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1.
3.
J Travel Med ; 26(8)2019 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-31616923

RESUMO

RATIONALE FOR REVIEW: Young adults of childbearing age and pregnant women are travelling more frequently to tropical areas, exposing them to specific arboviral infections such as dengue, zika and chikungunya viruses, which may impact ongoing and future pregnancies. In this narrative review, we analyse their potential consequences on pregnancy outcomes and discuss current travel recommendations. MAIN FINDINGS: Dengue virus may be associated with severe maternal complications, particularly post-partum haemorrhage. Its association with adverse fetal outcomes remains unclear, but prematurity, growth retardation and stillbirths may occur, particularly in cases of severe maternal infection. Zika virus is a teratogenic infectious agent associated with severe brain lesions, with similar risks to other well-known TORCH pathogens. Implications of chikungunya virus in pregnancy are mostly related to intrapartum transmission that may be associated with severe neonatal infections and long-term morbidity. TRAVEL RECOMMENDATIONS: Few agencies provide specific travel recommendations for travelling pregnant patients or couples trying to conceive and discrepancies exist, particularly regarding Zika virus prevention. The risks significantly depend on epidemiological factors that may be difficult to predict. Prevention relies principally on mosquito control measures. Couples trying to conceive and pregnant women should receive adequate information about the potential risks. It seems reasonable to advise pregnant women to avoid unnecessary travel to Aedes spp. endemic regions. The current rationale to avoid travel and delay conception is debatable in the absence of any epidemic. Post-travel laboratory testing should be reserved for symptomatic patients.

6.
Sci Rep ; 9(1): 11169, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31371776

RESUMO

A 59-year-old tobacco smoker male with chronic bronchitis living in Taravao, French Polynesia, Pacific, presented with a two-year growing nodule in the middle lobe of the right lung. A guided bronchoalveolar lavage inoculated onto Löwenstein-Jensen medium yielded colonies of a rapidly-growing non-chromogenic mycobacterium designed as isolate P7213. The isolate could not be identified using routine matrix-assisted laser desorption ionization-time of flight-mass spectrometry and phenotypic and probe-hybridization techniques and yielded 100% and 97% sequence similarity with the respective 16S rRNA and rpoB gene sequences of Mycobacterium virginiense in the Mycobacterium terrae complex. Electron microscopy showed a 1.15 µm long and 0.38 µm large bacillus which was in vitro susceptible to rifampicin, rifabutin, ethambutol, isoniazid, doxycycline and kanamycin. Its 4,511,948-bp draft genome exhibited a 67.6% G + C content with 4,153 coding-protein genes and 87 predicted RNA genes. Genome sequence-derived DNA-DNA hybridization, OrthoANI and pangenome analysis confirmed isolate P7213 was representative of a new species in the M. terrae complex. We named this species "Mycobacterium mephinesia".

7.
Intervirology ; 62(2): 51-56, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31307046

RESUMO

BACKGROUND: Differential diagnosis between acute-phase Zika and dengue is challenging because of a similar clinical presentation and the lack of available molecular diagnosis tools in most of endemic areas. OBJECTIVES: Our study aimed to evaluate the use of simple laboratory parameters to differentiate these infections. METHODS: We retrospectively compared simple hematology and biochemistry values in 81 and 341 patients with confirmed Zika and dengue, respectively, collected from June 2013 to March 2014 during the French Polynesia outbreaks. RESULTS: Thrombocytopenia, neutropenia, leukopenia, lymphopenia, and elevated aspartate aminotransaminases were significantly more frequent in dengue than in Zika (p < 0.001). Platelets <100 × 109/L, neutrophils <0.5 × 109/L, lymphocytes <0.5 × 109/L, and aspartate aminotransaminases >100 IU/mL were found in dengue but not in Zika. The positive predictive value of the -association of leukocytes <4 × 109/L + lymphocytes <1 × 109/L + aspartate aminotransaminases >40 IU/mL for the diagnosis of dengue was 90%, with an accuracy of 82.4%. CONCLUSION: For the differential diagnosis between acute-phase Zika and dengue, there is no specific standard laboratory pattern. We identified cutoff values and a combination of laboratory parameters that are a strong argument against Zika and in favor of dengue.


