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1.
Washington, D.C.; PAHO; 2020-06-18.
em Inglês, Espanhol | PAHO-IRIS | ID: phr-52607

RESUMO

In 2020, Haiti and the Bolivarian Republic of Venezuela have reported confirmed cases. The following is a summary of the epidemiological situation reported by Haiti and Venezuela. In Haiti, between epidemiological week (EW) 32 of 2014 and EW 17 of 2020, there were 1,033 suspected diphtheria cases1 reported, including 130 deaths; of the total cases, 345 were confirmed (335 laboratory-confirmed and 10 by epidemiological link).


En 2020, Haití y la República Bolivariana de Venezuela han reportado casos confirmados de difteria. A continuación, un resumen de la situación epidemiológica reportada por ambos países. En Haití, entre la semana epidemiológica (SE) 32 de 2014 y la SE 17 de 2020 se notificaron 1.033 casos sospechosos1 de difteria, incluidas 130 defunciones; de los cuales 345 casos fueron confirmados, 335 por laboratorio y 10 por nexo epidemiológico.


Assuntos
Emergências , Regulamento Sanitário Internacional , Difteria , Emergências , Regulamento Sanitário Internacional , Difteria
2.
Int J Infect Dis ; 96: 422-430, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32387447

RESUMO

OBJECTIVE: To determine the seroprevalence of antibodies against of diphtheria, tetanus, and pertussis among Thai adolescents. METHODS: A cross-sectional study was conducted among Thai adolescents aged 11-20 years who had completed five doses of diphtheria, tetanus, and pertussis (DTP)-containing vaccine during childhood, either diphtheria toxoid, tetanus toxoid, whole-cell pertussis (DTwP) or diphtheria toxoid, tetanus toxoid, acellular pertussis (DTaP) vaccine. Protective antibodies against diphtheria, tetanus, and pertussis were defined as anti-diphtheria toxoid IgG ≥0.1 IU/ml, anti-tetanus toxoid IgG ≥0.1 IU/ml, and anti-Bordetella pertussis toxin IgG ≥5 IU/ml, respectively. RESULTS: Of 220 adolescents (median age 16 years), 45% had received a tetanus toxoid, reduced diphtheria toxoid (Td) booster vaccine during adolescence, and none (0%) had received a tetanus toxoid, reduced diphtheria toxoid, acellular pertussis (Tdap) booster vaccine. Overall, 50%, 99%, and 57% of adolescents demonstrated protective antibodies against diphtheria, tetanus, and pertussis, respectively. The geometric mean concentrations (GMCs) of antibodies against diphtheria (p = 0.06) and tetanus (p < 0.001) were higher among adolescents who had received Td vaccine. Nevertheless, the antibody levels against both diseases waned over time, regardless of Td booster vaccination. Likewise, pertussis antibody levels gradually declined after the fifth childhood dose of DTwP/DTaP vaccine. CONCLUSIONS: Approximately half of these healthy Thai adolescents had not maintained protective antibodies against diphtheria and pertussis. A booster vaccination with diphtheria toxoid and/or acellular pertussis-containing vaccines is a crucial strategy to prevent such diseases in this population.


Assuntos
Anticorpos Antibacterianos/sangue , Difteria/sangue , Tétano/sangue , Coqueluche/sangue , Adolescente , Adulto , Criança , Estudos Transversais , Difteria/epidemiologia , Difteria/prevenção & controle , Vacina contra Difteria, Tétano e Coqueluche/administração & dosagem , Feminino , Humanos , Imunização Secundária , Masculino , Estudos Soroepidemiológicos , Tétano/epidemiologia , Tétano/prevenção & controle , Tailândia/epidemiologia , Coqueluche/epidemiologia , Coqueluche/prevenção & controle , Adulto Jovem
3.
Artigo em Inglês | MEDLINE | ID: mdl-32305971

RESUMO

Immunization strategies for the elderly are frequently perceived as comprising only vaccines against influenza, Streptococcus pneumoniae, and herpes zoster. However, besides these vaccines, which are recommended specifically for the elderly, regular booster vaccinations against tetanus, diphtheria, and in some cases pertussis and polio, are recommended in many countries for adults including the elderly. Vaccination recommendations for adults differ greatly between individual countries and coverage data are scarce. A substantial proportion of adults, and particularly of the older age groups, do not have protective antibody concentrations against diphtheria, whereas tetanus-specific antibody concentrations are generally higher. Protection against pertussis is unsatisfactory in all adults, and development of improved vaccines is ongoing. Future vaccination strategies should include regular and well-documented booster shots throughout life, as post-booster antibody concentrations correlate with pre-booster antibody concentrations.


