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1.
Rev Sci Tech ; 38(1): 185-198, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31564731

RESUMO

Viral haemorrhagic fevers (VHFs) are a group of infectious, devastating and severe diseases caused by enveloped single-stranded RNA viruses. The endemicity, emergence or re-emergence of different VHF viruses and lack of vaccines and antiviral therapy for most VHFs result in a significant global threat. Most VHF viruses are restricted to specific parts of the world, and the dramatic expansion of their geographical distribution beyond their original habitats would greatly affect global public health. In the past few decades alone, several outbreaks have affected the Middle East, a part of the world containing arid to semi-arid, hot and water-scarce countries. Political instability, natural and humanitarian crises, direct contact with domesticated animals and climate change are the main factors in the dissemination of different zoonotic diseases, including vector-borne diseases. Some VHF viruses have been introduced into the Middle East (e.g. Alkhurma haemorrhagic fever) and others have been re-introduced and have become endemic in the region. Dengue fever, Crimean Congo haemorrhagic fever, Rift Valley fever and hantavirus haemorrhagic fever with renal syndrome are examples of re-emerging or endemic viruses in the region. The temporal and spatial extension of VHF distribution mandates a particular engagement from all the actors in the fields of animal, human and environmental health. The One Health concept is a multidisciplinary and multisectoral approach for promoting collaboration, coordination and communication among different nations, sectors and disciplines, which is highly relevant to the fight against endemic, emerging and re-emerging infectious agents at the human-animal-environment interface. The adoption of the One Health approach is a promising solution to addressing public health threats in the Middle East.


Assuntos
Febres Hemorrágicas Virais , Saúde Única , Animais , Surtos de Doenças , Febre Hemorrágica da Crimeia/epidemiologia , Febres Hemorrágicas Virais/epidemiologia , Humanos , Oriente Médio , Saúde Pública/normas , Zoonoses/epidemiologia
2.
Med. clín (Ed. impr.) ; 153(5): 205-212, sept. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-183997

RESUMO

El incremento de los viajes internacionales, la creciente presencia de vectores transmisores de arbovirus en nuestro país, las alertas de fiebres hemorrágicas, como el actual brote de ébola en la R. D. del Congo y los casos autóctonos de fiebre hemorrágica de Crimea-Congo en nuestro país, ponen de nuevo en primer plano las enfermedades tropicales. El aislamiento de los casos sospechosos de enfermedades de alta transmisibilidad y letalidad ha de ser una prioridad (fiebres hemorrágicas, MERS-CoV). Al valorar al paciente, una cuidadosa historia clínica basada en los aspectos epidemiológicos de la zona de procedencia, las actividades realizadas, el tiempo de estancia en el mismo y el inicio de los síntomas nos ayudarán finalmente, si no al diagnóstico definitivo, sí al menos a descartar las enfermedades que signifiquen una amenaza para él. Por su frecuencia y gravedad la malaria debe ser descartada, sin olvidar las otras causas habituales de fiebre con las que el médico de urgencias debe estar familiarizado también


The increase in international travel, the growing presence of arbovirus vectors in our country, and notifications of haemorrhagic fever such as the current outbreak of Ebola in D.R. Congo and the cases of Crimea-Congo haemorrhagic fever in our country have again cast the spotlight on tropical diseases Isolating suspected cases of highly contagious and lethal diseases must be a priority (Haemorrhagic fever, MERS-CoV). Assessing the patient, taking a careful medical history based on epidemiological aspects of the area of origin, activities they have carried out, their length of stay in the area and the onset of symptoms, will eventually help us, if not to make a definitive diagnosis, at least to exclude diseases that pose a threat to these patients. Malaria should be ruled out because of its frequency, without forgetting other common causes of fever familiar to emergency doctors


