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1.
Eur J Public Health ; 31(3): 588-590, 2021 07 13.
Artigo em Inglês | MEDLINE | ID: mdl-33313745

RESUMO

From October to December 2019, 18 shigellosis cases (median age: 4.3 years, range: 0-21) were identified in the Reception Center for refugees/migrants on the Greek island of Samos. Fifteen cases (83.3%) were Afghani. Median time from arrival to symptoms onset was 53 days (40-101). Isolates from 14 cases, serotyped as Shigella flexneri 1b, and from three cases, serotyped as S. sonnei phase S (I), presented a multidrug-resistant phenotype. S. flexneri 1b isolates also produced extended-spectrum ß-lactamases. Shigella flexneri 2a isolate from the remaining case was resistant to sulfomethoxazole, trimethoprim and pefloxacin. Improvement of hygiene and strengthening of laboratory investigation is needed.


Assuntos
Disenteria Bacilar , Refugiados , Migrantes , Antibacterianos/uso terapêutico , Pré-Escolar , Disenteria Bacilar/tratamento farmacológico , Disenteria Bacilar/epidemiologia , Grécia/epidemiologia , Humanos , Testes de Sensibilidade Microbiana , Saúde Pública
2.
BMC Res Notes ; 5: 527, 2012 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-23009598

RESUMO

BACKGROUND: Highly infectious diseases (HIDs) are defined as being transmissible from person to person, causing life-threatening illnesses and presenting a serious public health hazard. The sampling, handling and transport of specimens from patients with HIDs present specific bio-safety concerns. FINDINGS: The European Network for HID project aimed to record, in a cross-sectional study, the infection control capabilities of referral centers for HIDs across Europe and assesses the level of achievement to previously published guidelines. In this paper, we report the current diagnostic capabilities and bio-safety measures applied to diagnostic procedures in these referral centers. Overall, 48 isolation facilities in 16 European countries were evaluated. Although 81% of these referral centers are located near a biosafety level 3 laboratory, 11% and 31% of them still performed their microbiological and routine diagnostic analyses, respectively, without bio-safety measures. CONCLUSIONS: The discrepancies among the referral centers surveyed between the level of practices and the European Network of Infectious Diseases (EUNID) recommendations have multiple reasons of which the interest of the individuals in charge and the investment they put in preparedness to emerging outbreaks. Despite the fact that the less prepared centers can improve by just updating their practice and policies any support to help them to achieve an acceptable level of biosecurity is welcome.


Assuntos
Doenças Transmissíveis/diagnóstico , Coleta de Dados/estatística & dados numéricos , Hospitais de Isolamento/normas , Controle de Infecções/normas , Técnicas de Laboratório Clínico/métodos , Técnicas de Laboratório Clínico/normas , Estudos Transversais , Coleta de Dados/métodos , Europa (Continente) , Hospitais de Isolamento/métodos , Humanos , Controle de Infecções/métodos , Técnicas Microbiológicas/métodos , Técnicas Microbiológicas/normas
3.
Scand J Infect Dis ; 41(11-12): 877-80, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19922073

RESUMO

We investigated the probability of nosocomial transmission of Crimean-Congo haemorrhagic fever (CCHF) virus among healthcare workers (HCWs) who cared for the first CCHF case in Greece. Specific IgM and/or IgG antibodies against CCHF virus were not detected in the 21 HCWs studied. Although person-to-person transmission did not take place, education of HCWs about the modes of CCHF virus transmission and appropriate infection control measures is needed in order to avoid future nosocomial cases.


