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2.
Cell ; 184(6): 1604-1620, 2021 03 18.
Artículo en Inglés | MEDLINE | ID: mdl-33740455

RESUMEN

Historically, emerging viruses appear constantly and have cost millions of human lives. Currently, climate change and intense globalization have created favorable conditions for viral transmission. Therefore, effective antivirals, especially those targeting the conserved protein in multiple unrelated viruses, such as the compounds targeting RNA-dependent RNA polymerase, are urgently needed to combat more emerging and re-emerging viruses in the future. Here we reviewed the development of antivirals with common targets, including those against the same protein across viruses, or the same viral function, to provide clues for development of antivirals for future epidemics.


Asunto(s)
Antivirales/uso terapéutico , Enfermedades Transmisibles Emergentes/tratamiento farmacológico , Enfermedades Transmisibles Emergentes/epidemiología , Terapia Molecular Dirigida/métodos , Pandemias , Virosis/tratamiento farmacológico , Virosis/epidemiología , Virus/enzimología , Animales , Antivirales/farmacología , Enfermedades Transmisibles Emergentes/virología , Humanos , Proteínas del Envoltorio Viral/antagonistas & inhibidores , Virosis/virología , Internalización del Virus/efectos de los fármacos
3.
Nat Med ; 27(3): 388-395, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33723452

RESUMEN

Epidemic nowcasting broadly refers to assessing the current state by understanding key pathogenic, epidemiologic, clinical and socio-behavioral characteristics of an ongoing outbreak. Its primary objective is to provide situational awareness and inform decisions on control responses. In the event of large-scale sustained emergencies, such as the COVID-19 pandemic, scientists need to constantly update their aims and analytics with respect to the rapidly evolving emergence of new questions, data and findings in order to synthesize real-time evidence for policy decisions. In this Perspective, we share our views on the functional aims, rationale, data requirements and challenges of nowcasting at different stages of an epidemic, drawing on the ongoing COVID-19 experience. We highlight how recent advances in the computational and laboratory sciences could be harnessed to complement traditional approaches to enhance the scope, timeliness, reliability and utility of epidemic nowcasting.


Asunto(s)
/epidemiología , Enfermedades Transmisibles Emergentes/epidemiología , Epidemias , Predicción/métodos , Enfermedades Transmisibles Emergentes/diagnóstico , Brotes de Enfermedades/historia , Epidemias/historia , Historia del Siglo XXI , Humanos , Pandemias , Reproducibilidad de los Resultados
4.
JMIR Public Health Surveill ; 7(3): e26719, 2021 03 24.
Artículo en Inglés | MEDLINE | ID: mdl-33759790

RESUMEN

BACKGROUND: Patient travel history can be crucial in evaluating evolving infectious disease events. Such information can be challenging to acquire in electronic health records, as it is often available only in unstructured text. OBJECTIVE: This study aims to assess the feasibility of annotating and automatically extracting travel history mentions from unstructured clinical documents in the Department of Veterans Affairs across disparate health care facilities and among millions of patients. Information about travel exposure augments existing surveillance applications for increased preparedness in responding quickly to public health threats. METHODS: Clinical documents related to arboviral disease were annotated following selection using a semiautomated bootstrapping process. Using annotated instances as training data, models were developed to extract from unstructured clinical text any mention of affirmed travel locations outside of the continental United States. Automated text processing models were evaluated, involving machine learning and neural language models for extraction accuracy. RESULTS: Among 4584 annotated instances, 2659 (58%) contained an affirmed mention of travel history, while 347 (7.6%) were negated. Interannotator agreement resulted in a document-level Cohen kappa of 0.776. Automated text processing accuracy (F1 85.6, 95% CI 82.5-87.9) and computational burden were acceptable such that the system can provide a rapid screen for public health events. CONCLUSIONS: Automated extraction of patient travel history from clinical documents is feasible for enhanced passive surveillance public health systems. Without such a system, it would usually be necessary to manually review charts to identify recent travel or lack of travel, use an electronic health record that enforces travel history documentation, or ignore this potential source of information altogether. The development of this tool was initially motivated by emergent arboviral diseases. More recently, this system was used in the early phases of response to COVID-19 in the United States, although its utility was limited to a relatively brief window due to the rapid domestic spread of the virus. Such systems may aid future efforts to prevent and contain the spread of infectious diseases.


