Posts filed under ‘Zoonosis’

Human Rabies — Virginia, 2017

MMWR January 4, 2019  V.67 N.5152 P.1410–1414

Julia Murphy, DVM1; Costi D. Sifri, MD2; Rhonda Pruitt3; Marcia Hornberger4; Denise Bonds4; Jesse Blanton, DrPH5; James Ellison, PhD5; R. Elaine Cagnina2; Kyle B. Enfield2; Miriam Shiferaw, MD5; Crystal Gigante, PhD5; Edgar Condori5; Karen Gruszynski, PhD1,6; Ryan M. Wallace, DVM5

On May 9, 2017, the Virginia Department of Health was notified regarding a patient with suspected rabies. The patient had sustained a dog bite 6 weeks before symptom onset while traveling in India.

On May 11, CDC confirmed that the patient was infected with a rabies virus that circulates in dogs in India.

Despite aggressive treatment, the patient died, becoming the ninth person exposed to rabies abroad who has died from rabies in the United States since 2008.

A total of 250 health care workers were assessed for exposure to the patient, 72 (29%) of whom were advised to initiate postexposure prophylaxis (PEP). The total pharmaceutical cost for PEP (rabies immunoglobulin and rabies vaccine) was approximately $235,000.

International travelers should consider a pretravel consultation with travel health specialists; rabies preexposure prophylaxis is warranted for travelers who will be in rabies endemic countries for long durations, in remote areas, or who plan activities that might put them at risk for a rabies exposures.

PDF

https://www.cdc.gov/mmwr/volumes/67/wr/pdfs/mm675152a2-H.pdf

More information for international travelers about rabies considerations can be found on the CDC’s rabies webpage.

FULL TEXT

https://www.cdc.gov/rabies/index.html

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January 26, 2019 at 12:41 pm

Correlación entre criterios clínicos y de laboratorio de casos notificados por sospecha de hantavirosis y el resultado de la técnica de referencia.

Rev. Chil. Infectol. Junio 2016 V.33 N.3 P.275-281

Actualmente en Chile, debido a la elevada sospecha clínica de enfermedad por hantavirus y el alto impacto en salud pública que esto provoca, se hace necesario reforzar al equipo de salud, los criterios de sospecha clínica y epidemiológica de hantavirosis.

Objetivo:

Analizar la información contenida en las notificaciones de sospecha de infección por hantavirus versus la técnica de referencia para el diagnóstico confirmatorio de casos sospechosos, ELISA IgM de captura anti-hantavirus.

Material y Método:

Mediante cálculo de precisión diagnóstica se analizó la correlación que existe entre la información entregada en las notificaciones versus el resultado de la confirmación mediante la técnica de referencia.

Resultados:

De 1.566 pacientes estudiados 3,4% (53 casos) fue confirmado para SCPH. De las notificaciones analizadas 58,6% estaban con datos incompletos. Los porcentajes de positividad de la técnica de referencia asociada a fiebre, mialgia y cefalea, fueron de 80-85%. Destaca que la presencia de inmunoblastos (> 10%), presenta: S: 25%, E: 98%, VPP: 37%, VPN: 97%. Paratrombocitopenia se obtuvo: S: 98%, E: 74%, VPP: 16%, VPN: 100%.

Conclusión:

Se hace necesario reiterar a nivel del sistema sanitario chileno la importancia de contar con datos completos en los formularios de notificación. La presencia de trombocitopenia e inmunoblastos (> 10%) fue altamente sensible y especifica, respectivamente, en la detección de pacientes con SCPH. Con el fin de optimizar la sospecha de infección por hantavirus, según la definición de caso sospechoso, se plantea la necesidad de desarrollar programas de capacitación para la sospecha clínica y lectura de parámetros de laboratorio, tales como presencia de inmunoblastos en el hemograma, así como incluir un algoritmo con el fin de optimizar la sospecha y el uso adecuado de los recursos sanitarios.