Assuntos
Humanos , Controle Sanitário de Viajantes , Doença Relacionada a Viagens , Isolamento de Pacientes/tendências , Saúde do Viajante , Doenças Transmissíveis Importadas/epidemiologia , Febres Hemorrágicas Virais/epidemiologia , Infecções por Arbovirus/epidemiologia , Arbovirus/isolamento & purificação , Meningite/epidemiologia , Febre Tifoide/epidemiologia , Rickettsia/isolamento & purificação , Coronavirus/isolamento & purificação , Esquistossomose/epidemiologia
3.
PLoS One ; 14(4): e0215224, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31017931

RESUMO

Rodents serve as reservoirs and/or vectors for several human infections of high morbidity and mortality in the tropics. Population growth and demographic shifts over the years have increased contact with these mammals, thereby increasing opportunities for disease transmission. In Africa, the burden of rodent-borne diseases is not well described. To investigate human seroprevalence of selected rodent-borne pathogens, sera from 657 healthy adults in ten rural communities in Ghana were analyzed. An in-house enzyme-linked immunosorbent assay (ELISA), for immunoglobulin G (IgG) antibodies to Lassa virus was positive in 34 (5%) of the human samples. Using commercial kits, antibodies to hantavirus serotypes, Puumala and Dobrava, and Leptospira bacteria were detected in 11%, 12% and 21% of the human samples, respectively. Forty percent of residents in rural farming communities in Ghana have measurable antibodies to at least one of the rodent-borne pathogens tested, including antibodies to viral hemorrhagic fever viruses. The high seroprevalence found in rural Ghana to rodent-borne pathogens associated with both sporadic cases and larger disease outbreaks will help define disease threats and inform public health policy to reduce disease burden in underserved populations and deter larger outbreaks.


Assuntos
Reservatórios de Doenças/microbiologia , Reservatórios de Doenças/virologia , Vetores de Doenças , Roedores/microbiologia , Roedores/virologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Agricultura , Animais , Anticorpos Antibacterianos/sangue , Anticorpos Antivirais/sangue , Feminino , Gana/epidemiologia , Hantavirus/imunologia , Infecções por Hantavirus/epidemiologia , Febres Hemorrágicas Virais/epidemiologia , Humanos , Febre Lassa/epidemiologia , Vírus Lassa/imunologia , Leptospira/imunologia , Leptospirose/epidemiologia , Masculino , Pessoa de Meia-Idade , População Rural , Estudos Soroepidemiológicos , Adulto Jovem , Zoonoses/epidemiologia
4.
East Mediterr Health J ; 24(11): 1049-1057, 2019 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-30701519

RESUMO

Background: The emergence and re-emergence of viral haemorrhagic fevers (VHFs) is a growing concern worldwide. They are associated with major epidemics with an estimated 51-101 million cases each year, of which around 67 000 are fatal. In 2007, 13 countries in the Eastern Mediterranean Region reported VHF cases. Aims: The main purpose of the study was to review the epidemiological situation in the Region vis-à-vis VHFs to obtain baseline epidemiological information for the establishment of the Emerging Dangerous Pathogen Laboratory Network (EDPLN). Methods: A literature search was performed using PubMed, ProMED-Mail and GIDEON databases. Reported data included disease burden (reported cases and deaths), human prevalence (general population, high-risk groups), vectors and reservoirs. A scoring method was employed to divide countries into 4 groups (very highly, highly, medium and low affected countries). Results: Very highly affected countries were Afghanistan, Egypt, Islamic Republic of Iran, Saudi Arabia and Sudan. Highly affected countries were Djibouti, Morocco, Oman, Pakistan, Tunisia and Yemen. Medium affected countries were Iraq, Somalia and United Arab Emirates. Low affected countries were Bahrain, Jordan, Lebanon, Libya, Palestine, Qatar and Syrian Arab Republic. Conclusions: This study contributes in prioritizing countries to be part of EDPLN and in addressing specific needs related to outbreak investigations, surveillance and research.