Asunto(s)
Enfermedades Transmisibles Emergentes/diagnóstico , Registros Electrónicos de Salud , Almacenamiento y Recuperación de la Información/métodos , Vigilancia en Salud Pública/métodos , Viaje/estadística & datos numéricos , Algoritmos , Enfermedades Transmisibles Emergentes/epidemiología , Estudios de Factibilidad , Femenino , Humanos , Aprendizaje Automático , Masculino , Persona de Mediana Edad , Procesamiento de Lenguaje Natural , Reproducibilidad de los Resultados , Estados Unidos/epidemiología
6.
Prev Vet Med ; 188: 105281, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33530012

RESUMEN

Pigs (Sus scrofa) may be important surveillance targets for risk assessment and risk-based control planning against emerging zoonoses. Pigs have high contact rates with humans and other animals, transmit similar pathogens as humans including CoVs, and serve as reservoirs and intermediate hosts for notable human pandemics. Wild and domestic pigs both interface with humans and each other but have unique ecologies that demand different surveillance strategies. Three fundamental questions shape any surveillance program: where, when, and how can surveillance be conducted to optimize the surveillance objective? Using theory of mechanisms of zoonotic spillover and data on risk factors, we propose a framework for determining where surveillance might begin initially to maximize a detection in each host species at their interface. We illustrate the utility of the framework using data from the United States. We then discuss variables to consider in refining when and how to conduct surveillance. Recent advances in accounting for opportunistic sampling designs and in translating serology samples into infection times provide promising directions for extracting spatio-temporal estimates of disease risk from typical surveillance data. Such robust estimates of population-level disease risk allow surveillance plans to be updated in space and time based on new information (adaptive surveillance) thus optimizing allocation of surveillance resources to maximize the quality of risk assessment insight.


Asunto(s)
Enfermedades Transmisibles Emergentes/epidemiología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/veterinaria , Vigilancia en Salud Pública/métodos , Enfermedades de los Porcinos/epidemiología , Enfermedades de los Porcinos/virología , Zoonosis/epidemiología , Animales , Animales Salvajes/virología , Coronavirus/aislamiento & purificación , Reservorios de Enfermedades/virología , Humanos , Sus scrofa/virología , Porcinos/virología , Zoonosis/transmisión
7.
J Med Microbiol ; 70(3)2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33599604

RESUMEN

Over a decade ago, a multidrug-resistant nosocomial fungus Candida auris emerged worldwide and has since become a significant challenge for clinicians and microbiologists across the globe. A resilient pathogen, C. auris survives harsh disinfectants, desiccation and high-saline environments. It readily colonizes the inanimate environment, susceptible patients and causes invasive infections that exact a high toll. Prone to misidentification by conventional microbiology techniques, C. auris rapidly acquires multiple genetic determinants that confer multidrug resistance. Whole-genome sequencing has identified four distinct clades of C. auris, and possibly a fifth one, in circulation. Even as our understanding of this formidable pathogen grows, the nearly simultaneous emergence of its distinct clades in different parts of the world, followed by their rapid global spread, remains largely unexplained. We contend that certain host-pathogen-environmental factors have been evolving along adverse trajectories for the last few decades, especially in regions where C. auris originally appeared, until these factors possibly reached a tipping point to compel the evolution, emergence and spread of C. auris. Comparative genomics has helped identify several resistance mechanisms in C. auris that are analogous to those seen in other Candida species, but they fail to fully explain how high-level resistance rapidly develops in this yeast. A better understanding of these unresolved aspects is essential not only for the effective management of C. auris patients, hospital outbreaks and its global spread but also for forecasting and tackling novel resistant pathogens that might emerge in the future. In this review, we discuss the emergence, spread and resistance of C. auris, and propose future investigations to tackle this resilient pathogen.


Asunto(s)
Candida/fisiología , Candidiasis/microbiología , Enfermedades Transmisibles Emergentes/microbiología , Farmacorresistencia Fúngica Múltiple , Microbiología Ambiental , Antiinfecciosos/farmacología , Antiinfecciosos/uso terapéutico , Candida/clasificación , Candida/aislamiento & purificación , Candida/patogenicidad , Candidiasis/epidemiología , Candidiasis/transmisión , Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/transmisión , Infección Hospitalaria/epidemiología , Infección Hospitalaria/microbiología , Infección Hospitalaria/transmisión , Salud Global , Humanos , Virulencia
9.
Eye (Lond) ; 35(4): 1117-1139, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33514902