Assuntos
Técnicas de Laboratório Clínico/métodos , Dengue/diagnóstico , Infecção por Zika virus/diagnóstico , Doença Aguda , Adulto , Aspartato Aminotransferases/sangue , Bioquímica/métodos , Dengue/sangue , Vírus da Dengue , Diagnóstico Diferencial , Surtos de Doenças , Feminino , Hematologia/métodos , Humanos , Masculino , Polinésia , Valor Preditivo dos Testes , Curva ROC , Estudos Retrospectivos , Adulto Jovem , Zika virus , Infecção por Zika virus/sangue
8.
9.
Emerg Infect Dis ; 25(4): 827-830, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30882332

RESUMO

A unique outbreak of Ross River virus (RRV) infection was reported in Fiji in 1979. In 2013, RRV seroprevalence among residents was 46.5% (362/778). Of the residents who were seronegative in 2013 and retested in 2015, 10.9% (21/192) had seroconverted to RRV, suggesting ongoing endemic circulation of RRV in Fiji.


Assuntos
Infecções por Alphavirus/diagnóstico , Vírus do Rio Ross/imunologia , Infecções por Alphavirus/sangue , Infecções por Alphavirus/epidemiologia , Anticorpos Antivirais/sangue , Fiji/epidemiologia , Humanos , Vírus do Rio Ross/isolamento & purificação , Estudos Soroepidemiológicos
12.
Emerg Infect Dis ; 24(10): 1850-1858, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30226164

RESUMO

Congenital Zika virus syndrome consists of a large spectrum of neurologic abnormalities seen in infants infected with Zika virus in utero. However, little is known about the effects of Zika virus intrauterine infection on the neurocognitive development of children born without birth defects. Using a case-control study design, we investigated the temporal association of a cluster of congenital defects with Zika virus infection. In a nested study, we also assessed the early childhood development of children recruited in the initial study as controls who were born without known birth defects,. We found evidence for an association of congenital defects with both maternal Zika virus seropositivity (time of infection unknown) and symptomatic Zika virus infection during pregnancy. Although the early childhood development assessment found no excess burden of developmental delay associated with maternal Zika virus infection, larger, longer-term studies are needed.


Assuntos
Desenvolvimento Infantil , Exposição Materna/efeitos adversos , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/etiologia , Efeitos Tardios da Exposição Pré-Natal , Infecção por Zika virus/complicações , Infecção por Zika virus/epidemiologia , Zika virus , Adulto , Estudos de Casos e Controles , Criança , Pré-Escolar , Anormalidades Congênitas/epidemiologia , Anormalidades Congênitas/etiologia , Estudos Transversais , Feminino , Geografia Médica , História do Século XXI , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Razão de Chances , Avaliação de Resultados da Assistência ao Paciente , Polinésia/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/história , Vigilância em Saúde Pública , Adulto Jovem , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/virologia
15.
Expert Rev Anti Infect Ther ; 16(6): 471-483, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29897831

RESUMO

INTRODUCTION: Zika virus (ZIKV) recently emerged as a global public health emergency of international concern. ZIKV is responsible for severe neurological complications in adults and infection during pregnancy and can lead to congenital Zika syndrome. There is no licensed vaccine or drug to prevent or treat ZIKV infection. Areas covered: The aim of this article is to provide an overview and update of the progress of research on anti-ZIKV vaccine and medications until the end of 2017, with a special emphasis on drugs that can be used during pregnancy. Expert commentary: Development of new vaccines and drugs is challenging and several points particular to ZIKV infections augment this difficulty: (1) Cross-reactions between ZIKV and other flaviviruses, the impact of ZIKV vaccination on subsequent flavivirus infections, and vice-versa, is unknown, (2) Drugs against ZIKV should be safe in pregnant women, and (3) Evaluation of the efficacy of vaccine and drugs against ZIKV in clinical trials phase II-IV will be complicated due to the decline of ZIKV circulation.