Assuntos
Busca de Comunicante/métodos , Infecção Hospitalar/transmissão , Febre Hemorrágica da Crimeia/transmissão , Adulto , Infecção Hospitalar/epidemiologia , Feminino , Grécia/epidemiologia , Pessoal de Saúde/estatística & dados numéricos , Vírus da Febre Hemorrágica da Crimeia-Congo , Febre Hemorrágica da Crimeia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
4.
Curr Drug Targets ; 10(10): 1041-8, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19860646

RESUMO

As resistance of influenza viruses to antiviral agents continues to evolve, new issues arise concerning appropriate therapy and novel therapeutic means that target influenza infections. Emergence of novel influenza mutations may lead to phenotypic as well as clinical resistance that may become a problem in serious influenza cases. Moreover, crucial public health issues emerge such as appropriate antiviral stockpiling for prepandemic and pandemic phases. The use of antiviral agents against seasonal, avian, and pandemic influenza should be an integral part of current pandemic preparedness planning and should be based on local and international surveillance data on antiviral resistance. As we tackle such resistance issues there appears to be an urgent need for developing strategies to conserve current antivirals against influenza, develop new agents or formulations that will exploit current pharmacokinetic knowledge, and study combination regimens.


Assuntos
Antivirais/farmacologia , Sistemas de Liberação de Medicamentos , Influenza Humana/tratamento farmacológico , Animais , Antivirais/provisão & distribuição , Surtos de Doenças , Farmacorresistência Viral , Planejamento em Saúde/métodos , Humanos , Mutação , Saúde Pública/métodos
5.
Travel Med Infect Dis ; 7(5): 312-5, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19747668

RESUMO

Pre-travel services are underused by travellers visiting friends and relatives (VFRs). The objective of this study was to define the proportion and the profile of VFRs who seek pre-travel counselling in Greece. The study was conducted prospectively, from July, 2005 to December, 2007, in seven Health Departments of the Prefectures in Athens and Attica, where 35.6% of the Greek population resides; migrants account for 17% and 8% of the population in these areas, respectively. 2548 travellers seeking pre-travel advice were studied; 23 (0.9%) were identified as VFRs. Children younger than 15 years accounted for 30.4% of VFRs, compared to 2.3% among non-VFRs. VFRs were younger than non-VFRs (mean ages: 29.9 versus 40.4 years, respectively). A comparison of VFRs with non-VFRs revealed that VFRs travelled for longer periods of time, stayed at local people's home more frequently (87% versus 15.5%), and travelled on an organized trip less frequently (4.3% versus 54.6%). Considering the fact that 36,056 VFRs travelled from Greece to Africa and Asia during 2005-2007, and that only 1 out of 700 VFRs to these destinations pre-travel advice in Greece, communication strategies to access efficiently this group of travellers should be explored urgently.


Assuntos
Aconselhamento , Viagem , Adolescente , Idoso , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Feminino , Grécia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Vacinação
6.
Int J Infect Dis ; 13(6): 713-6, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19155182

RESUMO

In June 2008 the first non-imported fatal case of Crimean-Congo hemorrhagic fever (CCHF) was recorded in northern Greece. We present herein the public health interventions and the case definitions we developed for the epidemiological investigation. The possibility of CCHF establishing endemicity in this area is discussed.


Assuntos
Notificação de Doenças , Vírus da Febre Hemorrágica da Crimeia-Congo , Febre Hemorrágica da Crimeia/prevenção & controle , Controle de Infecções/métodos , Saúde Pública , Animais , Vetores Aracnídeos , Evolução Fatal , Feminino , Grécia/epidemiologia , Vírus da Febre Hemorrágica da Crimeia-Congo/isolamento & purificação , Febre Hemorrágica da Crimeia/diagnóstico , Febre Hemorrágica da Crimeia/virologia , Humanos , Pessoa de Meia-Idade , Carrapatos
8.
Int J Antimicrob Agents ; 33(5): 405.e1-7, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19095416

