Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 219
Filter
1.
J Proteome Res ; 19(11): 4259-4274, 2020 11 06.
Article in English | MEDLINE | ID: mdl-33095583

ABSTRACT

Emerging and re-emerging infectious diseases due to RNA viruses cause major negative consequences for the quality of life, public health, and overall economic development. Most of the RNA viruses causing illnesses in humans are of zoonotic origin. Zoonotic viruses can directly be transferred from animals to humans through adaptation, followed by human-to-human transmission, such as in human immunodeficiency virus (HIV), severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV), and, more recently, SARS coronavirus 2 (SARS-CoV-2), or they can be transferred through insects or vectors, as in the case of Crimean-Congo hemorrhagic fever virus (CCHFV), Zika virus (ZIKV), and dengue virus (DENV). At the present, there are no vaccines or antiviral compounds against most of these viruses. Because proteins possess a vast array of functions in all known biological systems, proteomics-based strategies can provide important insights into the investigation of disease pathogenesis and the identification of promising antiviral drug targets during an epidemic or pandemic. Mass spectrometry technology has provided the capacity required for the precise identification and the sensitive and high-throughput analysis of proteins on a large scale and has contributed greatly to unravelling key protein-protein interactions, discovering signaling networks, and understanding disease mechanisms. In this Review, we present an account of quantitative proteomics and its application in some prominent recent examples of emerging and re-emerging RNA virus diseases like HIV-1, CCHFV, ZIKV, and DENV, with more detail with respect to coronaviruses (MERS-CoV and SARS-CoV) as well as the recent SARS-CoV-2 pandemic.


Subject(s)
Communicable Diseases, Emerging , Proteomics , RNA Virus Infections , Animals , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques , Communicable Diseases, Emerging/diagnosis , Communicable Diseases, Emerging/therapy , Communicable Diseases, Emerging/virology , Coronavirus Infections/diagnosis , Humans , Pandemics , Pneumonia, Viral , RNA Virus Infections/diagnosis , RNA Virus Infections/therapy , RNA Virus Infections/virology , RNA Viruses
2.
Transfus Apher Sci ; 59(3): 102790, 2020 Jun.
Article in English | MEDLINE | ID: mdl-32345485

ABSTRACT

Use of convalescent plasma transfusions could be of great value in the current pandemic of coronavirus disease (COVID-19), given the lack of specific preventative and therapeutic options. This convalescent plasma therapy is of particular interest when a vaccine or specific therapy is not yet available for emerging viruses, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. This report summarizes existing literature around convalescent plasma as a therapeutic option for COVID-19. It also includes recommendations for establishing a convalescent plasma program, enhancement considerations for convalescent plasma, and considerations around pathogen reduction treatment of convalescent plasma. Time is of the essence to set up protocols for collection, preparation, and administration of apheresis-collected convalescent plasma in response to the current pandemic. The immediate use of convalescent plasma provides prompt availability of a promising treatment while specific vaccines and treatments are evaluated and brought to scale. Further development of improved convalescent plasma, vaccines and other therapeutics depends on quick generation of additional data on pathogenesis and immune response. Additionally, given the lack of information around the natural history of this disease, PRT should be considered to add a layer of safety to protect recipients of convalescent plasma.


Subject(s)
Communicable Diseases, Emerging/therapy , Coronavirus Infections/therapy , Pandemics , Pneumonia, Viral/therapy , Antibodies, Neutralizing/blood , Antibodies, Neutralizing/therapeutic use , Antibodies, Viral/blood , Antibodies, Viral/therapeutic use , Betacoronavirus/immunology , Blood Safety , COVID-19 , Communicable Diseases, Emerging/virology , Convalescence , Coronavirus Infections/blood , Coronavirus Infections/prevention & control , Donor Selection , Humans , Immunization, Passive , Meta-Analysis as Topic , Pandemics/prevention & control , Plasmapheresis , Pneumonia, Viral/blood , Pneumonia, Viral/prevention & control , SARS-CoV-2 , Severe Acute Respiratory Syndrome/therapy , United States , United States Food and Drug Administration , Virus Inactivation , COVID-19 Serotherapy
3.
Mycopathologia ; 185(5): 801-812, 2020 Oct.
Article in English | MEDLINE | ID: mdl-31845178

