Posts filed under ‘Medicina del viajero’

Pregnant Women Hospitalized with Chikungunya Virus Infection, Colombia, 2015

Emerging Infectious Diseases November 2017 V.23 N.11

Maria Escobar, Albaro J. Nieto, Sara Loaiza-Osorio, Juan S. Barona, and Fernando Rosso

Fundación Clínica Valle del Lili, Cali, Colombia (M. Escobar, A.J. Nieto, S. Loaiza-Osorio, F. Rosso); Icesi University, Cali (M. Escobar, A.J. Nieto, J.S. Barona, F. Rosso)

In 2015 in Colombia, 60 pregnant women were hospitalized with chikungunya virus infections confirmed by reverse transcription PCR.

Nine of these women required admission to the intensive care unit because of sepsis with hypoperfusion and organ dysfunction; these women met the criteria for severe acute maternal morbidity. No deaths occurred.

Fifteen women delivered during acute infection; some received tocolytics to delay delivery until after the febrile episode and prevent possible vertical transmission. As recommended by a pediatric neonatologist, 12 neonates were hospitalized to rule out vertical transmission; no clinical findings suggestive of neonatal chikungunya virus infection were observed.

With 36 women (60%), follow-up was performed 1 year after acute viremia; 13 patients had arthralgia in >2 joints (a relapse of infection).

Despite disease severity, pregnant women with chikungunya should be treated in high-complexity obstetric units to rule out adverse outcomes. These women should also be followed up to treat potential relapses.

PDF

https://wwwnc.cdc.gov/eid/article/23/11/pdfs/17-0480.pdf

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October 18, 2017 at 8:27 am

Specific Biomarkers Associated With Neurological Complications and Congenital Central Nervous System Abnormalities From Zika Virus–Infected Patients in Brazil

Journal of Infectious Diseases July 15, 2017 V.216 N.2 P.172–181

Yiu-Wing Kam; Juliana Almeida Leite; Fok-Moon Lum; Jeslin J L Tan; Bernett Lee …

Background

Zika virus (ZIKV) infections have been linked to different levels of clinical outcomes, ranging from mild rash and fever to severe neurological complications and congenital malformations.

Methods

We investigated the clinical and immunological response, focusing on the immune mediators profile in 95 acute ZIKV-infected adult patients from Campinas, Brazil. These patients included 6 pregnant women who later delivered during the course of this study. Clinical observations were recorded during hospitalization. Levels of 45 immune mediators were quantified using multiplex microbead-based immunoassays.

Results

Whereas 11.6% of patients had neurological complications, 88.4% displayed mild disease of rash and fever. Several immune mediators were specifically higher in ZIKV-infected patients, and levels of interleukin 10, interferon gamma-induced protein 10 (IP-10), and hepatocyte growth factor differentiated between patients with or without neurological complications. Interestingly, higher levels of interleukin 22, monocyte chemoattractant protein 1, TNF-α, and IP-10 were observed in ZIKV-infected pregnant women carrying fetuses with fetal growth–associated malformations. Notably, infants with congenital central nervous system deformities had significantly higher levels of interleukin 18 and IP-10 but lower levels of hepatocyte growth factor than those without such abnormalities born to ZIKV-infected mothers.

Conclusions

This study identified several key markers for the control of ZIKV pathogenesis. This will allow a better understanding of the molecular mechanisms of ZIKV infection in patients.