Assuntos
Doenças Transmissíveis Emergentes/epidemiologia , Febres Hemorrágicas Virais/epidemiologia , Animais , Doenças Transmissíveis Emergentes/mortalidade , Reservatórios de Doenças/virologia , Vetores de Doenças , Epidemias/estatística & dados numéricos , Febres Hemorrágicas Virais/mortalidade , Humanos , Região do Mediterrâneo/epidemiologia , Oriente Médio/epidemiologia , Vigilância da População/métodos , Prevalência
6.
J Int Med Res ; 46(10): 4032-4038, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30088790

RESUMO

It is generally accepted that human immunodeficiency virus (HIV) is the etiological agent of acquired immune deficiency syndrome. According to this claim, HIV was transferred to humans from contact with monkeys around 35-50 years ago. However, this claim has not been sufficiently confirmed epidemiologically. The spread and incubation period of the plague epidemic has led to the theory that the Black Death was caused by hemorrhagic viruses. Having examined detailed historical data, we have concluded that the bacterium Yersenia pestis was an infectious agent in the epidemic, together with another agent which we suggest was HIV. Our considerations were mainly based on the existence of the CCR5 delta 32 mutation, which protects against HIV infection and has been present in the Caucasian population for over 2000 years. The combination of two infectious agents led to the devastation of the Black Death, the removal of HIV carriers, and an increase in the number of CCR5Δ32 mutations in the Caucasian population. In sub-Saharan Africa, this epidemic and subsequent sanitation process did not occur, which explains the much higher level of HIV genetic information in this part of the world.


Assuntos
Epidemias/estatística & dados numéricos , Infecções por HIV , Receptores CCR5/genética , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/genética , Síndrome de Imunodeficiência Adquirida/história , África ao Sul do Saara/epidemiologia , Grupo com Ancestrais do Continente Africano/genética , Ásia/epidemiologia , Evolução Biológica , Epidemias/história , Europa (Continente)/epidemiologia , Grupo com Ancestrais do Continente Europeu/genética , Evolução Molecular , Infecções por HIV/epidemiologia , Infecções por HIV/genética , Infecções por HIV/história , Febres Hemorrágicas Virais/epidemiologia , Febres Hemorrágicas Virais/genética , Febres Hemorrágicas Virais/história , Heterozigoto , História do Século XV , História do Século XVI , História do Século XVII , História do Século XX , História do Século XXI , História Antiga , História Medieval , Humanos , Peste/epidemiologia , Peste/genética , Peste/história , Varíola/epidemiologia , Varíola/genética , Varíola/história
8.
Methods Mol Biol ; 1604: 3-31, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28986822

RESUMO

As successive epidemics have swept the world, the scientific community has quickly learned from them about the emergence and transmission of communicable diseases. Epidemics usually occur when health systems are unprepared. During an unexpected epidemic, health authorities engage in damage control, fear drives action, and the desire to understand the threat is greatest. As humanity recovers, policy-makers seek scientific expertise to improve their "preparedness" to face future events.Global spread of disease is exemplified by the spread of yellow fever from Africa to the Americas, by the spread of dengue fever through transcontinental migration of mosquitos, by the relentless influenza virus pandemics, and, most recently, by the unexpected emergence of Ebola virus, spread by motorbike and long haul carriers. Other pathogens that are remarkable for their epidemic expansions include the arenavirus hemorrhagic fevers and hantavirus diseases carried by rodents over great geographic distances and the arthropod-borne viruses (West Nile, chikungunya and Zika) enabled by ecology and vector adaptations. Did we learn from the past epidemics? Are we prepared for the worst?The ultimate goal is to develop a resilient global health infrastructure. Besides acquiring treatments, vaccines, and other preventive medicine, bio-surveillance is critical to preventing disease emergence and to counteracting its spread. So far, only the western hemisphere has a large and established monitoring system; however, diseases continue to emerge sporadically, in particular in Southeast Asia and South America, illuminating the imperfections of our surveillance. Epidemics destabilize fragile governments, ravage the most vulnerable populations, and threaten the global community.Pandemic risk calculations employ new technologies like computerized maintenance of geographical and historical datasets, Geographic Information Systems (GIS), Next Generation sequencing, and Metagenomics to trace the molecular changes in pathogens during their emergence, and mathematical models to assess risk. Predictions help to pinpoint the hot spots of emergence, the populations at risk, and the pathogens under genetic evolution. Preparedness anticipates the risks, the needs of the population, the capacities of infrastructure, the sources of emergency funding, and finally, the international partnerships needed to manage a disaster before it occurs. At present, the world is in an intermediate phase of trying to reduce health disparities despite exponential population growth, political conflicts, migration, global trade, urbanization, and major environmental changes due to global warming. For the sake of humanity, we must focus on developing the necessary capacities for health surveillance, epidemic preparedness, and pandemic response.