ABSTRACT

Pythiosis is an emerging infectious disease caused by the aquatic oomycete Pythium insidiosum, a fungal-like organism. It is believed that P. insidiosum's zoospores, its infected form, play major role in pathogenesis. Vascular and ocular infections are the most common clinical manifestation in humans. It is difficult to establish the diagnosis given its relatively rarity and difficulty to distinguish P. insidiosum from other molds. Delay in diagnosis and treatment has been associated with poor outcomes. High index of suspicion is the key, particularly in thalassemia patients with arterial insufficiency and patients with fungal keratitis/endophthalmitis without improvement on antifungal therapy. Tissue culture and zoospore induction remain gold standard for diagnosis; however, DNA-based method should be performed simultaneously. The combination of radical surgery, antifungal agents, and immunotherapy has been recommended. It was previously believed that surgery with negative surgical margins was the essential to survive in vascular pythiosis; however, it was recently found that patients could have residual disease despite documented negative surgical margins as infected clot may be dislodged to proximal arterial sites prior to surgery. Serum ß-D-glucan (BG) has been used to monitor disease response after treatment initiation in vascular pythiosis. A significant decrease in BG levels within 2 weeks after surgery is indicative of the absence of residual infection. Unfortunately, monitoring tools for ocular pythiosis are not yet available. Itraconazole plus terbinafine have generally been used in P. insidiosum-infected patients; however, antibacterial agents, including azithromycin and linezolid, have also been used with favorable outcomes in ocular disease. Recently, azithromycin or clarithromycin plus doxycyclin were used in two relapsed vascular pythiosis patients with good outcomes.


Subject(s)
Pythiosis , Pythium , Anti-Bacterial Agents/therapeutic use , Antifungal Agents/pharmacology , Communicable Diseases, Emerging/diagnosis , Communicable Diseases, Emerging/therapy , Communicable Diseases, Emerging/transmission , Drug Combinations , Eye Infections, Fungal/diagnosis , Eye Infections, Fungal/therapy , Immunotherapy/methods , Itraconazole/pharmacology , Oomycetes , Pathology, Molecular , Pythiosis/diagnosis , Pythiosis/pathology , Pythiosis/therapy , Pythiosis/transmission , Pythium/drug effects , Pythium/isolation & purification , Serologic Tests , Spores, Fungal/isolation & purification , Terbinafine/pharmacology , Thalassemia/complications , Vascular System Injuries/diagnosis , Vascular System Injuries/microbiology , Vascular System Injuries/therapy , beta-Glucans/blood
4.
Rev Epidemiol Sante Publique ; 68(2): 133-136, 2020 Apr.
Article in English | MEDLINE | ID: mdl-31862272

ABSTRACT

The social, economic and political consequences of emerging infectious disease (EID) may escape the sphere in which they first arise. In recent years, many EIDs have revealed the close links between human, animal and plant health, highlighting the need for multi-scale, multisectorial EID management. Human beings play a dual role in EID because they can promote their development through numerous human-environment interfaces and expanding international trade. On the other hand, their ability to analyze, interpret and act on the determinants of EID allows them to access the expertise necessary to control these EIDs. This expertise must be constantly adapted to remain relevant as the EID evolves, particularly in its virulence or transmission channels. Flexibility should become an inherent part of the expertise-based decision-making process even if it means going backwards. A certain degree of transparency and feedback to citizens is necessary for the acceptability of political decisions basing on expertise. A key step in the management of EID is the appropriate management of the early signal of infectious emergence. This step combines multidisciplinary skills allowing access to the best pathway for containing EID by implementing early countermeasures adapted to the situation. New digital technologies could significantly improve this early detection phase. Finally, experts have a fundamental role to play because they are located at the interface between operational actors and decision-makers, which allows multidirectional feedback, ideally in real time, between professional actors and decision makers. To combat current and future EIDs, expertise should be based on a multi-sectorial approach, promotion of collegiality and continuously adaptation to the evolving nature of EIDs.


Subject(s)
Communicable Diseases, Emerging/prevention & control , Communicable Diseases, Emerging/therapy , Infection Control , Interdisciplinary Research , Preventive Medicine , Animals , Communicable Diseases, Emerging/epidemiology , Expert Testimony , Humans , Infection Control/methods , Infection Control/organization & administration , Infection Control/trends , Interdisciplinary Communication , Interdisciplinary Research/methods , Interdisciplinary Research/organization & administration , Interdisciplinary Research/trends , Preventive Medicine/methods , Preventive Medicine/organization & administration , Preventive Medicine/trends , Research/organization & administration , Research/standards , Research/trends
5.
J Pak Med Assoc ; 70(Suppl 3)(5): S34-S37, 2020 May.
Article in English | MEDLINE | ID: mdl-32515373

ABSTRACT

Infectious diseases resulting in epidemics and pandemics have moulded human history and continue to do so even today. Cholera, plague, human immunodeficiency virus (HIV), and influenza have been some of the most brutal killers. The advancement of medical science has helped us win the war against several of these deadly agents. However, despite all our efforts, new agents continue to emerge. Studying the pandemics of the past helps us respond better to those affecting the globe today. In this narrative review, we present the greatest pandemics of the past, and discuss how the lessons from history may aid us in preparing for the future.