RESUMO

Metallo-beta-lactamases (MBLs) are being reported with increasing frequency and from several countries worldwide and are becoming the prevalent and most clinically significant determinants of carbapenem resistance. Furthermore, MBL-producing strains that exhibit a pan-resistant phenotype are increasingly detected. Initially MBLs were detected in Pseudomonas aeruginosa, however nowadays they are frequently found in Acinetobacter baumannii, Klebsiella pneumoniae and other Enterobacteriaceae. MBLs spread easily on plasmids and cause nosocomial infections and outbreaks with excess mortality. Such infections mainly concern patients admitted to Intensive Care Units with several co-morbidities and a history of prolonged administration of antibiotics. MBL-producing strains exhibit resistance to almost all currently available antibiotics. In vitro studies reveal that tigecycline and colistin are the only antibacterial agents with consistent activity against MBL-producing strains. Randomised controlled trials are required in order to evaluate the available therapeutic regimens, including treatment combinations. Tigecycline and colistin should be used under appropriate prescribing practices. Surveillance to monitor the emergence of resistance to these agents as well as implementation of infection control measures should be strengthened. MBL inhibitors are urgently needed, however, none is in late pre-clinical development.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Negativas/enzimologia , Infecções por Bactérias Gram-Negativas/microbiologia , beta-Lactamases/biossíntese , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Surtos de Doenças , Transferência Genética Horizontal , Bactérias Gram-Negativas/isolamento & purificação , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/epidemiologia , Humanos , Plasmídeos
9.
Recent Pat Antiinfect Drug Discov ; 3(3): 192-8, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18991801

RESUMO

Visceral leishmaniasis continues to be an important public health problem worldwide. This vector-borne infection affects approximately 500,000 people annually with more than 50,000 associated deaths, a number that among parasite diseases is surpassed by malaria only. Leishmaniasis was recently selected by the World Health Organization for elimination by 2015. Major obstacles for achieving this goal include lack of an antileishmanial vaccine, wide-spread resistance to pentavalent antimonials in the State of Bihar, India where half of cases globally occur, and drawbacks of alternative antileishmanial drugs, including prolonged administration, serious adverse effects, and high costs in poor endemic areas. During the past decade, significant progress has been made towards the development of new and less toxic antileishmanial agents, including the oral agent miltefosine. Currently, there are several agents with antileishmanial activity under investigation as well as patents that may deserve further testing within combination regimens. In order to preserve the activity of available antileishmanial agents, monitoring of their delivery, response, and resistance should be implemented globally. Combination regimens should be further investigated in large trials. The costs of antileishmanial agents should be minimized in poor endemic areas where there are needed most.


Assuntos
Antiprotozoários/uso terapêutico , Leishmaniose Visceral/tratamento farmacológico , Anfotericina B/uso terapêutico , Quimioterapia Combinada , Humanos , Leishmaniose Visceral/etiologia , Leishmaniose Visceral/imunologia
10.
J Antimicrob Chemother ; 62(6): 1407-12, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18786938

RESUMO

OBJECTIVES: To study the performance of the Becton-Dickinson Link 2 Strep A Rapid Test, a rapid antigen detection test (RADT) for diagnosing streptococcal pharyngitis in children presenting to private offices and to the Pediatric Outpatient Clinic of a university hospital, in relation to clinical criteria (fever, tender anterior cervical lymph nodes, tonsillar exudate and absence of cough), and its impact on antibiotic prescription. METHODS: Children were enrolled in Group A (enrolment by private-practice paediatricians; diagnosis by clinical picture only), Group B (enrolment by private-practice paediatricians; diagnosis by RADT and culture) or Group C (enrolment by hospital-affiliated paediatricians in the Pediatric Outpatient Clinic; diagnosis by RADT and culture). RESULTS: During a 2 year period, 820 children were enrolled [369 (45%) in Group A, 270 (33%) in Group B and 181 (22%) in Group C]. Streptococcal pharyngitis was diagnosed by RADT and culture in 146 (32.4%) of the 451 tested children. The sensitivity, specificity and positive and negative predictive values of the RADT were 83.1%, 93.3%, 82.4% and 93.6%, respectively. A stepwise increase in the sensitivity of the RADT was noted among children with one, two, three or four clinical criteria (60.9% to 95.8%). Paediatricians without access to laboratory tests were more likely to prescribe antibiotics compared with paediatricians with access to tests (72.2% versus 28.2%, P < 0.001). Private-practice paediatricians prescribed antibiotics more frequently compared with hospital-affiliated paediatricians (55.7% versus 19.9%, P < 0.001). CONCLUSIONS: Our findings support screening of all children with pharyngitis for Centor criteria and subsequently performing an RADT to guide decision for antibiotic administration. Such a strategy has an important impact on limiting throat culture testing and is associated with reduced antibiotic prescription.