PDF

https://scielo.conicyt.cl/pdf/rci/v33n3/art04.pdf

 

January 20, 2019 at 8:05 pm

1er caso de SCPH diagnosticado en la Región de Antofagasta, Chile. 

Rev. Chil. Infectol. Agosto 2012 V.29 N.4 P.477-477

En Chile, desde 1995 se han confirmado casos del SCPH desde Valparaíso hasta Aysén, correspondiendo la mayor incidencia a las regiones de Aysén, Los Lagos, Araucanía y Bío Bío. El agente etiológico del SCPH es un virus ARN del género hantavirus, familia Bunyaviridae, variedad Andes.

El reservorio es el “ratón de cola larga” (Oligoryzomis longicaudatus) el cual se distribuye desde la Región de Atacama hasta la Región de Magallanes (XII°). El virus es eliminado por el ratón a través de sus secreciones (saliva, orina y heces) e ingresa al hombre por vía digestiva, cutánea o aérea, siendo esta última la más frecuente1. La transmisión de persona a persona está documentada, pero se considera excepcional.

El SCPH es un cuadro agudo grave con alta letalidad (30-55%) y sin tratamiento específico. El período de incubación puede durar hasta 45 días. Los primeros síntomas son fiebre, mialgias, cefalea y ocasionalmente diarrea; días después aparece la fase de compromiso respiratorio, con disnea progresiva e insuficiencia respiratoria grave. Es indispensable la terapia de soporte hemodinámico y manejo de la falla respiratoria en una UCI.

PDF

https://scielo.conicyt.cl/pdf/rci/v29n4/art22.pdf

January 20, 2019 at 8:02 pm

Hantavirus Cardiopulmonary Syndrome Due to Imported Andes Hantavirus Infection in Switzerland: A Multidisciplinary Challenge, Two Cases and a Literature Review.

Clin Infect Dis. November 13, 2018 V.67 N.11 P.1788-1795.

Kuenzli AB1, Marschall J1, Schefold JC1, Schafer M1, Engler OB2, Ackermann-Gäumann R2, Reineke DC1, Suter-Riniker F3, Staehelin C1.

Author information

1 Bern University Hospital and University of Bern, Switzerland.

2 Spiez Laboratory, Federal Office for Civil Protection, Switzerland.

3 Institute for Infectious Diseases, University of Bern, Switzerland.

Abstract

Two travellers returning from South America were diagnosed with Andes hantavirus infection, the only member of the Hantaviridae family known to be transmitted from person to person.

We describe the clinical course and therapeutic and infection control measures.

While both patients showed high viral load (VL) and shedding over several months, 1 patient recovered within 1 week from severe respiratory illness that required noninvasive ventilation, whereas the second patient developed severe hantavirus cardiopulmonary syndrome that required extracorporeal membrane oxygenation for 27 days.

The clinical course in the latter patient was complicated by severe disseminated intravascular coagulopathy with diffuse hemorrhage that necessitated mass transfusions, as well as by multiple organ failure, including the need for renal replacement therapy.

Results of VL in blood, respiratory secretions, and semen for the first 9 months of follow-up are reported. To our knowledge, these are the first cases of Andes hantavirus infection detected in Europe.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233683/pdf/ciy443.pdf

January 19, 2019 at 11:17 am

Incubation period of hantavirus cardiopulmonary syndrome.

Emerg Infect Dis. August 2006 V.12 N.8 P.1271-3.

Vial PA1, Valdivieso F, Mertz G, Castillo C, Belmar E, Delgado I, Tapia M, Ferrés M.

Author information

1 Faculdad se Medicina Clinica Alemana, Universidad del Desarrollo, Las Condes 12438, Lo Barnechea, Santiago 0000, Chile. pvial@udd.cl

Abstract

The potential incubation period from exposure to onset of symptoms was 7-39 days (median 18 days) in 20 patients with a defined period of exposure to Andes virus in a high-risk area.