Assuntos
Febres Hemorrágicas Virais/epidemiologia , Febres Hemorrágicas Virais/transmissão , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis/genética , Doenças Transmissíveis/transmissão , Sistemas de Informação Geográfica , Saúde Global , Febres Hemorrágicas Virais/genética , Humanos
9.
Methods Mol Biol ; 1604: 55-78, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28986825

RESUMO

This article will outline surveillance approaches for viral hemorrhagic fevers. Specific methods for surveillance of clinical samples will be emphasized. Separate articles will describe methods for surveillance of rodent-borne viruses (roboviruses) and arthropod-borne viruses (arboviruses). Since the appearance of hantaviruses and arenaviruses in the Americas, more than 30 different species in each group have been established, and therefore they have become the most frequently emerging viruses. Flaviviruses such as yellow fever and dengue viruses, although easier to recognize, are also more widely spread and therefore considered a very important public health issue, particularly for under-developed countries. On the other hand, marburgviruses and ebolaviruses, previously thought to be restricted to the African continent, have recently been shown to be more global. For many of these agents virus isolation has been a challenging task: trapping the specific vectors (mosquitoes and ticks), and reservoirs (rodents and bats), or obtaining the samples from suspected clinical human cases demands special protective gear, uncommon devices (respirators), special facilities (BSL-3 and 4), and particular skills to recognize the slow and inapparent cytopathic effects in cell culture. Alternatively, serological and molecular approaches have been very helpful in discovering and describing newly emerging viruses in many areas where the previous resources are unavailable. Unfortunately, in many cases, detailed studies have been performed only after outbreaks occur, and then active surveillance is needed to prevent viral dissemination in human populations.


Assuntos
Febre Hemorrágica com Síndrome Renal/epidemiologia , Febre Hemorrágica com Síndrome Renal/genética , Febres Hemorrágicas Virais/epidemiologia , Febres Hemorrágicas Virais/genética , Animais , Arbovirus/genética , Arbovirus/patogenicidade , Arenavirus/genética , Arenavirus/patogenicidade , Hantavirus/genética , Hantavirus/patogenicidade , Febre Hemorrágica com Síndrome Renal/virologia , Febres Hemorrágicas Virais/virologia , Humanos , Saúde Pública
10.
Int J Infect Dis ; 66: 65-73, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29138016

RESUMO

OBJECTIVES: Lassa fever (LF), a priority emerging pathogen likely to cause major epidemics, is endemic in much of West Africa and is difficult to distinguish from other viral hemorrhagic fevers, including Ebola virus disease (EVD). Definitive diagnosis requires laboratory confirmation, which is not widely available in affected settings. The public health action to contain a LF outbreak and the challenges encountered in an EVD-affected setting are reported herein. METHODS: In February 2016, a rapid response team was deployed in Liberia in response to a cluster of LF cases. Active case finding, case investigation, contact tracing, laboratory testing, environmental investigation, risk communication, and community awareness raising were undertaken. RESULTS: From January to June 2016, 53 suspected LF cases were reported through the Integrated Disease Surveillance and Response system (IDSR). Fourteen cases (26%) were confirmed for LF, 14 (26%) did not have a sample tested, and 25 (47%) were classified as not a case following laboratory analysis. The case fatality rate in the confirmed cases was 29%. One case of international exportation was reported from Sweden. Difficulties were identified in timely specimen collection, packaging, and transportation (in confirmed cases, the time from sample collection to sample result ranged from 2 to 64 days) and a lack of response interventions for early cases. CONCLUSIONS: The delay in response to this outbreak could have been related to a number of challenges in this EVD-affected setting: a need to strengthen the IDSR system, develop preparedness plans, train rapid response teams, and build laboratory capacity. Prioritizing these actions will aid in the timely response to future outbreaks.