PDF

https://watermark.silverchair.com/api/watermark?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAdgwggHUBgkqhkiG9w0BBwagggHFMIIBwQIBADCCAboGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMuj_a-VAMddE_zlaHAgEQgIIBi63-XH3OORdTvNkyg01iIpJuW3POLRfocSGreL0dwgD_6lfvv3yIkhP83MPEjgbyM9hazTt8DxQ_2IqEP6eND0h1g-VCwKcveB1byxBTEz8KSJ33u-ZLO-0iet2RmKK6HMazACV8sW8KfaiLYfdKTUnyv4RSn2jfuq4U0F2hnTo_1WGmLFnsCrbfRbbQHnrudA9e_MPedHJfZAnRm53kkbzUtza0KfnfJx80cCVKJu2wGYXY5INohc43UMAEgsI2wAbXr7Xwd2RE8CXHlNPJnhI8YYhhjz_Yj4dnOfsSbzwL0inCX7tnqdFt5GsWbaM7Oa3zpl391yhxwE1HYUvCOZnyEAQpu2XTB_4h6ko7T1WDr_Jd-4H9W1HtVK1_ILzddKywF3yVCYmk35oC1RXv9gPslai0Hkjlpnb46k9VPEeQOOhXMzRYU7koX2RpuWfXAah7nfzaS0evT50mVl2GoS7mcMwtfDNFOCP_5mujf0ZaGhrTLgav_RbLq-dKMQA7DP0LVlBEsjtL61zI

September 27, 2017 at 8:50 am

Dengue Virus 1 Outbreak in Buenos Aires, Argentina, 2016

Emerging Infectious Diseases October 2017 V.23 N.10

Estefanía Tittarelli, Silvina B. Lusso, Stephanie Goya, Gabriel L. Rojo, Mónica I. Natale, Mariana Viegas, Alicia S. Mistchenko, and Laura E. Valinotto

Hospital de Niños “Ricardo Gutiérrez” Buenos Aires, Argentina (E. Tittarelli, S.B. Lusso, S. Goya, G.L. Rojo, M.I. Natale, M. Viegas, A.S. Mistchenko, L.E. Valinotto); CONICET, Buenos Aires (E. Tittarelli, S. Goya, M. Viegas, L.E. Valinotto); Comisión de Investigaciones Científicas de la Provincia de Buenos Aires, Buenos Aires (A.S. Mistchenko).

Abstract

The largest outbreak of dengue in Buenos Aires, Argentina, occurred during 2016. Phylogenetic, phylodynamic, and phylogeographic analyses of 82 samples from dengue patients revealed co-circulation of 2 genotype V dengue virus lineages, suggesting that this virus has become endemic to the Buenos Aires metropolitan area.

PDF

https://wwwnc.cdc.gov/eid/article/23/10/pdfs/16-1718.pdf

September 24, 2017 at 10:56 am

Editor’s Choice: Coinfection With Zika and Dengue-2 Viruses in a Traveler Returning From Haiti, 2016: Clinical Presentation and Genetic Analysis

Clinical Infectious Diseases January 1, 2017 V.64 N.1 P.72-75

BRIEF REPORTS

Nicole M. Iovine, John Lednicky, Kartikeya Cherabuddi, Hannah Crooke, Sarah K. White, Julia C. Loeb, Eleonora Cella, Massimo Ciccozzi, Marco Salemi, and J. Glenn Morris, Jr

1Division of Infectious Diseases, Department of Medicine, College of Medicine

2Emerging Pathogens Institute

3Department of Environmental and Global Health, College of Public Health and Health Professions

4Department of Epidemiology, College of Public Health and Health Professions

5Department of Pathology, Immunology and Laboratory Sciences, College of Medicine, University of Florida, Gainesville

6Department of Infectious Parasitic and Immunomediated Diseases, Reference Centre on Phylogeny, Molecular Epidemiology and Microbial Evolution/Epidemiology Unit, Istituto Superiore di Sanita, Rome, Italy

Zika virus and dengue virus serotype 2 were isolated from a patient with travel to Haiti who developed fever, rash, arthralgias, and conjunctivitis. The infecting Zika virus was related to Venezuelan and Brazilian strains but evolved along a lineage originating from strains isolated in 2014 in the same region of Haiti.

