con la inflamación y lesión tisular en un modelo animal que refleja la infección en los embarazos humanos muy de cerca. Si la microcefalia es la punta del iceberg para los bebés infectados durante el embarazo, el resto del iceberg puede ser más grande de lo que la comunidad científica imagina.

Se hizo un seguimiento de los embarazos infectados en el 1er o 3er trimestre, evaluando regularmente la infección materna y el desarrollo fetal y examinando el grado de infección en el feto cuando las gestaciones llegaban a término.

Tres de los fetos infectados tenían cabezas pequeñas, pero no tan pequeñas en relación con la normalidad para cumplir el estándar humano para diagnosticar la microcefalia, que es el resultado más llamativo y ampliamente discutido de la infección por ZIKV, ya que los médicos brasileños despertaron la alarma en 2014 cuando detectaron que en muchos bebés se había detenido el desarrollo del cerebro.

El nuevo estudio no encontró desarrollo anormal del cerebro, pero sí se descubrió una inflamación inusual en los ojos fetales, en las retinas y nervios ópticos, en los embarazos infectados durante el primer trimestre.

Los ojos son básicamente parte del SNC humano. El nervio óptico crece justo fuera del cerebro fetal durante el embarazo. Por lo tanto, tiene sentido observar este daño en los monos y en el embarazo humano, problemas como atrofia coriorretiniana o microftalmía en la que todo el ojo o partes del ojo simplemente no crecen hasta el tamaño esperado.

Las similitudes entre los embarazos de mono y las complicaciones reportadas en los embarazos humanos afectados por ZIKV, establecen además la infección en monos como una forma de estudiar la progresión de la infección y los problemas de salud asociados en las personas

Fuentes:

Reporte Epidemiológico de Córdoba Junio 2017

Public Library of Science – PLOS Pathogens May 2017

Highly efficient maternal-fetal Zika virus transmission in pregnant rhesus macaques

Sydney M. Nguyen , Kathleen M. Antony , Dawn M. Dudley , Sarah Kohn, Heather A. Simmons, Bryce Wolfe, M. Shahriar Salamat, Leandro B. C. Teixeira, Gregory J. Wiepz, Troy H. Thoong, Matthew T. Aliota, Andrea M. Weiler, Gabrielle L. Barry,  [ … ], Thaddeus G. Golos …

Infection with Zika virus (ZIKV) is associated with human congenital fetal anomalies. To model fetal outcomes in nonhuman primates, we administered Asian-lineage ZIKV subcutaneously to four pregnant rhesus macaques. While non-pregnant animals in a previous study contemporary with the current report clear viremia within 10–12 days, maternal viremia was prolonged in 3 of 4 pregnancies. Fetal head growth velocity in the last month of gestation determined by ultrasound assessment of head circumference was decreased in comparison with biparietal diameter and femur length within each fetus, both within normal range. ZIKV RNA was detected in tissues from all four fetuses at term cesarean section. In all pregnancies, neutrophilic infiltration was present at the maternal-fetal interface (decidua, placenta, fetal membranes), in various fetal tissues, and in fetal retina, choroid, and optic nerve (first trimester infection only). Consistent vertical transmission in this primate model may provide a platform to assess risk factors and test therapeutic interventions for interruption of fetal infection. The results may also suggest that maternal-fetal ZIKV transmission in human pregnancy may be more frequent than currently appreciated.

FULL TEXT

http://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1006378

 

PDF

http://journals.plos.org/plospathogens/article/file?id=10.1371/journal.ppat.1006378&type=printable

June 2, 2017 at 8:08 am

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