Subject(s)
Communicable Diseases, Emerging , History , Pandemics/prevention & control , Civil Defense/organization & administration , Communicable Diseases, Emerging/classification , Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/prevention & control , Communicable Diseases, Emerging/therapy , Global Health , Humans , World Health Organization
6.
Br J Dermatol ; 180(6): 1302-1311, 2019 06.
Article in English | MEDLINE | ID: mdl-30585627

ABSTRACT

BACKGROUND: Human polyomaviruses (HPyVs) are small, nonenveloped, double-stranded DNA viruses that express tumour antigen proteins. Fourteen species of polyomaviruses have been discovered in humans, and since the 2008 discovery of the first cutaneous polyomavirus - Merkel cell polyomavirus (MCPyV) - six more species have been detected in the skin: trichodysplasia spinulosa-associated polyomavirus (TSPyV), HPyV6, HPyV7, HPyV9, HPyV10 and HPyV13. Of these cutaneous species, only MCPyV, TSPyV, HPyV6 and HPyV7 have been definitively associated with diseases of the skin, most commonly in immunocompromised individuals. MCPyV is a predominant aetiology in Merkel cell carcinomas. TSPyV is one of the aetiological factors of trichodysplasia spinulosa. HPyV6 and HPyV7 have been recently linked to pruritic skin eruptions. The roles of HPyV9, HPyV10 and HPyV13 in pathogenesis, if any, are still unknown, but their molecular features have provided some insight into their functional biology. RESULTS: In this review, we summarize the known molecular mechanisms, clinical presentation and targeted therapies of each of the eight cutaneous HPyVs. CONCLUSIONS: We hope that heightened awareness and clinical recognition of HPyVs will lead to increased reports of HPyV-associated diseases and, consequently, a more robust understanding of how to diagnose and treat these conditions.


Subject(s)
Communicable Diseases, Emerging/virology , Polyomavirus Infections/virology , Polyomavirus/physiology , Skin Diseases, Viral/virology , Tumor Virus Infections/virology , Carcinogenesis , Communicable Diseases, Emerging/therapy , Humans , Immunocompromised Host , Polyomavirus/genetics , Polyomavirus Infections/therapy , Skin Diseases, Viral/therapy , Tumor Virus Infections/therapy
7.
Pediatr Transplant ; 23(1): e13303, 2019 02.
Article in English | MEDLINE | ID: mdl-30338634

ABSTRACT

Recent years have brought a rise in newly emergent viral infections, primarily in the form of previously known arthropod-transmitted viruses that have increased significantly in both incidence and geographical range. Of particular note are DENV, CHIKV, and ZIKV, which are transmitted mostly by Aedes species of mosquitoes that exhibit a wide and increasing global distribution. Being important pathogens for the general population, these viruses have the potential to be devastating in the international transplant community, with graft rejection and death as possible outcomes of infection. In this review, we discuss the current state of knowledge for these viruses as well as repercussions of infection in the solid organ and HSCT population, with a focus, when possible, on pediatric patients.


Subject(s)
Arbovirus Infections , Communicable Diseases, Emerging , Organ Transplantation , Postoperative Complications , Arbovirus Infections/diagnosis , Arbovirus Infections/epidemiology , Arbovirus Infections/etiology , Arbovirus Infections/therapy , Child , Communicable Diseases, Emerging/diagnosis , Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/etiology , Communicable Diseases, Emerging/therapy , Global Health , Humans , Pediatrics , Postoperative Complications/diagnosis , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Postoperative Complications/therapy , Risk Factors
8.
Semin Diagn Pathol ; 36(3): 164-169, 2019 May.
Article in English | MEDLINE | ID: mdl-31006555

ABSTRACT

Trypanosoma cruzi, the protozoan that causes Chagas disease, is primarily transmitted by three main Triatomine vectors in endemic areas. However, the infection has become a potential emerging disease because the vector is found in non-endemic areas, there is migration of infected asymptomatic people that can infect the vector, become blood donors, or pass the disease vertically (congenital infections). Lastly, the disease can be acquired through contaminated food (oral transmission). This review will present the different transmission pathways, clinical manifestations, diagnostic modalities and treatment considerations of Chagas disease.


Subject(s)
Chagas Disease/transmission , Communicable Diseases, Emerging/transmission , Trypanosoma cruzi/physiology , Chagas Disease/diagnosis , Chagas Disease/parasitology , Chagas Disease/therapy , Communicable Diseases, Emerging/diagnosis , Communicable Diseases, Emerging/parasitology , Communicable Diseases, Emerging/therapy , Humans
9.
Semin Diagn Pathol ; 36(3): 193-196, 2019 May.
Article in English | MEDLINE | ID: mdl-31053264

ABSTRACT

Transboundary animal diseases are those that can move through a population of animals and cause considerable economic and societal harm. Many have high mortality, and in low-income areas, can quickly destroy herds and flocks of agricultural animals. Although much of One Health, which sits at the intersection of human, animal, and environmental health, focuses on the zoonotic diseases, in fact transboundary animal diseases can harm both humans and the environment through robbing communities of livelihoods and nutrition, and creating environmental contamination through extensive carcass disposal requirements. Transboundary animal diseases continue to circulate in the world, predominantly in low-income regions or in areas with less than optimal biosecurity. This paper will review three prominent emerging and re-emerging transboundary animal diseases, describing their pathology and diagnostics, as well as economic and food security impacts, which are substantial. Attention to these devastating diseases should be a One Health priority.