PDF

https://cid.oxfordjournals.org/content/64/1/72.full.pdf+html

August 19, 2017 at 10:26 am

EDITORIAL – Oropuche virus: A virus present but ignored

Rev.MVZ Córdoba 20(3):4675-4676, 2015

Virus de Oropuche: Un virus ignorado pero presente

El virus de Oropouche deriva su nombre de la localidad de Vegas de Oropuche, la cual se encuentra en la isla de Trinidad y Tobago, en donde fue detectado en 1955 en un paciente febril y en mosquitos Coquilletidia venezuelenzis.

El virus de Oropouche es prevalente en muchas regiones de América del Sur y del Caribe.

En el ciclo silvestre, el virus tiene varios mosquitos vectores: Culicoides paraensis, Coquilletidia venezuelenzis y Aedes serratus.

Los mamíferos silvestres son picados por estos mosquitos y aumentan las viremias, como en el oso perezoso (Bradypus tridactiyus), primates (Aloutta sanguinus) y roedores entre otros.

En el ciclo urbano los vectores son mosquitos Culicoides paraensis y Culex quinquefasciatus, ambos muy comunes en los ambientes tropicales de Colombia …

PDF

http://www.scielo.org.co/pdf/mvz/v20n3/v20n3a01.pdf

August 16, 2017 at 2:02 pm

Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure — United States (Including U.S. Territories), July 2017

MMWR July 28, 2017 V.66 N.29 P.781-793

Update

Titilope Oduyebo, MD1; Kara D. Polen, MPH1; Henry T. Walke, MD1; Sarah Reagan-Steiner, MD1; Eva Lathrop, MD1; Ingrid B. Rabe, MBChB1; Wendi L. Kuhnert-Tallman, PhD1; Stacey W. Martin, MSc1; Allison T. Walker, PhD1; Christopher J. Gregory, MD1; Edwin W. Ades, PhD1; Darin S. Carroll, PhD1; Maria Rivera, MPH1; Janice Perez-Padilla, MPH1; Carolyn Gould, MD1; Jeffrey B. Nemhauser, MD1; C. Ben Beard, PhD1; Jennifer L. Harcourt, PhD1; Laura Viens, MD1; Michael Johansson, PhD1; Sascha R. Ellington, MSPH1; Emily Petersen, MD1; Laura A. Smith, MA1; Jessica Reichard, MPA1; Jorge Munoz-Jordan, PhD1; Michael J. Beach, PhD1; Dale A. Rose, PhD1; Ezra Barzilay, MD1; Michelle Noonan-Smith1; Denise J. Jamieson, MD1; Sherif R. Zaki, MD1; Lyle R. Petersen, MD1; Margaret A. Honein, PhD1; Dana Meaney-Delman, MD1

CDC has updated the interim guidance for U.S. health care providers caring for pregnant women with possible Zika virus exposure in response to 1) declining prevalence of Zika virus disease in the World Health Organization’s Region of the Americas (Americas) and 2) emerging evidence indicating prolonged detection of Zika virus immunoglobulin M (IgM) antibodies.

Zika virus cases were first reported in the Americas during 2015–2016; however, the incidence of Zika virus disease has since declined.

As the prevalence of Zika virus disease declines, the likelihood of false-positive test results increases. In addition, emerging epidemiologic and laboratory data indicate that, as is the case with other flaviviruses, Zika virus IgM antibodies can persist beyond 12 weeks after infection.

Therefore, IgM test results cannot always reliably distinguish between an infection that occurred during the current pregnancy and one that occurred before the current pregnancy, particularly for women with possible Zika virus exposure before the current pregnancy.

These limitations should be considered when counseling pregnant women about the risks and benefits of testing for Zika virus infection during pregnancy.

This updated guidance emphasizes a shared decision-making model for testing and screening pregnant women, one in which patients and providers work together to make decisions about testing and care plans based on patient preferences and values, clinical judgment, and a balanced assessment of risks and expected outcomes…..

PDF

https://www.cdc.gov/mmwr/volumes/66/wr/pdfs/mm6629e1.pdf

July 28, 2017 at 5:17 pm

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

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