Assuntos
Antibacterianos/uso terapêutico , Antígenos de Bactérias/análise , Testes Imunológicos/métodos , Faringite/microbiologia , Prescrições/estatística & dados numéricos , Infecções Estreptocócicas/diagnóstico , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Sensibilidade e Especificidade , Streptococcus/isolamento & purificação
11.
Curr Opin Infect Dis ; 21(4): 337-43, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18594283

RESUMO

PURPOSE OF REVIEW: Nosocomial influenza constitutes a serious risk among patients with underlying diseases and those of extreme age, and is associated with excess health-care costs. This article will review recent literature on this area. RECENT FINDINGS: Despite longstanding recommendations and the fact that influenza vaccination of health-care workers improves patient and employee safety, vaccine coverage among health-care workers remains low worldwide. The Centers for Disease Prevention and Control recommends the use of signed declination forms for those health-care workers who refuse vaccination. Rapid antigen detection tests may accurately diagnose influenza at the point of care, and their use has been associated with reduced antibiotic use, diagnostic tests, and costs. Multiplex molecular methods may simultaneously detect several respiratory viruses and might prove advantageous for surveillance within hospitals. The beginning of the 2007-2008 influenza season was marked by the detection of a significant proportion of influenza A/H1N1 viruses resistant to oseltamivir in Europe. Given the prohibiting rates of resistance to adamantanes worldwide, our means for containing outbreaks within health-care facilities may narrow. SUMMARY: Provision of influenza vaccine at no cost and at the work site, education to promote vaccination, and switch to a mandatory influenza vaccination policy should be implemented in order to achieve high and sustained vaccine coverage among health-care workers. Surveillance to monitor antiviral resistance in influenza viruses should be enhanced. Development of new antivirals is needed.


Assuntos
Infecção Hospitalar/prevenção & controle , Influenza Humana/prevenção & controle , Antivirais/farmacologia , Infecção Hospitalar/transmissão , Farmacorresistência Viral , Humanos , Vírus da Influenza A Subtipo H1N1/efeitos dos fármacos , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Vacinas contra Influenza/imunologia , Influenza Humana/diagnóstico , Influenza Humana/imunologia , Influenza Humana/transmissão , Técnicas de Diagnóstico Molecular , Oseltamivir/farmacologia
12.
Vaccine ; 26(11): 1408-10, 2008 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-18313179

RESUMO

We conducted a nationwide survey to investigate reasons for influenza vaccine uptake or refusal among health-care workers (HCWs) in Greece. Vaccination rates increased with increasing age, and among HCWs working in Northern Greece, in direct contact with patients, and with influenza vaccination in the past. Self-protection was the main reason for vaccination (89.1%), whereas 55.2% of HCWs reported vaccination to protect patients. Main reasons for refusing vaccination were perception of not being at risk for influenza (43.2%) and fear of vaccine adverse effects (33.4%).