Subject(s)
Animal Diseases/epidemiology , Communicable Diseases, Emerging/epidemiology , Food Supply , One Health , Animal Diseases/diagnosis , Animal Diseases/pathology , Animal Diseases/therapy , Animals , Communicable Diseases, Emerging/diagnosis , Communicable Diseases, Emerging/pathology , Communicable Diseases, Emerging/therapy , Environmental Health , Humans , Zoonoses
10.
Rev Sci Tech ; 38(2): 537-551, 2019 Sep.
Article in English, French, Spanish | MEDLINE | ID: mdl-31866677

ABSTRACT

Since 1970, aquaculture has grown at a rate of between 5% and 10% per annum. It has achieved this by expanding into new areas, farming new (often non-native) species and intensifying production. These features of aquaculture, combined with large-scale movements of animals, have driven disease emergence, with negative consequences for both production and biodiversity. Efforts to improve the management of emerging diseases of aquatic animals must include actions to reduce the rate of disease emergence, enhance disease detection and reporting, and improve responses to prevent disease spread. The rate of disease emergence can be reduced by understanding the underpinning mechanisms and developing measures to mitigate them. The three principal mechanisms of disease emergence, namely, host switching, decreased host immunocompetence and increased pathogen virulence, have many drivers. The most important of these drivers are those that expose susceptible hosts to novel pathogens (e.g. the introduction of non-native hosts, translocation of pathogens, and increased interaction between wild and farmed populations), followed by host switching. Exposure to wild populations can be reduced through infrastructure and management measures to reduce escapes or exclude wild animals (e.g. barrier nets, filtration and closed-confinement technology). A high standard of health management ensures immunocompetence and resistance to putative new pathogens and strains, and thus reduces the rate of emergence. Appropriate site selection and husbandry can reduce the likelihood of pathogens developing increased virulence by preventing their continuous cycling in geographically or temporally linked populations. The under-reporting of emerging aquatic animal diseases constrains appropriate investigation and timely response. At the producer level, employing information and communications technology (e.g. smartphone applications and Cloud computing) to collect and manage data, coupled with a farmer-centric approach to surveillance, could improve reporting. In addition, reporting behaviours must be understood and disincentives mitigated. At the international level, improving the reporting of emerging diseases to the World Organisation for Animal Health allows Member Countries to implement appropriate measures to reduce transboundary spread. Reporting would be incentivised if the global response included the provision of support to low-income countries to, in the short term, control a reported emerging disease, and, in the longer term, develop aquatic animal health services. Early detection and reporting of emerging diseases are only of benefit if Competent Authorities' responses prevent disease spread. Effective responses to emerging diseases are challenging because basic information and tools are often lacking. Consequently, responses are likely to be sub-optimal unless contingency plans have been developed and tested, and decision-making arrangements have been well established.