RESUMEN

Emerging infectious diseases (EIDs) are an increasing threat to public health on a global scale. In recent times, the most prominent outbreaks have constituted RNA viruses, spreading via droplets (COVID-19 and Influenza A H1N1), directly between humans (Ebola and Marburg), via arthropod vectors (Dengue, Zika, West Nile, Chikungunya, Crimean Congo) and zoonotically (Lassa fever, Nipah, Rift Valley fever, Hantaviruses). However, specific approved antiviral therapies and vaccine availability are scarce, and public health measures remain critical. Patients can present with a spectrum of ocular manifestations. Emerging infectious diseases should therefore be considered in the differential diagnosis of ocular inflammatory conditions in patients inhabiting or returning from endemic territories, and more general vigilance is advisable in the context of a global pandemic. Eye specialists are in a position to facilitate swift diagnosis, improve clinical outcomes, and contribute to wider public health efforts during outbreaks. This article reviews those emerging viral diseases associated with reports of ocular manifestations and summarizes details pertinent to practicing eye specialists.


Asunto(s)
Enfermedades Transmisibles Emergentes/diagnóstico , Infecciones Virales del Ojo/diagnóstico , Virosis/diagnóstico , Animales , Vectores Artrópodos , Enfermedades Transmisibles Emergentes/epidemiología , Brotes de Enfermedades , Infecciones Virales del Ojo/epidemiología , Humanos , Virus ARN/patogenicidad , Virosis/epidemiología
10.
Trends Parasitol ; 37(3): 179-181, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33487571

RESUMEN

Spatiobehavioral characteristics are stable for, and hence predictive of, most cases of contagious diseases. They should be acknowledged as a formal way of defining the epidemiology of new contagious diseases at the early stage, enabling health authorities to implement precision control and prevention of the disease at the first moment possible.


Asunto(s)
Enfermedades Transmisibles Emergentes , Métodos Epidemiológicos , Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/prevención & control , Epidemiología/tendencias , Salud Global/tendencias , Humanos , Modelos Teóricos
11.
Science ; 371(6530): 741-745, 2021 02 12.
Artículo en Inglés | MEDLINE | ID: mdl-33436525

RESUMEN

We are currently faced with the question of how the severity of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may change in the years ahead. Our analysis of immunological and epidemiological data on endemic human coronaviruses (HCoVs) shows that infection-blocking immunity wanes rapidly but that disease-reducing immunity is long-lived. Our model, incorporating these components of immunity, recapitulates both the current severity of SARS-CoV-2 infection and the benign nature of HCoVs, suggesting that once the endemic phase is reached and primary exposure is in childhood, SARS-CoV-2 may be no more virulent than the common cold. We predict a different outcome for an emergent coronavirus that causes severe disease in children. These results reinforce the importance of behavioral containment during pandemic vaccine rollout, while prompting us to evaluate scenarios for continuing vaccination in the endemic phase.


Asunto(s)
/epidemiología , Infecciones por Coronavirus/epidemiología , Enfermedades Endémicas , Inmunidad Adaptativa , Adolescente , Adulto , Distribución por Edad , Anticuerpos Antivirales/sangre , Anticuerpos Antivirales/inmunología , /transmisión , Niño , Preescolar , Enfermedades Transmisibles Emergentes/epidemiología , Coronavirus/inmunología , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/mortalidad , Enfermedades Endémicas/prevención & control , Epidemias , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Lactante , /patogenicidad , Estudios Seroepidemiológicos , Síndrome Respiratorio Agudo Grave/epidemiología , Índice de Severidad de la Enfermedad
12.
Nat Commun ; 12(1): 151, 2021 01 08.
Artículo en Inglés | MEDLINE | ID: mdl-33420058

RESUMEN

Mosquito-borne viruses threaten the Caribbean due to the region's tropical climate and seasonal reception of international tourists. Outbreaks of chikungunya and Zika have demonstrated the rapidity with which these viruses can spread. Concurrently, dengue fever cases have climbed over the past decade. Sustainable disease control measures are urgently needed to quell virus transmission and prevent future outbreaks. Here, to improve upon current control methods, we analyze temporal and spatial patterns of chikungunya, Zika, and dengue outbreaks reported in the Dominican Republic between 2012 and 2018. The viruses that cause these outbreaks are transmitted by Aedes mosquitoes, which are sensitive to seasonal climatological variability. We evaluate whether climate and the spatio-temporal dynamics of dengue outbreaks could explain patterns of emerging disease outbreaks. We find that emerging disease outbreaks were robust to the climatological and spatio-temporal constraints defining seasonal dengue outbreak dynamics, indicating that constant surveillance is required to prevent future health crises.