Assuntos
Pessoal de Saúde/estatística & dados numéricos , Influenza Humana/imunologia , Influenza Humana/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde , Adulto , Pessoal Técnico de Saúde , Atitude do Pessoal de Saúde , Feminino , Grécia/epidemiologia , Pesquisas sobre Atenção à Saúde , Educação em Saúde , Humanos , Influenza Humana/epidemiologia , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros , Médicos , Inquéritos e Questionários , Vacinação
13.
Scand J Infect Dis ; 40(3): 266-8, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-17907042

RESUMO

The aim of the current study was to investigate the contribution of various strategies to increase influenza vaccine uptake among health care workers (HCWs) working in hospitals in Greece during the 2005-2006 season. A total of 132 Greek public hospitals participated in the study. The mean HCWs vaccination rate against influenza during 2005-2006 was 16.36% compared with 1.72% during the previous season. Logistic regression analysis showed that the implementation of the following strategies was significantly associated with influenza vaccination rates above the mean vaccination rate: a mobile vaccination team (OR 2.942, 95% CI 1.154-5.382, p-value 0.016) and lectures on influenza and influenza vaccine (OR 2.386, 95% CI 0.999-5.704, p-value 0.036). In conclusion, in Greece influenza vaccination rates among HCWs remain low; however, the implementation of specific strategies was associated with increased vaccine uptakes.


Assuntos
Vacinas contra Influenza , Influenza Humana/prevenção & controle , Vacinação/estatística & dados numéricos , Educação , Grécia , Pessoal de Saúde , Hospitais , Humanos , Sistemas Automatizados de Assistência Junto ao Leito
14.
Curr Opin Infect Dis ; 20(5): 495-500, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17762783

RESUMO

PURPOSE OF REVIEW: Crimean-Congo hemorrhagic fever is a tick-borne viral zoonosis with the potential of human-to-human transmission, affecting wide areas in Asia, Southeastern Europe, and Africa. Hemorrhagic manifestations constitute a prominent symptom of late stage disease with case fatality rates from 10% to 50%. The purpose of this article is to review recent literature on Crimean-Congo hemorrhagic fever with emphasis on its epidemiology and management. RECENT FINDINGS: Climate and environmental changes may affect Crimean-Congo hemorrhagic fever epidemiology and trigger community outbreaks. Risk factors for acquisition of infection have been well studied. In the hospital, high-risk activities include interventions for gastrointestinal bleeding and needle stick injuries. Reverse transcription-polymerase chain reaction may rapidly diagnose Crimean-Congo hemorrhagic fever with high sensitivity and specificity. Ribavirin is the only promising therapeutic agent currently available but case-control studies have not been conducted. Recently, the Mx proteins have been found to act against Crimean-Congo hemorrhagic fever virus and deserve further research. SUMMARY: Clinicians should be aware of the potential of importation of Crimean-Congo hemorrhagic fever cases from endemic areas and nosocomial transmission. Studies on the efficacy of ribavirin are needed.


Assuntos
Vírus da Febre Hemorrágica da Crimeia-Congo , Febre Hemorrágica da Crimeia , Ribavirina/uso terapêutico , Animais , Antivirais/uso terapêutico , Vírus da Febre Hemorrágica da Crimeia-Congo/genética , Vírus da Febre Hemorrágica da Crimeia-Congo/isolamento & purificação , Vírus da Febre Hemorrágica da Crimeia-Congo/fisiologia , Febre Hemorrágica da Crimeia/diagnóstico , Febre Hemorrágica da Crimeia/tratamento farmacológico , Febre Hemorrágica da Crimeia/epidemiologia , Febre Hemorrágica da Crimeia/virologia , Humanos , Carrapatos , Zoonoses
15.
Int J Antimicrob Agents ; 27(2): 87-96, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16423509

RESUMO

Methicillin-resistant Staphylococcus aureus (MRSA) should no longer be regarded as a strictly nosocomial pathogen. During the past decade, community-acquired MRSA (CA-MRSA) infections among young persons without healthcare-associated (HCA) risk factors have emerged in several areas worldwide. These infections are caused by strains that almost exclusively carry the staphylococcal cassette chromosome mec type IV element and the Panton-Valentine leukocidin genes and, unlike HCA-MRSA strains, are not multiresistant. Although the majority of CA-MRSA infections are mild skin and soft tissue infections, severe life-threatening cases of necrotizing pneumonia, necrotizing fasciitis, myonecrosis and sepsis have been reported. Clindamycin is an effective agent for skin and soft tissue infections, however attention should be paid to the possibility of the emergence of resistance during treatment in strains with the macrolide, lincosamide and group B streptogramin (MLS(B))-inducible resistance phenotype. For patients with invasive infections that may be caused be CA-MRSA, vancomycin, teicoplanin and linezolid represent appropriate empirical therapeutic options.