Depuis les années 1970, l'aquaculture connaît un taux de croissance de 5 % à 10 % par an. Cette croissance a été rendue possible par le développement de nouvelles filières, l'élevage d'espèces nouvelles (et souvent non autochtones) et l'intensification de la production. Ces caractéristiques du secteur, associées à des transferts massifs d'espèces aquatiques ont entraîné l'émergence de maladies nouvelles, avec des effets négatifs aussi bien sur la production que sur la biodiversité. Les efforts d'amélioration de la gestion des maladies émergentes des animaux aquatiques doivent comporter des mesures visant à réduire l'incidence des maladies émergentes, à améliorer la détection et la notification des maladies et à optimiser les réponses déployées en cas de maladies afin d'en prévenir la propagation. Il est possible de réduire le taux d'émergence des maladies dès lors que les mécanismes sous-jacents à leur survenue sont bien compris et que les mesures appropriées sont prises pour les contrecarrer. Les trois principaux mécanismes d'émergence de maladies, à savoir la colonisation de nouveaux hôtes par des agents pathogènes, la baisse de l'immunocompétence des hôtes et la virulence accrue des agents pathogènes ont plusieurs facteurs déclenchants. Parmi ceux-ci, les plus importants sont ceux qui exposent les hôtes sensibles à des agents pathogènes nouveaux (par exemple l'introduction d'espèces hôtes non autochtones, les transferts d'agents pathogènes et les interactions accrues entre les populations sauvages et d'élevage), suivis par la colonisation de nouvelles espèces hôtes par des agents pathogènes. L'exposition aux populations sauvages peut être atténuée au moyen d'infrastructures appropriées et de mesures de gestion visant à limiter les évasions ou à exclure les espèces sauvages (par exemple, filets de retenue, filtration des eaux et technologies de confinement en système fermé). Une gestion sanitaire de haut niveau qualitatif permet de préserver l'immunocompétence et la résistance à de nouveaux agents et souches pathogènes potentiels, réduisant ainsi le taux d'émergence de nouvelles maladies. Une sélection appropriée du site de production et des techniques d'élevage permet de réduire la probabilité que les agents pathogènes puissent acquérir une virulence accrue, en les empêchant de prolonger leur cycle dans des populations spatialement ou temporellement reliées. La sous-déclaration de maladies émergentes des animaux aquatiques limite les possibilités de procéder à des enquêtes appropriées et d'organiser la réponse en temps voulu. Au niveau des producteurs, le niveau de notification peut être amélioré en recourant aux technologies de l'information et de la communication (par exemple les applications sur téléphonie mobile et l'informatique en nuage) pour la collecte et la gestion des données et en leur associant une méthodologie de la surveillance centrée sur l'éleveur. En outre, il est essentiel de comprendre les comportements en matière de notification et d'atténuer les facteurs de dissuasion. Au niveau international, la notification de maladies émergentes à l'Organisation mondiale de la santé animale permet aux Pays membres de mettre en place des mesures appropriées pour réduire leur propagation transfrontalière. Une méthode incitative envisageable pour améliorer la notification consiste à ce que la réponse mondiale prévoie d'apporter aux pays à faible revenu le soutien nécessaire pour que ceux-ci puissent, à court terme, lutter contre chaque maladie émergente notifiée et, à plus long terme, créer des Services nationaux chargés de la santé des animaux aquatiques. La détection précoce et la notification rapide des maladies émergentes ne portent leurs fruits que si les réponses mises en place par les Autorités compétentes empêchent toute propagation de ces maladies. Le déploiement de réponses efficaces en cas de maladie émergente est difficile, car les pays manquent souvent d'informations et d'outils de base. En conséquence, les réponses sont souvent inadéquates, à moins que des plans d'urgence n'aient été élaborés et testés, soutenus par des instruments décisionnels bien établis.


Desde 1970 la acuicultura ha registrado una tasa de crecimiento anual de entre el 5% y el 10%, cosa que ha logrado expandiéndose a nuevos territorios, cultivando nuevas especies (a menudo no autóctonas) e intensificando la producción. Estas características de la acuicultura, combinadas con los desplazamientos a gran escala de animales, han provocado la aparición de enfermedades y su cortejo de efectos negativos sobre la producción y la diversidad biológica. Las iniciativas para gestionar más eficazmente las enfermedades emergentes de los animales acuáticos deben incluir medidas que reduzcan la tasa de aparición de enfermedades, ayuden a detectarlas y notificarlas y mejoren las respuestas destinadas a impedir que se propaguen. La tasa de aparición de enfermedades se puede reducir entendiendo los mecanismos que subyacen al proceso e implantando medidas para contrarrestarlos. Los tres principales de esos mecanismos (a saber, el cambio de hospedador, la menor inmunocompetencia de los organismos hospedadores y la mayor virulencia de los patógenos) resultan de la suma de muchos factores. Los más importantes son aquellos que entrañan la exposición de un hospedador sensible a nuevos patógenos (p.ej. la introducción de hospedadores no autóctonos, el traslado de patógenos y el aumento de las interacciones entre poblaciones salvajes y poblaciones de cultivo) y aquellos que desembocan en un cambio de hospedador. Para reducir los niveles de exposición a poblaciones salvajes se pueden implantar medidas de gestión o de infraestructura que hagan difícil que los animales escapen o los aíslen de la fauna salvaje (como redes de barrera, filtración y tecnología de confinamiento cerrado). Una gestión sanitaria de buena calidad asegura la inmunocompetencia y la resistencia a cepas y patógenos supuestamente nuevos, reduciendo con ello la tasa de aparición de enfermedades emergentes. La selección de emplazamientos apropiados y el uso de métodos de cría convenientes pueden reducir la probabilidad de que los patógenos adquieran mayor virulencia porque evitan la continuidad de sus ciclos reproductivos entre poblaciones conectadas entre sí, ya sea geográfica o temporalmente. La insuficiente notificación de enfermedades emergentes de los animales acuáticos supone un lastre para estudiarlas debidamente y responder a ellas con celeridad. Las soluciones para mejorar los niveles de notificación trabajando desde la propia explotación podrían pasar por el uso de las tecnologías de información y comunicación (como las aplicaciones de teléfono inteligente o la informática «en nube¼) para obtener y gestionar datos, combinado con fórmulas de vigilancia cuya figura central sea el productor. Es preciso además entender los comportamientos ligados al hecho de notificar o no una enfermedad y restar peso a aquellos factores que desincentiven la notificación. A escala internacional, una más eficaz notificación de enfermedades emergentes a la Organización Mundial de Sanidad Animal permite a los Países Miembros aplicar medidas apropiadas para reducir la propagación transfronteriza. Algo que incentivaría la notificación es que entre las medidas mundiales de respuesta estuviera la prestación de apoyo a los países de renta baja para ayudarlos, a corto plazo, a controlar la enfermedad emergente notificada y, a más largo plazo, a dotarse de buenos servicios de sanidad acuícola. La pronta detección y notificación de enfermedades emergentes solo resulta provechosa si la respuesta de las autoridades competentes evita que la enfermedad se propague. Lo que dificulta una respuesta eficaz a las enfermedades emergentes es la frecuente falta de información y herramientas básicas. Lo más probable, por lo tanto, es que las respuestas no sean las idóneas a menos que se tengan elaborados y ensayados planes de emergencia y se tengan bien implantados mecanismos decisorios al respecto.