Asunto(s)
Fiebre Chikungunya/epidemiología , Enfermedades Transmisibles Emergentes/epidemiología , Dengue/epidemiología , Brotes de Enfermedades/estadística & datos numéricos , Enfermedades Endémicas/estadística & datos numéricos , Infección por el Virus Zika/epidemiología , Adolescente , Aedes/virología , Animales , Fiebre Chikungunya/prevención & control , Fiebre Chikungunya/transmisión , Fiebre Chikungunya/virología , Virus Chikungunya/aislamiento & purificación , Niño , Preescolar , Enfermedades Transmisibles Emergentes/prevención & control , Enfermedades Transmisibles Emergentes/transmisión , Enfermedades Transmisibles Emergentes/virología , Dengue/prevención & control , Dengue/transmisión , Dengue/virología , Virus del Dengue/aislamiento & purificación , Brotes de Enfermedades/prevención & control , República Dominicana/epidemiología , Enfermedades Endémicas/prevención & control , Monitoreo Epidemiológico , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Control de Mosquitos , Mosquitos Vectores/virología , Análisis Espacio-Temporal , Adulto Joven , Virus Zika/aislamiento & purificación , Infección por el Virus Zika/prevención & control , Infección por el Virus Zika/transmisión , Infección por el Virus Zika/virología
13.
Vector Borne Zoonotic Dis ; 21(3): 149-159, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33316200

RESUMEN

Objective: This review describes the current scenario of a priority group of emerging infectious diseases (EIDs) listed by World Health Organization (WHO), and their main determinants and drivers for the emergence/spread of the diseases. The gaps and strategies developed by India to meet the WHO guidelines on the effective control of epidemic-prone diseases and outbreaks are also presented in the review. Methods: Epidemiologic information of EIDs, namely Crimean-Congo hemorrhagic fever (CCHF), Ebola and Marburg viruses (EboV and MarV), Zika virus (ZIKAV), Rift Valley fever (RVF), Middle East respiratory syndrome, severe acute respiratory syndrome (SARS), Nipah and Hendra virus (NiV and HeV), and Lassa fever virus (LASV), was drawn from international and national electronic databases to assess the situation. A brief view on the novel coronavirus disease 2019 (COVID-19) in India is also included. Results: There are no reports for human infection of EboV, MarV, RVF, and LASV in India. CCHF, SARS, ZIKAV, and NiV have been involved in outbreaks in eight states of India, while COVID-19 is currently reported from majority of states. India has deeply strengthened its surveillance and response system of outbreaks and epidemic-prone diseases. Conclusions: Despite its enormous improvements made in the anticipation of such threats, still more efforts are needed in sensitization of populations as well as hospital management in the context to EIDs, as addressed in the review. Furthermore, there is still a need for more research and development activities to efficiently control EIDs.


Asunto(s)
Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/prevención & control , /epidemiología , Brotes de Enfermedades/prevención & control , Monitoreo Epidemiológico , Humanos , India/epidemiología , Organización Mundial de la Salud
14.
Viruses ; 12(12)2020 12 09.
Artículo en Inglés | MEDLINE | ID: mdl-33316899

RESUMEN

Emerging infectious diseases are of great concern to public health, as highlighted by the ongoing coronavirus disease 2019 (COVID-19) pandemic. Such diseases are of particular danger during mass gathering and mass influx events, as large crowds of people in close proximity to each other creates optimal opportunities for disease transmission. The Hashemite Kingdom of Jordan and the Kingdom of Saudi Arabia are two countries that have witnessed mass gatherings due to the arrival of Syrian refugees and the annual Hajj season. The mass migration of people not only brings exotic diseases to these regions but also brings new diseases back to their own countries, e.g., the outbreak of MERS in South Korea. Many emerging pathogens originate in bats, and more than 30 bat species have been identified in these two countries. Some of those bat species are known to carry viruses that cause deadly diseases in other parts of the world, such as the rabies virus and coronaviruses. However, little is known about bats and the pathogens they carry in Jordan and Saudi Arabia. Here, the importance of enhanced surveillance of bat-borne infections in Jordan and Saudi Arabia is emphasized, promoting the awareness of bat-borne diseases among the general public and building up infrastructure and capability to fill the gaps in public health preparedness to prevent future pandemics.