Assuntos
Difteria/prevenção & controle , Encefalite Transmitida por Carrapatos/prevenção & controle , Fatores Imunológicos/uso terapêutico , Tétano/prevenção & controle , Vacinas/uso terapêutico , Coqueluche/prevenção & controle , Anticorpos Antibacterianos , Vacina contra Difteria, Tétano e Coqueluche/uso terapêutico , Humanos , Imunização Secundária , Vacinação , Vacinas Combinadas , Vacinas Virais/uso terapêutico
4.
Artigo em Inglês | MEDLINE | ID: mdl-32305985

RESUMO

People who travel to countries where they are at risk of contracting specific infections often need specific vaccines. To make correct recommendations in this respect several points have to be considered. The state of health of the traveler should be known as well as his or her destination and travel style. Very important, however, is the age of the traveler. As advancing age leads to changes in the immune system, in older individuals many infections are more severe. On the other hand, most vaccines are less immunogenic in the elderly. In this chapter, we will discuss which vaccines are necessary for older travelers visiting (mainly) tropical and subtropical countries, how these vaccines have to be used, and if perhaps their use has to be altered in older individuals. First, standard vaccinations will be addressed. When the immunization state of the individual is incomplete because certain vaccinations are expired or missing, it has to be updated. Vaccinations against tetanus, diphtheria, influenza, pneumococcal diseases, measles, and poliomyelitis have to be considered in this respect, because the risk of getting infected with these diseases in tropical and subtropical regions or in regions with poor hygienic conditions is often higher or at least the same as in industrialized countries. The second and main part of this chapter contains the typical travel vaccines. We will deal with vaccinations against cholera, hepatitis A and B, Japanese encephalitis, invasive meningococcal diseases, rabies, typhoid fever, and yellow fever. Clinical courses and epidemiology of the different infections are presented. The respective vaccines are discussed in detail, especially their efficiency in older individuals as far as data are available in this respect. Finally, recommendations for their use in older travelers will be given.


Assuntos
Fatores Imunológicos/uso terapêutico , Viagem , Vacinas/uso terapêutico , Idoso , Cólera/prevenção & controle , Difteria/prevenção & controle , Encefalite Japonesa/prevenção & controle , Encefalite Transmitida por Carrapatos/prevenção & controle , Hepatite A/prevenção & controle , Hepatite B/prevenção & controle , Humanos , Influenza Humana/prevenção & controle , Infecções Meningocócicas/prevenção & controle , Poliomielite/prevenção & controle , Raiva/prevenção & controle , Tétano/prevenção & controle , Febre Tifoide , Vacinação , Febre Amarela/prevenção & controle
5.
BMC Infect Dis ; 20(1): 308, 2020 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-32334517

RESUMO

BACKGROUND: Diphtheria outbreaks occurred in endemic areas and imported and indigenous cases are reported in UE/EEA. Because of the high infectiveness and severity of the disease, early and accurate diagnosis of each suspected case is essential for the treatment and management of the case and close contacts. The aim of the study was to establish simple and rapid testing methods based on Loop-Mediated Isothermal Amplification (LAMP) assay for the detection of Corynebacterium diphtheriae and differentiation between toxigenic and non-toxigenic strains. METHODS: Corynebacterium diphtheriae and Corynebacterium ulcerans isolates from the National Institute of Public Health-National Institute of Hygiene collection were used for the development of LAMP assay for the diagnosis of diphtheria and nontoxigenic C. diphtheriae infections. Various colorimetric methods for visualization of results were investigated. Sensitivity and specificity of the assay were examined using a collection of DNA samples from various gram-positive and gram-negative bacteria. RESULTS: The LAMP assay for tox and dtxR genes was developed. The sensitivity and specificity of the assay were calculated as 100%. The detection limit was estimated as 1.42 pg/µl concentration of DNA template when the reaction was conducted for 60 min. However, the detection limit was lowered 10 times for every 10 min of reduction in the time of incubation during the reaction. Positive results were successfully detected colorimetrically using hydroxynaphthol blue, calcein, QuantiFluor, and lateral flow Milenia HybriDetect dipsticks. CONCLUSION: The assay developed in the study might be applied for point-of-care testing of diphtheria and other C. diphtheriae infections as well as for other infections caused by diphtheria-toxin producing Corynebacterium species. It is highly sensitive, specific, inexpensive, easy to use, and suitable for low-resource settings.