Subject(s)
Animal Diseases , Aquaculture , Communicable Diseases, Emerging/veterinary , Animal Diseases/prevention & control , Animal Diseases/transmission , Animals , Animals, Wild , Communicable Diseases, Emerging/therapy , Communicable Diseases, Emerging/transmission , Global Health
11.
Curr Opin Rheumatol ; 30(3): 256-263, 2018 05.
Article in English | MEDLINE | ID: mdl-29389830

ABSTRACT

PURPOSE OF REVIEW: To review the emergence, clinical features, pathogenesis, and treatment of acute chikungunya (CHIK) fever and chronic CHIK arthritis. RECENT FINDINGS: Since 2004, CHIK, an arboviral infection, has spread throughout the world, infecting millions of people. The illness occurs in two phases: an acute viremic infection followed by chronic arthritis. In less developed countries, there are limited resources and effective treatment. For acutely ill CHIK fever patients, management is symptomatic. The treatment of chronic CHIK arthritis should be determined by an understanding of pathogenesis. Is chronic CHIK arthritis a persistent viral infection or a postinfectious inflammatory process? Multiple proinflammatory cytokines, chemokines, and growth factors have been identified in chronic CHIK arthritis. Attempts to isolate CHIK virus from synovial fluid have been unsuccessful. Given pathogenetic similarities (as well as differences) compared with rheumatoid arthritis and the painful, disabling nature of the arthritis, it is not surprising that disease-modifying antirheumatic drugs such as methotrexate have begun to be used. SUMMARY: CHIK infection has emerged with major arthritic epidemics for which evidence-based therapy is limited. But there is an opportunity to improve the treatment of chronic CHIK arthritis and, from this disease, to gain understanding of the pathogenesis and treatment of inflammatory arthritis more generally.


Subject(s)
Arthritis, Infectious/therapy , Chikungunya Fever/therapy , Chikungunya virus/isolation & purification , Communicable Diseases, Emerging/therapy , Arthritis, Infectious/diagnosis , Arthritis, Infectious/virology , Chikungunya Fever/diagnosis , Chikungunya Fever/etiology , Chikungunya Fever/virology , Chronic Disease , Communicable Diseases, Emerging/diagnosis , Communicable Diseases, Emerging/virology , Humans
12.
Microb Ecol ; 76(1): 19-36, 2018 Jul.
Article in English | MEDLINE | ID: mdl-27480226

ABSTRACT

The threat from microorganisms is complex, and the approaches for reducing the challenges the world is facing are also multifaceted, but a combination approach including several simple steps can make a difference and reduce morbidity and mortality and the economic cost of fighting infectious diseases. This paper discusses the continually evolving infectious disease landscape, contributing factors in the rise of the threat, reasons for optimism, and the policies, technologies, actions, and institutions that might be harnessed to further reduce the dangers introduced by pathogens. It builds upon and updates the work of other authors that have recognized the dangers of emerging and re-emerging pathogens and have explored and documented potential solutions.


Subject(s)
Communicable Diseases, Emerging/etiology , Communicable Diseases, Emerging/therapy , Bioterrorism , Climate Change , Communicable Diseases, Emerging/economics , Communicable Diseases, Emerging/transmission , Disaster Planning , Disasters , Drug Misuse , Drug Resistance , Drug Users , Forecasting , Global Warming , Humans , Prescription Drug Overuse , Risk Factors , Sexual Behavior , Social Conditions , Travel , Urbanization , Vaccination
13.
Rev Epidemiol Sante Publique ; 66(1): 81-90, 2018 Feb.
Article in English | MEDLINE | ID: mdl-29223514

ABSTRACT

We present here the proceedings of the 5th seminar on emerging infectious diseases, held in Paris on March 22nd, 2016, with seven priority proposals that can be outlined as follows: encourage research on the prediction, screening and early detection of new risks of infection; develop research and surveillance concerning transmission of pathogens between animals and humans, with their reinforcement in particular in intertropical areas ("hot-spots") via public support; pursue aid development and support in these areas of prevention and training for local health personnel, and foster risk awareness in the population; ensure adapted patient care in order to promote adherence to treatment and to epidemic propagation reduction measures; develop greater awareness and better education among politicians and healthcare providers, in order to ensure more adapted response to new types of crises; modify the logic of governance, drawing from all available modes of communication and incorporating new information-sharing tools; develop economic research on the fight against emerging infectious diseases, taking into account specific driving factors in order to create a balance between preventive and curative approaches.