Asunto(s)
Quirópteros/virología , Enfermedades Transmisibles Emergentes/epidemiología , Coronavirus/aislamiento & purificación , Salud Pública , Zoonosis/epidemiología , Animales , Enfermedades Transmisibles Emergentes/virología , Coronavirus/clasificación , Coronavirus/patogenicidad , Brotes de Enfermedades/prevención & control , Humanos , Jordania , Arabia Saudita , Zoonosis/transmisión , Zoonosis/virología
15.
Viruses ; 13(1)2020 12 27.
Artículo en Inglés | MEDLINE | ID: mdl-33375455

RESUMEN

The emergence of arthropod-borne viruses (arboviruses) as linked to land-use changes, especially the growing agricultural intensification and expansion efforts in rural parts of Africa, is of growing health concern. This places an additional burden on health systems as drugs, vaccines, and effective vector-control measures against arboviruses and their vectors remain lacking. An integrated One Health approach holds potential in the control and prevention of arboviruses. Land-use changes favour invasion by invasive alien plants (IAPs) and investigating their impact on mosquito populations may offer a new dimension to our understanding of arbovirus emergence. Of prime importance to understand is how IAPs influence mosquito life-history traits and how this may affect transmission of arboviruses to mammalian hosts, questions that we are exploring in this review. Potential effects of IAPs may be significant, including supporting the proliferation of immature and adult stages of mosquito vectors, providing additional nutrition and suitable microhabitats, and a possible interaction between ingested secondary plant metabolites and arboviruses. We conclude that aspects of vector biology are differentially affected by individual IAPs and that while some plants may have the potential to indirectly increase the risk of transmission of certain arboviruses by their direct interaction with the vectors, the reverse holds for other IAPs. In addition, we highlight priority research areas to improve our understanding of the potential health impacts of IAPs.


Asunto(s)
Infecciones por Arbovirus/epidemiología , Infecciones por Arbovirus/transmisión , Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/transmisión , Culicidae/virología , Especies Introducidas , Mosquitos Vectores/virología , Plantas , Animales , Infecciones por Arbovirus/virología , Enfermedades Transmisibles Emergentes/virología , Ecosistema , Humanos
17.
Malar J ; 19(1): 386, 2020 Nov 02.
Artículo en Inglés | MEDLINE | ID: mdl-33138814

RESUMEN

The COVID-19 pandemic has had a considerable impact on other health programmes in countries, including on malaria, and is currently under much discussion. As many countries are accelerating efforts to eliminate malaria or to prevent the re-establishment of malaria from recently eliminated countries, the COVID-19 pandemic has the potential to cause major interruptions to ongoing anti-malaria operations and risk jeopardizing the gains that have been made so far. Sri Lanka, having eliminated malaria in 2012, was certified by the World Health Organization as a malaria-free country in 2016 and now implements a rigorous programme to prevent its re-establishment owing to the high receptivity and vulnerability of the country to malaria. Sri Lanka has also dealt with the COVID-19 epidemic quite successfully limiting the cumulative number of infections and deaths through co-ordinated efforts between the health sector and other relevant sectors, namely the military, the Police Department, Departments of Airport and Aviation and Foreign Affairs, all of which have been deployed for the COVID-19 epidemic under the umbrella of a Presidential Task Force. The relevance of imported infections and the need for a multi-sectoral response are features common to both the control of the COVID-19 epidemic and the Prevention of Re-establishment (POR) programme for malaria. Sri Lanka's malaria POR programme has, therefore, creatively integrated its activities with those of the COVID-19 control programme. Through highly coordinated operations the return to the country of Sri Lankan nationals stranded overseas by the COVID-19 pandemic, many from malaria endemic countries, are being monitored for malaria as well as COVID-19 in an integrated case surveillance system under quarantine conditions, to the success of both programmes. Twenty-three imported malaria cases were detected from February to October through 2773 microscopic blood examinations performed for malaria in quarantine centres, this number being not much different to the incidence of imported malaria during the same period last year. This experience highlights the importance of integrated case surveillance and the need for a highly coordinated multi-sectoral approach in dealing with emerging new infections. It also suggests that synergies between the COVID-19 epidemic control programme and other health programmes may be found and developed to the advantage of both.