Assuntos
Colorimetria/métodos , Corynebacterium diphtheriae/genética , Difteria/microbiologia , Técnicas de Amplificação de Ácido Nucleico/métodos , Proteínas de Bactérias/genética , Colorimetria/instrumentação , Corynebacterium diphtheriae/isolamento & purificação , Proteínas de Ligação a DNA/genética , Bactérias Gram-Negativas/genética , Bactérias Gram-Positivas/genética , Humanos , Limite de Detecção , Testes Imediatos
6.
Washington, D.C.; PAHO; 2020-03-03.
em Inglês, Espanhol | PAHO-IRIS | ID: phr-51929

RESUMO

In 2018 and 2019, Colombia, Haiti, and the Bolivarian Republic of Venezuela have reported confirmed cases. In 2020, Haiti and the Bolivarian Republic of Venezuela have reported confirmed cases. The following is a summary of the epidemiological situation reported by Haiti and Venezuela. In Haiti, between epidemiological week (EW) 32 of 2014 and EW 8 of 2020, there were 1,002 probable cases 1 reported, including 126 deaths; of the total cases, 334 were confirmed (325 laboratory-confirmed and 9 by epidemiological link).


En 2018 y 2019, Colombia, Haití y la República Bolivariana de Venezuela reportaron casos confirmados de difteria. En 2020, Haití y la República Bolivariana de Venezuela reportaron casos confirmados de difteria. A continuación, un resumen de la situación epidemiológica reportada por Haití y Venezuela. En Haití, entre la semana epidemiológica (SE) 32 de 2014 y la SE 8 de 2020 se notificaron 1.002 casos probables1, incluidas 126 defunciones; de los cuales 334 casos fueron confirmados (325 por laboratorio y 9 por nexo epidemiológico).


Assuntos
Regulamento Sanitário Internacional , Emergências , Difteria , Regulamento Sanitário Internacional , Emergências , Difteria
7.
Am J Trop Med Hyg ; 102(1): 164-176, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31769388

RESUMO

Accurate and cost-effective identification of areas where co-endemic infections occur would enable public health managers to identify opportunities for implementation of integrated control programs. Dried blood spots collected during cross-sectional lymphatic filariasis surveys in coastal Kenya were used for exploratory integrated detection of IgG antibodies against antigens from several parasitic infections (Wuchereria bancrofti, Schistosoma mansoni, Plasmodium spp., Ascaris lumbricoides, and Strongyloides stercoralis) as well as for detection of responses to immunizing agents used against vaccine-preventable diseases (VPDs) (measles, diphtheria, and tetanus) using a multiplex bead assay (MBA) platform. High heterogeneity was observed in antibody responses by pathogen and antigen across the sentinel sites. Antibody seroprevalence against filarial antigens were generally higher in Ndau Island (P < 0.0001), which also had the highest prevalence of filarial antigenemia compared with other communities. Antibody responses to the Plasmodium species antigens circumsporozoite protein (CSP) and merozoite surface protein-1 (MSP-1)19 were higher in Kilifi and Kwale counties, with Jaribuni community showing higher overall mean seroprevalence (P < 0.0001). Kimorigo community in Taita-Taveta County was the only area where antibody responses against S. mansoni Sm25 recombinant antigen were detected. Seroprevalence rates to Strongyloides antigen NIE ranged between 3% and 26%, and there was high heterogeneity in immune responses against an Ascaris antigen among the study communities. Differences were observed between communities in terms of seroprevalence to VPDs. Seroprotection to tetanus was generally lower in Kwale County than in other counties. This study has demonstrated that MBA holds promise for rapid integrated monitoring of trends of infections of public health importance in endemic areas.