Assuntos
Doença pelo Vírus Ebola/diagnóstico , Febre Lassa/diagnóstico , Adolescente , Adulto , Criança , Pré-Escolar , Busca de Comunicante , Surtos de Doenças , Feminino , Doença pelo Vírus Ebola/epidemiologia , Febres Hemorrágicas Virais/epidemiologia , Humanos , Lactente , Libéria/epidemiologia , Masculino , Pessoa de Meia-Idade , Saúde Pública , Suécia/epidemiologia , Adulto Jovem
11.
Lancet ; 390(10113): 2662-2672, 2017 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-29031848

RESUMO

BACKGROUND: Predicting when and where pathogens will emerge is difficult, yet, as shown by the recent Ebola and Zika epidemics, effective and timely responses are key. It is therefore crucial to transition from reactive to proactive responses for these pathogens. To better identify priorities for outbreak mitigation and prevention, we developed a cohesive framework combining disparate methods and data sources, and assessed subnational pandemic potential for four viral haemorrhagic fevers in Africa, Crimean-Congo haemorrhagic fever, Ebola virus disease, Lassa fever, and Marburg virus disease. METHODS: In this multistage analysis, we quantified three stages underlying the potential of widespread viral haemorrhagic fever epidemics. Environmental suitability maps were used to define stage 1, index-case potential, which assesses populations at risk of infection due to spillover from zoonotic hosts or vectors, identifying where index cases could present. Stage 2, outbreak potential, iterates upon an existing framework, the Index for Risk Management, to measure potential for secondary spread in people within specific communities. For stage 3, epidemic potential, we combined local and international scale connectivity assessments with stage 2 to evaluate possible spread of local outbreaks nationally, regionally, and internationally. FINDINGS: We found epidemic potential to vary within Africa, with regions where viral haemorrhagic fever outbreaks have previously occurred (eg, western Africa) and areas currently considered non-endemic (eg, Cameroon and Ethiopia) both ranking highly. Tracking transitions between stages showed how an index case can escalate into a widespread epidemic in the absence of intervention (eg, Nigeria and Guinea). Our analysis showed Chad, Somalia, and South Sudan to be highly susceptible to any outbreak at subnational levels. INTERPRETATION: Our analysis provides a unified assessment of potential epidemic trajectories, with the aim of allowing national and international agencies to pre-emptively evaluate needs and target resources. Within each country, our framework identifies at-risk subnational locations in which to improve surveillance, diagnostic capabilities, and health systems in parallel with the design of policies for optimal responses at each stage. In conjunction with pandemic preparedness activities, assessments such as ours can identify regions where needs and provisions do not align, and thus should be targeted for future strengthening and support. FUNDING: Paul G Allen Family Foundation, Bill & Melinda Gates Foundation, Wellcome Trust, UK Department for International Development.


Assuntos
Febres Hemorrágicas Virais/epidemiologia , Pandemias , África/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Epidemias/estatística & dados numéricos , Humanos , Pandemias/estatística & dados numéricos , Medição de Risco
12.
Pan Afr Med J ; 27(Suppl 1): 3, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28721167

RESUMO

This case study was written based on events of an outbreak investigation of an unfamiliar disease in Ethiopia during October-December 2012. Ethiopia did not have reports of similar cases in the 50 years prior to this outbreak. In this case study, we recapitulate and analyse this outbreak investigation based on data gathered from the community, health facility, and laboratory systems. It can be used to teach: 1) the outbreak investigation process; 2) selection of appropriate epidemiological design for the investigation process, 3) basic statistical analysis of surveillance data, and 4) principals of disease control. The target audiences for this case study are officials working in public health and public health trainees. It will take at most 3.5 hours to complete this case study. At the end of the case study, participants should be able to apply the principals of outbreak investigation and use surveillance data to respond to an outbreak in their country-specific context.