Asunto(s)
Enfermedades Transmisibles Emergentes/prevención & control , Enfermedades Transmisibles Importadas/prevención & control , Infecciones por Coronavirus/complicaciones , Malaria/prevención & control , Pandemias , Neumonía Viral/complicaciones , Enfermedades Transmisibles Emergentes/complicaciones , Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Importadas/complicaciones , Enfermedades Transmisibles Importadas/epidemiología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Humanos , Malaria/complicaciones , Malaria/epidemiología , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Cuarentena , Sri Lanka/epidemiología , Viaje , Enfermedad Relacionada con los Viajes
18.
J R Soc Interface ; 17(172): 20200393, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33143594

RESUMEN

The basic reproductive number, R0, is one of the most common and most commonly misapplied numbers in public health. Often used to compare outbreaks and forecast pandemic risk, this single number belies the complexity that different epidemics can exhibit, even when they have the same R0. Here, we reformulate and extend a classic result from random network theory to forecast the size of an epidemic using estimates of the distribution of secondary infections, leveraging both its average R0 and the underlying heterogeneity. Importantly, epidemics with lower R0 can be larger if they spread more homogeneously (and are therefore more robust to stochastic fluctuations). We illustrate the potential of this approach using different real epidemics with known estimates for R0, heterogeneity and epidemic size in the absence of significant intervention. Further, we discuss the different ways in which this framework can be implemented in the data-scarce reality of emerging pathogens. Lastly, we demonstrate that without data on the heterogeneity in secondary infections for emerging infectious diseases like COVID-19 the uncertainty in outbreak size ranges dramatically. Taken together, our work highlights the critical need for contact tracing during emerging infectious disease outbreaks and the need to look beyond R0.


Asunto(s)
Betacoronavirus , Coinfección/complicaciones , Enfermedades Transmisibles Emergentes/epidemiología , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Modelos Biológicos , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Trazado de Contacto , Infecciones por Coronavirus/transmisión , Humanos , Pandemias , Neumonía Viral/transmisión , Factores de Riesgo
19.
Discov Med ; 29(158): 201-209, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33007195

RESUMEN

Sepsis is an important disorder in intensive care medicine, and the emphasis is not on infections but the imbalance in body reactions and life-threatening organ dysfunction. The infection, the imbalance in the body's reaction, and the deadly organ dysfunction are three aspects of sepsis. Currently, there is still a debate on suitable criteria for the diagnosis of patients with sepsis with continuing changes in the guidelines on sepsis management. Here we summarize recent advances on the definitions, diagnosis, and treatment in the clinical practice of sepsis management in the emergency department. We also highlight future research directions on sepsis. In particular, given the global outbreak of coronavirus disease 2019 (COVID-19), we briefly describe the relationship between COVID-19 and sepsis. How to manage sepsis caused by emerging pathogens such as COVID-19 is a new challenge for care professionals in the emergency department.


Asunto(s)
Betacoronavirus/patogenicidad , Enfermedades Transmisibles Emergentes/terapia , Infecciones por Coronavirus/terapia , Tratamiento de Urgencia/métodos , Neumonía Viral/terapia , Sepsis/terapia , Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico/métodos , Enfermedades Transmisibles Emergentes/complicaciones , Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/virología , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Servicio de Urgencia en Hospital/organización & administración , Humanos , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Sepsis/diagnóstico , Sepsis/virología , Índice de Severidad de la Enfermedad
20.
Yale J Biol Med ; 93(4): 579-585, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-33005122

RESUMEN

Not only do epidemics such as HIV/AIDS, Ebola Virus Disease (EVD), and the current Coronavirus Disease (COVID-19) cause the loss of millions of lives, but they also cost the global economy billions of dollars. Consequently, there is an urgent need to formulate interventions that will help control their spread and impact when they emerge. The education of young girls and women is one such historical approach. They are usually the vulnerable targets of disease outbreaks - they are most likely to be vehicles for the spread of epidemics due to their assigned traditional roles in resource-limited countries. Based on our work and the work of others on educational interventions, we propose six critical components of a cost-effective and sustainable response to promote girl-child education in resource-limited settings.


Asunto(s)
Enfermedades Transmisibles Emergentes , Infecciones por Coronavirus , Identidad de Género , Salud Global , Educación en Salud , Pandemias , Neumonía Viral , Betacoronavirus , Niño , Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/prevención & control , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Países en Desarrollo , Femenino , Salud Global/economía , Salud Global/educación , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Educación en Salud/métodos , Educación en Salud/organización & administración , Fiebre Hemorrágica Ebola/epidemiología , Fiebre Hemorrágica Ebola/prevención & control , Humanos , Evaluación de Necesidades , Pandemias/economía , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control
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