Assuntos
Anticorpos Anti-Helmínticos/sangue , Anticorpos Antiprotozoários/sangue , Imunoglobulina G/sangue , Doenças Parasitárias/epidemiologia , Doenças Parasitárias/imunologia , Estudos Soroepidemiológicos , Anticorpos Antibacterianos/sangue , Anticorpos Antivirais/sangue , Difteria/prevenção & controle , Vacina contra Difteria e Tétano/imunologia , Humanos , Quênia , Sarampo/prevenção & controle , Vacina contra Sarampo/imunologia , Tétano/prevenção & controle
8.
Br J Oral Maxillofac Surg ; 58(3): 358-360, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31864859

RESUMO

Diphtheria is an infectious disease caused by Corynebacterium diphtheriae, and is generally characterised by proliferation of the bacteria in the upper respiratory tract, formation of a pseudomembrane, and systemic diffusion of the diphtheria toxin throughout the body. We present the case of a young man with pseudomembranous plaques on the tongue and floor of the mouth, who received systemic and locoregional medical treatment, with a satisfactory outcome after 14 days.


Assuntos
Corynebacterium diphtheriae , Difteria , Humanos , Masculino , Nariz , Traqueia
9.
BMC Infect Dis ; 19(1): 1049, 2019 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-31829153

RESUMO

BACKGROUND: Diphtheria has been reported as an outbreak in some regions in Indonesia, most especially in East Java Province. Resistance to penicillin, erythromycin, and other antibiotics, single or multiple, has been reported in several studies. This study aims to evaluate the first-line antibiotic susceptibility pattern of toxigenic Corynebacterium diphtheriae isolates. METHODS: This descriptive observational study was performed from August to November 2018. C. diphtheriae isolates were collected from diphtheria patients and carriers in East Java from 2012 to 2017 and kept at the Balai Besar Laboratorium Kesehatan Daerah Surabaya or the Public Health Laboratory of Surabaya. Sample selection was done by random cluster sampling. The sensitivity test by E-test®of the five antibiotics (penicillin, oxacillin, erythromycin, azithromycin, and clarithromycin) was done to determine the minimum inhibitory concentration (MIC). The Clinical and Laboratory Standards Institute M45A (2015) Corynebacterium spp. for penicillin and erythromycin was used as standard. RESULTS: From 114 targeted isolates, 108 were viable and toxigenic. The E-test was performed on the viable isolates. The majority of the hosts were male (58.3%), with median (range) age of 6.5 (1-14) years. Half of the samples were from the 1 to 5-year-old age group. The isolates were acquired much more from patients (78.7%) than carriers (21.3%) and from pharyngeal swab (74.1%). Most of these isolates were from Madura Island (47.2%) and the northern and eastern parts of the province (horseshoe area). Mitis isolates were the major variant (76.9%). The susceptibility pattern of C. diphtheriae to erythromycin was better than that to penicillin. The E-test result for penicillin was 68.52% susceptible, 31.48% intermediate, and 0% resistant (MIC range, < 0.016 to 2 µg/L) and for erythromycin (MIC range, < 0.016 to > 256 µg/L) was 85.2% susceptible, 12% intermediate, and 2.8% resistant The MIC range for oxacillin was 1 to 96 µg/L, while for both azithromycin and clarithromycin were <  0.016 to > 256 µg/L. CONCLUSION: The susceptibility rate of C. diphtheriae to erythromycin is higher than that to penicillin. The regular update of antibiotic selection to the national guidelines is recommended. The MIC reference standard to azithromycin and clarithromycin is also needed.


Assuntos
Antibacterianos/uso terapêutico , Corynebacterium diphtheriae/efeitos dos fármacos , Difteria/tratamento farmacológico , Difteria/epidemiologia , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Eritromicina/uso terapêutico , Penicilinas/uso terapêutico , Adolescente , Criança , Pré-Escolar , Corynebacterium diphtheriae/isolamento & purificação , Feminino , Humanos , Indonésia/epidemiologia , Lactente , Masculino , Testes de Sensibilidade Microbiana
10.
Washington, D.C.; PAHO; 2019-12-06.
em Inglês, Espanhol | PAHO-IRIS | ID: phr-51850

RESUMO

In 2019, Colombia, Haiti, and the Bolivarian Republic of Venezuela have reported confirmed cases. In 2018, the same three countries reported confirmed cases. The following is a summary of the epidemiological situation reported by Colombia, Haiti, and Venezuela. In Colombia, one confirmed case of diphtheria has been reported in 2019. The case is a 4-year-old Venezuelan national and resident of Cúcuta Municipality in Norte de Santander Department, with an unverifiable vaccination history. The case had onset of symptoms on 12 October 2019; the case was confirmed by clinical-epidemiological and laboratory criteria (a sample of pharyngeal pseudomembrane tested positive for Corynebacterium diphtheriae and the diphtheria toxin gene by real-time PCR). No secondary cases related to this case were reported. In Haiti, between epidemiological week (EW) 32 of 2014 and EW 46 of 2019, there were 951 probable cases reported, including 119 deaths; of the total cases, 287 were confirmed (278 laboratory-confirmed and 9 by epidemiological link.