Subject(s)
Communicable Diseases, Emerging , Congresses as Topic , Infection Control , Information Dissemination/methods , Climate Change , Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/therapy , Ecology , Humans , Infection Control/methods , Infection Control/organization & administration , Infection Control/trends , Paris , Public Health/methods , Public Health/trends , Systems Integration
15.
Internist (Berl) ; 59(4): 334-340, 2018 Apr.
Article in German | MEDLINE | ID: mdl-29459991

ABSTRACT

Infectious diseases have recently gained wide public interest. Emerging infections and rising rates of antibiotic resistance are determining this trend. Both challenges will need to be addressed in international and local collaborations between different specialties in medicine and basic science. Infectious diseases as a clinical specialty in this scenario is directly responsible for the care of patients with infectious diseases. Its involvement in the care of patients with complicated infections has proved to be highly effective. Antibiotic stewardship programmes are effective measures in slowing the development of antibiotic resistance and have been widely implemented. But antibiotic stewardship specialists should not be confused with or taken as an alternative to infectious disease experts. Infectious diseases requires appropriate and specific training. It mainly uses the instrumentarium of internal medicine. With the current challenges in modern medicine, infectious diseases in Germany should thus be upgraded from a subspecialty to a clinical specialty, ideally within Internal Medicine.


Subject(s)
Infectious Disease Medicine/education , Internal Medicine/education , Specialization , Antimicrobial Stewardship , Communicable Diseases, Emerging/diagnosis , Communicable Diseases, Emerging/therapy , Curriculum , Drug Resistance, Microbial , Education, Medical, Graduate , Germany , Humans
16.
Clin Infect Dis ; 65(suppl_1): S39-S49, 2017 Aug 15.
Article in English | MEDLINE | ID: mdl-28859351

ABSTRACT

Since its creation, the Méditerranée-Infection foundation has aimed at optimizing the management of infectious diseases and surveying the local and global epidemiology. This pivotal role was permitted by the development of rational sampling, point-of-care tests, and extended automation as well as new technologies, including mass spectrometry for colony identification, real-time genomics for isolate characterization, and the development of versatile and permissive culture systems. By identifying and characterizing emerging microbial pathogens, these developments provided significant breakthroughs in infectious diseases.


Subject(s)
Bacteria/isolation & purification , Bacterial Infections/microbiology , Communicable Diseases, Emerging/microbiology , Communicable Diseases/diagnosis , Automation, Laboratory , Bacteria/pathogenicity , Bacterial Infections/diagnosis , Bacterial Infections/prevention & control , Bacterial Infections/therapy , Bacteriological Techniques , Communicable Diseases/microbiology , Communicable Diseases, Emerging/diagnosis , Communicable Diseases, Emerging/prevention & control , Communicable Diseases, Emerging/therapy , Genomics/methods , Humans , Laboratories , Mass Spectrometry , Point-of-Care Systems
17.
Infection ; 45(4): 545-549, 2017 Aug.
Article in English | MEDLINE | ID: mdl-27826871

ABSTRACT

INTRODUCTION: Morbidity and mortality of Herpes simplex virus encephalitis (HSE) remain high. Relapses of neurological signs may occur after initial clinical improvement under acyclovir treatment. METHODS: We report here a case of post-HSE anti-N-methyl-d-aspartate receptor-mediated encephalitis in an adult and perform a systematic search on PubMed to identify other cases in adults. RESULTS: We identified 11 previously published cases, to discuss diagnostic and therapeutic management. Symptoms in adults are often inappropriate behaviors, confusion and agitation. Diagnosis of anti-NMDA-R encephalitis after HSE is often delayed. Treatment consists in steroids, plasma exchange, and rituximab. Prognosis is often favorable. CONCLUSION: Anti-NMDA-R antibodies should be searched in cerebrospinal fluid of patients with unexpected evolution of HSE. This emerging entity reopens the hot debate about steroids in HSE.