Assuntos
Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/microbiologia , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/efeitos dos fármacos , Antibacterianos/uso terapêutico , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/prevenção & controle , Fatores Epidemiológicos , Humanos , Resistência a Meticilina/genética , Prognóstico , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/prevenção & controle , Staphylococcus aureus/genética , Staphylococcus aureus/patogenicidade , Virulência
16.
Scand J Infect Dis ; 36(9): 639-42, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15370649

RESUMO

Mycoplasma pneumoniae and Legionella pneumophila are increasingly recognized as important agents of community-acquired lower respiratory tract infections (LRTI). Mycoplasma pneumoniae has been also recognized as a cause of nosocomial infections. The aim of this study was to investigate the role of real time polymerase chain reaction (PCR) for the rapid diagnosis of these infections among hospitalized children with community-acquired LRTI. During 2001, 65 children were prospectively studied. Microbiological investigation consisted of capillary PCR with a LightCycler for M. pneumoniae and L. pneumophila in induced sputum or throat swab specimens, IgM enzyme immunoassay for M. pneumoniae and immunofluorescence for L. pneumophila in paired sera. Serology testing showed acute M. pneumoniae infection in 18 (27.5%) patients and L. pneumophila in 1 (1.5%). M. pneumoniae was also detected in sputum specimen by capillary PCR in 9 (50%) serologically diagnosed cases, including 4 (22%) with non-diagnostic IgM levels in the acute phase. Capillary PCR and IgM enzyme immunoassay diagnosed together 15 (83%) M. pneumoniae cases in the acute phase. It is concluded that M. pneumoniae is an important cause of LRTI necessitating hospitalization among children in Greece. Capillary PCR in sputum may diagnose M. pneumoniae LRTI in the acute setting and direct therapy and isolation of patients.


Assuntos
Infecções Comunitárias Adquiridas/diagnóstico , Legionella pneumophila/isolamento & purificação , Doença dos Legionários/diagnóstico , Mycoplasma pneumoniae/isolamento & purificação , Pneumonia por Mycoplasma/diagnóstico , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Adolescente , Distribuição por Idade , Sequência de Bases , Estudos de Casos e Controles , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/microbiologia , Infecção Hospitalar/diagnóstico , Infecção Hospitalar/epidemiologia , Feminino , Grécia/epidemiologia , Hospitalização , Humanos , Incidência , Lactente , Doença dos Legionários/epidemiologia , Masculino , Dados de Sequência Molecular , Pneumonia por Mycoplasma/epidemiologia , Estudos Prospectivos , Fatores de Risco , Distribuição por Sexo
17.
Am J Trop Med Hyg ; 70(5): 540-4, 2004 May.
Artigo em Inglês | MEDLINE | ID: mdl-15155988

RESUMO

The aim of this study was to investigate the incidence, epidemiology, and clinical manifestations of Q fever among hospitalized children in Greece. During a two-year period, 1,200 children with various clinical manifestations were prospectively tested for Coxiella burnetii infection by indirect immunofluorescence. Acute Q fever was diagnosed in eight (0.67%) patients. No chronic case of infection was detected. Multivariate analysis showed that children 11-14 years old and children reporting consumption of cheese from rural areas were at increased risk for this illness. Clinical manifestations of acute Q fever were pneumonia (two patients), meningitis (two), prolonged fever (two), hepatitis (one), and hemolytic-uremic syndrome (one). Q fever accounted for 2.9% of the cases with prolonged fever, 1.2% of the cases of meningitis, and 0.5% of the cases of pneumonia. Fever and headache were the most common symptoms at presentation. Our study indicates that Q fever is a rare cause of hospitalization during childhood.