En 2019, Colombia, Haití y la República Bolivariana de Venezuela han reportado casos confirmados de difteria. En 2018, estos mismos tres países también notificaron casos confirmados. A continuación, un resumen de la situación epidemiológica reportada por Colombia, Haití y Venezuela. En Colombia, se notificó un caso de difteria confirmado. El caso corresponde a un menor de 4 años, de nacionalidad venezolana, residente del municipio de Cúcuta, en el departamento de Norte de Santander, cuyos antecedentes de vacunación no se pudieron comprobar. El caso inició síntomas el 12 de octubre de 2019 y fue confirmado teniendo en cuenta los criterios clínicoepidemiológicos y de laboratorio (PCR en tiempo real positiva para Corynebacterium diphtheriae con gen de la toxina diftérica positivo a partir pseudomembrana faríngea). No hubo casos secundarios relacionados con este caso. En Haití, entre la semana epidemiológica (SE) 32 de 2014 y la SE 46 de 2019 se notificaron 951 casos probables, incluidas 119 defunciones; de los cuales 287 casos fueron confirmados (278 por laboratorio y 9 por nexo epidemiológico).


Assuntos
Regulamento Sanitário Internacional , Emergências , Difteria , Regulamento Sanitário Internacional , Emergências , Difteria
12.
Ig Sanita Pubbl ; 75(4): 317-325, 2019.
Artigo em Italiano | MEDLINE | ID: mdl-31887737

RESUMO

The possible risk of hyperimmunization after tetanus vaccination is currently discussed after the National Vaccine Prevention Plan 2017-2019 confirmed the recommendation of a booster dose every ten years. Due to the ubiquitous nature of tetanus spores and the inability to obtain herd-immunity through vaccination, efforts to reduce the incidence of tetanus aim at eliminating the disease. The only way to prevent infection is vaccination followed by recommended periodic booster doses. Between 2012 and 2016, Italy notified 45% (252/564) of all cases reported by the 26 EU Member States, most of them in the over 65 age group, generally women in the rural areas. The recommendation of the antipertussis vaccine, combined with anti-tetanus, in pregnancy and the indications for antitetanic prophylaxis by vaccination or specific immunoglobulins in emergency setting, gives rise to doubts about the risk of hyperimmunization. Studies generally agree on the safety of diphtheria-tetanus-pertussis combined vaccines during the third trimester of pregnancy, and the time elapsed since the previous tetanus vaccination seems not to be related to significant differences in the incidence of adverse events or obstetrical complications. In the emergency wards, given the relatively high incidence of tetanus in Italy, the risk/benefit ratio often leads to prefer vaccination to no-intervention. The administration of tetanus immunoglobulins in subjects not vaccinated in the last 10 years seems justified by the epidemiology of tetanus in Italy.


Assuntos
Vacinas contra Difteria, Tétano e Coqueluche Acelular/efeitos adversos , Vacinas contra Difteria, Tétano e Coqueluche Acelular/imunologia , Difteria/prevenção & controle , Imunização Secundária/efeitos adversos , Tétano/prevenção & controle , Coqueluche/prevenção & controle , Anticorpos Antibacterianos/imunologia , Difteria/imunologia , Vacinas contra Difteria, Tétano e Coqueluche Acelular/administração & dosagem , Feminino , Humanos , Itália , Tétano/imunologia , Coqueluche/imunologia
13.
Klin Lab Diagn ; 64(11): 681-685, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31747498