This period was 14-32 days (median 18 days) in 11 patients with exposure for <48 hours.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3291207/pdf/05-1127.pdf

January 19, 2019 at 11:15 am

Notes from the Field: Contact Tracing Investigation after First Case of Andes Virus in the United States – Delaware, February 2018

MMWR Morb Mortal Wkly Rep.October 19, 2018 V.67 N.41 P.1162-1163.

Kofman A, Eggers P, Kjemtrup A, Hall R, y cols.

In January 2018, a woman admitted to a Delaware hospital tested positive for New World hantavirus immunoglobulin M (IgM) and immunoglobulin G (IgG) by enzyme-linked immunosorbent assay (ELISA). Subsequent testing by CDC’s Viral Special Pathogens Branch detected New World hantavirus by nested reverse transcription–polymerase chain reaction (RT-PCR) and Andes virus by nucleic acid sequencing.

This case represents the first confirmed importation of Andes virus infection into the United States; two imported cases have also been reported in Switzerland (1).

Before her illness, the patient had traveled to the Andes region of Argentina and Chile from December 20, 2017, to January 3, 2018. She stayed in cabins and youth hostels in reportedly poor condition. No rodent exposures were reported.

After returning to the United States on January 10, she developed fever, malaise, and myalgias on January 14. On January 17, while ill, she traveled on two commercial domestic flights.

She was hospitalized during January 20–25 in Delaware and discharged to her home after clinical recovery. . . .

FULL TEXT

https://www.cdc.gov/mmwr/volumes/67/wr/mm6741a7.htm?s_cid=mm6741a7_w

PDF

https://www.cdc.gov/mmwr/volumes/67/wr/pdfs/mm6741a7-H.pdf

January 19, 2019 at 8:59 am

Hantavirus pulmonary syndrome outbreak in Argentina: molecular evidence for person-to-person transmission of Andes virus.

Virology. February 15, 1998  V.241 N.2 P.323-30. 

Padula PJ, Edelstein A, Miguel SD, López NM, y cols.

Servicio de Biologı́a Molecular, Dpto. de Virologı́a, Instituto Nacional de Enfermedades Infecciosas, A.N.L.I.S. “Dr. Carlos G. Malbrán,” Av. Velez Sarsfield 563, 1281, Buenos Aires, Argentina

An increase of Hantavirus Pulmonary Syndrome (HPS) cases around a southwestern Argentina town and in persons living 1400 km away but in contact with those cases was detected during the spring of 1996. In order to evaluate person-to-person transmission we compared the homology of PCR-amplified viral sequences of 26 Argentine and Chilean cases. Sixteen of them were epidemiologically linked cases and had the same sequence (Epilink/96) in the S segment 3′ noncoding region and in the M segment partial G1 and G2 region (a total of 1075 nucleotides). Contrarily, two geographical and contemporary but nonepidemiologically related cases differed from Epilink/96 in the compared regions. No significant differences, such as glycosylation or hydrophilic pattern, were found between Epilink/96 and the other sequences. Nucleotide and deduced amino acid sequence homologies between samples from southern Argentina and Chile ranged from 90.9 to 100% and 96.4 to 100%, respectively. Phylogenetic analysis revealed that all the analyzed southwestern viruses belong to the Andes lineage. Although human infection principally occurs via inhalation of contaminated rodent excreta, our results with Andes virus show the first direct genetic evidence of person-to-person transmission of a hantavirus.

abstract

https://www.sciencedirect.com/science/article/pii/S0042682297989765?via%3Dihub

PDF (CLIC en PDF)

https://ac.els-cdn.com/S0042682297989765/1-s2.0-S0042682297989765-main.pdf?_tid=69ea1d0e-eba2-4a53-bf98-434e133d90f9&acdnat=1547897723_e576398105909e08bc4d98b127cca0b5

January 19, 2019 at 8:57 am

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