Assuntos
Febre Q/epidemiologia , Adolescente , Distribuição por Idade , Criança , Pré-Escolar , Feminino , Grécia/epidemiologia , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Febre Q/tratamento farmacológico , Febre Q/etiologia , Fatores de Risco , Estações do Ano
18.
Lancet Infect Dis ; 2(11): 686-91, 2002 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-12409049

RESUMO

Q fever is a zoonosis caused by Coxiella burnetii. Farm animals and pets are the main reservoirs of infection, and transmission to human beings is mainly accomplished through inhalation of contaminated aerosols. This illness is associated with a wide clinical spectrum, from asymptomatic or mildly symptomatic seroconversion to fatal disease. Q fever in children has been rarely reported. We reviewed published work on this topic. Seroepidemiological studies show that children are frequently exposed to C burnetii. However, children are less frequently symptomatic than adults following infection, and may have milder diseases. Using the standard diagnostic criteria, we identified 46 published paediatric cases only. Self-limited febrile illness and pneumonia were the most common manifestations of acute Q fever. Chronic disease manifested as endocarditis and osteomyelitis. A history of exposure to possible sources of infection with C burnetii in a child with a compatible infectious syndrome should prompt testing for Q fever. Studies are required to determine the spectrum of morbidity associated with Q fever during childhood.


Assuntos
Coxiella burnetii , Febre Q/diagnóstico , Animais , Animais Domésticos , Anticorpos Antibacterianos/sangue , Criança , Coxiella burnetii/imunologia , Coxiella burnetii/isolamento & purificação , Reservatórios de Doenças , Endocardite Bacteriana/microbiologia , Endocardite Bacteriana/patologia , Grécia/epidemiologia , Humanos , Imunoquímica , Países Baixos/epidemiologia , Osteomielite/patologia , Pneumonia/microbiologia , Pneumonia/patologia , Febre Q/sangue , Febre Q/epidemiologia , Estudos Soroepidemiológicos , Espanha/epidemiologia , Suíça/epidemiologia , Zâmbia/epidemiologia
19.
Curr Opin Infect Dis ; 15(3): 289-94, 2002 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12015464

RESUMO

Visceral leishmaniasis is a vector-borne systemic infection, which affects half a million people each year in many areas of the world. Typical disease manifests with fever, hepatosplenomegaly, pancytopenia, and progressive deterioration of the host. Although molecular methods appear promising as a non-invasive diagnostic tool, definite diagnosis still relies on the demonstration of the parasite in tissue. Pentavalent antimonial compounds remain the mainstay of treatment worldwide, except in India. During the past decade, short courses of lipid formulations of amphotericin B were assessed and proved effective; however, their cost precludes their wide use in developing countries. Miltefosine, an oral active agent, was recently identified, and might fulfil our expectations for an effective, safe, easily administered and affordable antileishmanial treatment.


Assuntos
Leishmaniose Visceral/tratamento farmacológico , Leishmaniose Visceral/epidemiologia , Anfotericina B/administração & dosagem , Anfotericina B/efeitos adversos , Anfotericina B/economia , Anfotericina B/uso terapêutico , Animais , Gluconato de Antimônio e Sódio/administração & dosagem , Gluconato de Antimônio e Sódio/efeitos adversos , Gluconato de Antimônio e Sódio/economia , Gluconato de Antimônio e Sódio/uso terapêutico , Criança , Vetores de Doenças , Humanos , Leishmania donovani/patogenicidade , Leishmania donovani/fisiologia , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/fisiopatologia , Meglumina/administração & dosagem , Meglumina/efeitos adversos , Meglumina/economia , Meglumina/uso terapêutico , Antimoniato de Meglumina , Compostos Organometálicos/administração & dosagem , Compostos Organometálicos/efeitos adversos , Compostos Organometálicos/economia , Compostos Organometálicos/uso terapêutico , Prevalência
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