RESUMO

When the nasopharynx is colonized with toxigenic strains of the diphtheria pathogen, toxin is released, which contributes to the death of epithelial cells. But in bacterial carriers, the development of the clinical picture of the disease does not occur. This is due to the peculiarities of the state of their immune system, as well as the peculiarities of the production of diphtheria exotoxin by corynebacteria in the biofilm. Goal. Determining the nature of the cytopathic effect of C. diphtheriae as part of a biofilm in CHO-K1 cell culture. The planktonic and biofilm (120- and 720-hour) cultures of the strains were studied: C. diphtheriae gravis tox+ № 665, C. diphtheriae gravis tox+ № 6765, C. diphtheriae mitis tox+ № 269, C. diphtheriae gravis tox+ isolated from a patient with a diagnosis Localized oropharyngeal diphtheria C. diphtheriae gravis with a silent tox-gene. Biofilm (120- and 720-hour) cultures of diphtheria pathogen strains were obtained according to the Watnik method. The cytopathic effect of corynebacterial strains was studied on a CHO-K1 cell culture, taking into account in an inverted microscope. When studying the cytopathic effect of planktonic cultures of toxigenic strains of corynebacteria, it was found that the number of living CHO-K1 cells after 24 hours was insignificant (25.3±1.2%) and sharply decreased (2.5±0.5%) after 72 hours of cultivation. Under the influence of biofilm and, especially, 720-hour cultures, a different cytopathic effect dynamics was found: the number of living cells after 24 hours remained significant (82.5±2.2%), while at 72-hour it decreased to 25.0±3.0%. In the study of filtrates of planktonic and biofilm cultures of C. diphtheriae strain with a «silent¼ tox-gene, similar patterns were revealed. However, the number of live CHO-K1 cells when exposed to the filtrate of a 720-hour biofilm culture was significantly higher (p≤0.05) than when studying toxigenic strains of corynebacteria. Considering the nature of the cytopathic action, it was found that planktonic cultures of toxigenic strains of corynebacteria are characterized by a change in the cell monolayer, manifested by their thinning and elongation. The study of 720-hour biofilm cultures at 72-hour exposure revealed the appearance of a large number of rounded cells (63-69%). The cytopathic effect, formed under the influence of filtrates of planktonic and biofilm cultures of C. diphtheriae with a «silent¼ tox-gene, as well as strains of non-diphtheria corynebacteria, is characterized by rounding of cells and the formation of symplasts. In the biofilm, the intensity of the cytopathic effect of toxigenic C. diphtheriae strains and C. diphtheriae strain with a silent tox-gene decreased. CPD, manifested by thinning and lengthening of CHO-K1 cells, is associated with the action of diphtheria exotoxin, and rounding is associated with corynebacterial enzymes and, apparently, fragments of surface structures - adhesins. Decreased release of toxin and enzymes beyond the C. bihfilm matrix is a significant cause of the «asymptomatic¼ carriage of diphtheria.


Assuntos
Biofilmes , Corynebacterium diphtheriae/patogenicidade , Difteria , Animais , Infecções Assintomáticas , Células CHO , Cricetulus , Toxina Diftérica , Humanos
14.
Acta Med Indones ; 51(3): 195-196, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31699941

RESUMO

Human immunodeficiency virus (HIV) is one example of an emerging infection with total of 386 district of all province in Indonesia reported having such infection; with cumulative number of HIV infected patient from the year 1987 to 2014 is 150,296 while AIDS is 55,799 patients. The access to care only available for 153,887 patients among all HIV/AIDS patients of whom 70% are eligible for anti-retroviral (ARV) treatment and of these only half adhered to ARV treatment. In addition to that, there is an increased risk of other emerging diseases such as Zika virus, Monkey pox or Hanta pulmonary syndrome since a sporadic cases were reported around the region.Beside new diseases, tuberculosis, dengue virus, malaria and diphteria are continuously reported in Indonesia and classified as re-emerging illnesses. On this edition data on diphteria epidemiology in Indonesia will be shown by Karyanti et al.6 A recent outbreak of diphteria in Indonesia which involved almost all province in the country has led to a response named ORI (outbreak response of Immunization). Regardless of immunization, proper treatment including the distribution of anti-toxin and antibiotics are needed to stop the spread of this particular bacteria, further decreasing the mortality rate. In conclusion, the author of this paper mentioned that immunization gap needs to be handle systematically. Immunization data released on 2017 showed that complete immunization was given only to 20% of targeted group, while almost 75% were either unvaccinated or unknown. During the outbreak of diphteria in Indonesia, the WHO also reported several countries with similar problem such as Bangladesh, Haiti and Yamen. It was shown that a coordination between doctors in clinic/hospital with public health officer to conduct an epidemiological investigation, in conjunction with giving prophylaxis and assuring the logistics of anti-diphteria toxin and antibiotics were accessible were  the key of success in eliminating diphteria like it was in Bangladesh.Adherence to treatment are multifactorial for all illnesses. First, is the duration of treatment and the potential adverse event due to the medication. The Ministry of Health of the Republic of Indonesia has support the early diagnosis of HIV and delivering treatment as soon as possible, in order to avoid transmission of the disease. Second, looking at another side of the story for HIV infected patients, receiving ARV treatment as a long life treatment could possibly cause an adverse event somewhere along the line. Budiman et.al reported factors that might contribute to liver injury. His study shows that measuring baseline liver function test AST routinely might minimize the toxicity of ARV to patients particularly with a low body mass index. Last, despite the adherence to treatment and procedures in minimizing the risk of adverse event to medication, we are now facing the primary resistance virus that transmitted in the community as mentioned by Megasari et al.8 on her report regarding the transmission of drug resistance HIV virus to naïve patients in Bali.The Indonesian government through the Indonesian Ministry of Health has established a collaboration and one health approaches to tackle the threat of diseases in the country, particularly in infectious diseases.