Subject(s)
Acyclovir/therapeutic use , Anti-N-Methyl-D-Aspartate Receptor Encephalitis/diagnosis , Anti-N-Methyl-D-Aspartate Receptor Encephalitis/therapy , Antiviral Agents/therapeutic use , Encephalitis, Herpes Simplex/diagnosis , Encephalitis, Herpes Simplex/therapy , Anti-N-Methyl-D-Aspartate Receptor Encephalitis/drug therapy , Communicable Diseases, Emerging/diagnosis , Communicable Diseases, Emerging/drug therapy , Communicable Diseases, Emerging/therapy , Encephalitis, Herpes Simplex/drug therapy , Female , France , Humans , Middle Aged , Recurrence
18.
Vet Dermatol ; 28(1): 96-e21, 2017 Feb.
Article in English | MEDLINE | ID: mdl-28133871

ABSTRACT

BACKGROUND: Bartonellosis is a zoonotic infectious disease of worldwide distribution, caused by an expanding number of recently discovered Bartonella spp. OBJECTIVES: This review serves as an update on comparative medical aspects of this disease, including the epidemiology, pathogenesis, clinical diagnosis, treatment and challenges. RESULTS: Of comparative medical importance, Bartonella spp. are transmitted by several arthropod vectors, including fleas, keds, lice, sand flies, ticks and, potentially, mites and spiders. Prior to 1990, there was only one named Bartonella species (B. bacilliformis), whereas there are now over 36, of which 17 have been associated with an expanding spectrum of animal and human diseases. Recent advances in diagnostic techniques have facilitated documentation of chronic bloodstream and dermatological infections with Bartonella spp. in healthy and sick animals, in human blood donors, and in immunocompetent and immunocompromised human patients. The field of Bartonella research remains in its infancy and is rich in questions, for which patient relevant answers are badly needed. Directed Bartonella research could substantially reduce a spectrum of chronic and debilitating animal and human diseases, and thereby reduce suffering throughout the world. CONCLUSION: A One Health approach to this emerging infectious disease is clearly needed to define disease manifestations, to establish the comparative infectious disease pathogenesis of this stealth pathogen, to validate effective treatment regimens and to prevent zoonotic disease transmission.


Subject(s)
Bartonella Infections/etiology , Animals , Bartonella , Bartonella Infections/diagnosis , Bartonella Infections/therapy , Bartonella Infections/veterinary , Communicable Diseases, Emerging/diagnosis , Communicable Diseases, Emerging/therapy , Communicable Diseases, Emerging/veterinary , Humans , Zoonoses/diagnosis , Zoonoses/microbiology , Zoonoses/therapy , Zoonoses/transmission
19.
Rev Med Suisse ; 13(544-545): 66-69, 2017 Jan 11.
Article in French | MEDLINE | ID: mdl-28703540

ABSTRACT

Several outbreaks have made the news in 2016 : Ebola has come at an end, Zika is booming and a resurgence of yellow fever takes place in Africa. In Switzerland, two hospital outbreaks have been reported, caused by Mycobacterium chimerae and Burkholderia cepacia. A major new article has consolidated the notion that prolonged antibiotic therapy is unnecessary in Lyme disease. As multiresistant bacteria are increasing in frequency, innovative therapeutic approaches are under development. For lung infections, sensitive and specific methods are in need to refine their etiological diagnosis. In pneumonia, therapy can be shortened without risk compared with usual practice. Finally, the epidemiology of bacterial meningitis has changed in the last 10 years, with a decrease of incidence.


Plusieurs épidémies ont fait l'actualité en 2016 : celle d'Ebola qui est arrivée à son terme, celle de Zika qui est en pleine expansion et une résurgence de la fièvre jaune sur le continent africain. En Suisse, deux épidémies hospitalières ont été rapportées, dues aux bactéries Mycobacterium chimerae et Burkholderia cepacia. Un nouvel article majeur a consolidé la notion que l'antibiothérapie prolongée est inutile dans la maladie de Lyme. Les bactéries multirésistantes augmentent en fréquence ; des approches thérapeutiques innovatrices sont en développement. Pour les infections pulmonaires, on est toujours à la recherche de méthodes sensibles et spécifiques pour affiner le diagnostic étiologique. Dans la pneumonie, la durée du traitement peut être raccourcie sans risque par rapport à ce qui se fait usuellement. Enfin, l'épidémiologie des méningites bactériennes a beaucoup changé ces 10 dernières années, avec une diminution de l'incidence de cette maladie.


Subject(s)
Communicable Diseases , Anti-Bacterial Agents/classification , Anti-Bacterial Agents/isolation & purification , Anti-Bacterial Agents/therapeutic use , Communicable Diseases/diagnosis , Communicable Diseases/epidemiology , Communicable Diseases/therapy , Communicable Diseases, Emerging/microbiology , Communicable Diseases, Emerging/therapy , Communicable Diseases, Emerging/virology , Drug Resistance, Multiple, Bacterial , Epidemics/statistics & numerical data , Humans , Lyme Disease/therapy , Meningitis, Bacterial/diagnosis , Meningitis, Bacterial/epidemiology , Meningitis, Bacterial/therapy , Respiratory Tract Infections/drug therapy , Respiratory Tract Infections/epidemiology , Virus Diseases/diagnosis , Virus Diseases/epidemiology , Virus Diseases/therapy
SELECTION OF CITATIONS
SEARCH DETAIL