Assuntos
Antivirais/administração & dosagem , Vacinas Virais/administração & dosagem , Infecção por Zika virus/prevenção & controle , Adulto , Animais , Antivirais/efeitos adversos , Desenho de Drogas , Feminino , Humanos , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Gravidez , Complicações Infecciosas na Gravidez/virologia , Vacinação/métodos , Infecção por Zika virus/complicações , Infecção por Zika virus/epidemiologia
16.
Lancet Infect Dis ; 18(11): e355-e361, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29934112

RESUMO

Pandemic arboviruses have emerged as a major global health problem in the past four decades. Predicting where and when the next arbovirus epidemic will occur is a challenge, but history suggests that arboviral black swan events (epidemics that are difficult to predict and that have an extreme effect) will continue to occur as urban growth and globalisation expand. We briefly review unexpected arbovirus epidemics that have occurred in the past 50 years, with emphasis on the American and Pacific regions, to illustrate their unpredictability, and to highlight the need for improved global preparedness, including laboratory-based surveillance, prevention, and control programmes.


Assuntos
Infecções por Arbovirus/epidemiologia , Infecções por Arbovirus/veterinária , Arbovirus/isolamento & purificação , Surtos de Doenças , Animais , Aves , Saúde Global , Humanos , Clima Tropical
17.
Emerg Microbes Infect ; 7(1): 79, 2018 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-29739925

RESUMO

Based on serological evidence and viral isolation, Zika virus (ZIKV) has circulated for many years relatively benignly in a sylvatic cycle in Africa and an urban cycle in South East Asia (SEA). With the recent availability of limited but novel Indian ZIKV sequences to add to the plethora of SEA sequences, we traced the phylogenetic history and spatio-temporal dispersal pattern of ZIKV in Asia prior to its explosive emergence in the Pacific region and the Americas. These analyses demonstrated that the introduction and dispersal of ZIKV on the Pacific islands were preceded by an extended period of relatively silent transmission in SEA, enabling the virus to expand geographically and evolve adaptively before its unanticipated introduction to immunologically naive populations on the Pacific islands and in the Americas. Our findings reveal new features of the evolution and dispersal of this intriguing virus and may benefit future disease control strategies.


Assuntos
Evolução Molecular , Doenças dos Primatas/virologia , Infecção por Zika virus/veterinária , Infecção por Zika virus/virologia , Zika virus/genética , Aedes/fisiologia , Aedes/virologia , Substituição de Aminoácidos , Animais , Ásia/epidemiologia , Humanos , Macaca mulatta/virologia , Mosquitos Vetores/fisiologia , Mosquitos Vetores/virologia , Filogenia , Doenças dos Primatas/transmissão , Zika virus/classificação , Zika virus/isolamento & purificação , Zika virus/fisiologia , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/transmissão
18.
Sci Rep ; 8(1): 5440, 2018 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-29615676

RESUMO

While Zika virus (ZIKV) circulated for decades (African lineage strains) without report of outbreaks and severe complications, its emergence in French Polynesia and subsequently in the Americas (Asian lineage strains) was associated with description of severe neurological defects in newborns/neonates and adults. With the aim to identify virus lineage-dependent factors, we compared cell susceptibility, virus replication, cell death and innate immune responses following infection with two African and three contemporary Asian lineage strains of ZIKV. To this end, we used green monkey Vero and Aedes albopictus C6/36 cells and human monocyte-derived dendritic cells (DCs). The latter are involved in the pathogenesis of several mosquito-borne Flavivirus infections. In Vero and C6/36 cells, we observed strain- but not lineage-dependent differences in infection profiles. Nevertheless, in human DCs, no significant differences in susceptibility and virus replication were found between lineages and strains. ZIKV induced antiviral interferon type I/III in a limited fashion, with the exception of one African strain. None of the strains induced cell death or DC maturation in terms of MHC II, CD40, CD80/86 or CCR7 expression. Taken together, our data suggest that a large collection of virus isolates needs to be investigated before conclusions on lineage differences can be made.


Assuntos
Células Dendríticas/virologia , Zika virus/fisiologia , Animais , Células Dendríticas/metabolismo , Regulação da Expressão Gênica , Humanos , Interferons/genética , Especificidade da Espécie , Células Vero
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