Assuntos
Doenças Transmissíveis Emergentes/epidemiologia , Efeitos Psicossociais da Doença , Difteria/epidemiologia , Infecções por HIV/epidemiologia , Humanos , Indonésia/epidemiologia , Tuberculose/epidemiologia
15.
Acta Med Indones ; 51(3): 205-213, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31699943

RESUMO

BACKGROUND: in recent years, diphtheria has reemerged in several countries including Venezuela, Yemen, Bangladesh, and Haiti. Similarly, Indonesia also showed an increased number of diphtheria cases in 2010-2017 despite the Diphteria, Tetanus, Pertussis (DTP) immunization program applied in Indonesia for children. This study aimed to evaluate the epidemiology of diphtheria cases which occurred in Indonesia during 2010-2017. METHODS: this was a retrospective study of diphtheria cases in Indonesia. The following source of data about diphtheria disease burden and vaccine coverage was obtained from Ministry of Health Republic of Indonesia, Indonesian Pediatric Society and World Health Organization South East Asia Regional Office. RESULTS: the number of diphtheria cases in Indonesia were distributed across 30 provinces with a total of 811 cases in 2011; 1,192 cases in 2012; 296 cases in 2014; and 939 cases in 2017. Based on age group, the highest number of case fatality rate were in age group of 5-9 years old. Diphtheria immunization coverage in Indonesia among children was fluctuated, reported as 67.7 % in 2007, 61.9 % in 2010, 75.6% in 2013 and 61.3% in 2018. In addition to that, the organization of internal medicine has recommend booster of DPT immunization every 10 years for those children that had received complete DPT vaccination during childhood, however this was not applied. As the countermeasure towards this trend, the Ministry of Health implemented three rounds of Outbreak Response Immunization (ORI) targeted for the age group of 0-1-6 months old and 1-18 years old in 2017 and tailor approached for adults that had exposed to cases. Banten, DKI Jakarta and West Java were the first three provinces to implement this program considering their condensed population and high risk of disease transmission. CONCLUSION: in Indonesia, there was dramatic increase of diphtheria case in 2010-2017, where immunization in children should be reinforced by increasing coverage more than 95% and adult boosted vaccination approaches should be initiated to prevent the spread of these fatal diphtheria diseases in Indonesia.


Assuntos
Difteria/epidemiologia , Cobertura Vacinal/estatística & dados numéricos , Adolescente , Adulto , Criança , Pré-Escolar , Vacina contra Difteria, Tétano e Coqueluche , Surtos de Doenças , Feminino , Humanos , Indonésia/epidemiologia , Lactente , Masculino , Estudos Retrospectivos , Adulto Jovem
16.
Emerg Infect Dis ; 25(11): 2122-2123, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31625851

RESUMO

Corynebacterium ulcerans infection is emerging in humans. We conducted phylogenetic analyses of C. ulcerans and C. diptheriae, which revealed diverse diphtheria toxin in C. ulcerans. Diphtheria toxin diversification could decrease effectiveness of diphtheria toxoid vaccine and diphtheria antitoxin for preventing and treating illnesses caused by this bacterium.


Assuntos
Corynebacterium/genética , Toxina Diftérica/genética , Difteria/microbiologia , Mutação , Sequência de Aminoácidos , Difteria/epidemiologia , Difteria/prevenção & controle , Toxina Diftérica/química , Toxoide Diftérico , Variação Genética , Humanos , Japão/epidemiologia , Filogenia , RNA Ribossômico 16S/genética
17.
Med Sante Trop ; 29(3): 253-255, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31573517

RESUMO

Diphtheria is an infectious disease transmitted by air or by contact. There are three main species of corynebacterium: diphtheriae, ulcerans, and pseudotuberculosis. They may or may not secrete a toxin responsible for serious cardiac or neurological complications. The frequent clinical presentations are diphtheria angina and cutaneous diphtheria. When it is suspected, it is urgent to send cutaneous or pharyngeal samples to the National Reference Center. If toxin is present, serotherapy should be instituted and the case should be reported. Antibiotic therapy with amoxicillin or azithromycin is the standard treatment. Vaccine prevention begun in the middle of the 20th century has helped to slow epidemics.


Assuntos
Difteria/complicações , Hiperalgesia/microbiologia , Dermatopatias Bacterianas/complicações , Úlcera Cutânea/microbiologia , Adulto , Humanos , Masculino , Senegal
18.
Ned Tijdschr Geneeskd ; 1632019 10 10.
Artigo em Holandês | MEDLINE | ID: mdl-31609562

RESUMO

Respiratory diphtheria is an acute respiratory tract infection. The high mortality rates (5-10%) are related to airway obstruction and local and systemic effects of the diphtheria toxin. Vaccination against diphtheria has been available through the Dutch national vaccination programme since the 1950s. The disease has now become rare as a result of herd immunity by these vaccinations. As a consequence, the disease has largely been forgotten, which can result in it not being recognised and treated in time. In addition, diphtheria antitoxin is not always available. In this article, we are drawing attention to the need for immunisation. We also look back at how diphtheria prevention started in the Netherlands.


Assuntos
Antitoxina Diftérica/imunologia , Toxoide Diftérico/imunologia , Difteria/imunologia , Humanos , Imunização , Programas de Imunização , Países Baixos , Infecções Respiratórias/imunologia
19.
Cancer Invest ; 37(10): 546-557, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31597492

RESUMO

Immunotoxin targeted therapy is a promising way of cancer therapy that is made from a toxin attached to an antibody which target a specific protein presented on cancer cells. In this study, we introduce immunotoxins comprising of truncated pseudomonas exotoxin A (PEA) and diphtheria toxin (DT) conjugated to trastuzumab. The effectiveness of 20 and 30 µg/ml immunotoxins and trastuzumab were studied on SK-BR-3 and BT-474 HER2/neu positive breast cancer cell lines by a cell death assay test. The produced immunotoxins have the potential to reduce the therapeutic dose of the trastuzumab and in the same time achieve higher efficiency.


Assuntos
ADP Ribose Transferases/farmacologia , Toxinas Bacterianas/farmacologia , Neoplasias da Mama/tratamento farmacológico , Difteria/metabolismo , Exotoxinas/farmacologia , Imunotoxinas/farmacologia , Pseudomonas/metabolismo , Fatores de Virulência/farmacologia , Anticorpos Monoclonais/farmacologia , Linhagem Celular Tumoral , Feminino , Humanos , Receptor ErbB-2/metabolismo , Trastuzumab/farmacologia
20.
Washington, D.C.; PAHO; 2019-10-18.
em Inglês, Espanhol | PAHO-IRIS | ID: phr-51846

RESUMO

In 2019, Haiti and the Bolivarian Republic of Venezuela have reported confirmed cases. In 2018, there were three countries in the Region of the Americas (Colombia, Haiti, and Venezuela) that reported confirmed cases of diphtheria. The following is a summary of the updated epidemiological situation reported by Haiti and Venezuela. In Haiti, between epidemiological week (EW) 32 of 2014 and EW 36 of 2019, there were 933 probable cases reported, including 116 deaths; of the total cases, 287 were confirmed (278 laboratory-confirmed and 9 by epidemiological link).


En 2019, Haití y la República Bolivariana de Venezuela han reportado casos confirmados. En 2018, tres países de la Región de las Américas (Colombia, Haití y Venezuela) notificaron casos confirmados de difteria. A continuación, un resumen actualizado de la situación epidemiológica reportada por Haití y Venezuela. En Haití, entre la semana epidemiológica (SE) 32 de 2014 y la SE 36 de 2019 se notificaron 933 casos probables, incluidas 116 defunciones; de los cuales 287 casos fueron confirmados (278 por laboratorio y 9 por nexo epidemiológico).


Assuntos
Regulamento Sanitário Internacional , Emergências , Difteria , Regulamento Sanitário Internacional , Difteria
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