Assuntos
Surtos de Doenças , Epidemiologia/educação , Febres Hemorrágicas Virais/epidemiologia , Vigilância da População/métodos , Interpretação Estatística de Dados , Métodos Epidemiológicos , Etiópia/epidemiologia , Humanos , Saúde Pública/educação , Saúde Pública/métodos , População Rural
13.
PLoS Negl Trop Dis ; 11(4): e0005322, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28384205

RESUMO

Viral hemorrhagic fever (VHF) refers to a group of diseases characterized by an acute febrile syndrome with hemorrhagic manifestations and high mortality rates caused by several families of viruses that affect humans and animals. These diseases are typically endemic in certain geographical regions and sometimes cause major outbreaks. The history of hemorrhagic fever in the Arabian Peninsula refers to the 19th century and most outbreaks were reported in the Tihamah region-the Red Sea coastal plain of the Arabian Peninsula in the west and southwest of Saudi Arabia and Yemen. Herein, we describe the agents that cause VHFs and their epidemiology in Tihamah, the history of the diseases, transmission, species affected, and clinical signs. Finally, we address challenges in the diagnosis and control of VHFs in this region.


Assuntos
Febres Hemorrágicas Virais/epidemiologia , Zoonoses/epidemiologia , Animais , Demografia , Vírus da Dengue , Surtos de Doenças , Vírus da Encefalite Transmitidos por Carrapatos , Vírus da Febre Hemorrágica da Crimeia-Congo , Febres Hemorrágicas Virais/diagnóstico , Febres Hemorrágicas Virais/prevenção & controle , Humanos , Vírus da Febre do Vale do Rift , Arábia Saudita/epidemiologia , Iêmen/epidemiologia , Zoonoses/diagnóstico , Zoonoses/prevenção & controle
14.
Pan Afr Med J ; 28: 215, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29610653

RESUMO

Introduction: On 17 September 2015, Buliisa District Health Office reported multiple deaths due to haemorrhage to the Uganda Ministry of Health. We conducted an investigation to verify the existence of an outbreak and to identify the disease nature, mode of transmission and risk factors. Methods: We defined a suspected case as onset of hematemesis between 1 June 2015 and 15 October 2015 in a resident of Hoima, Buliisa or neighbouring districts. We identified cases by reviewing medical records and actively searching in the community. We interviewed case-patients and health-care workers and performed descriptive epidemiology to generate hypotheses on possible exposures. In a case-control study we compared exposures between 21 cases and 81 controls, matched by age (± 10 years), sex and village of residence. We collected 22 biological specimens from 19 case-patients to test for Viral Haemorrhagic Fevers (VHF). We analysed the data using the Mantel-Haenszel method to account for the matched study design. Results: We identified 56 cases with onset from June to October (attack rate 15/100,000 in Buliisa District and 5.2/100,000 in Hoima District). The age-specific attack rate was highest in persons aged 31-60 years (15/100,000 in Hoima and 47/100,000 in Buliisa); no persons below 15 years of age had the illness. In the case-control study, 42% (5/12) of cases vs. 0.0% (0/77) of controls had liver disease (ORM-H = ∞; 95%CI = 3.7-∞); 71% (10/14) of cases vs. 35% (28/81) of controls had ulcer disease (ORM-H = 13; 95% CI = 1.6-98); 27% (3/11) of cases vs. 14% (11/81) of controls used indomethacin prior to disease onset (ORM-H = 6.0; 95% CI = 1.0-36). None of the blood samples were positive for any of the VHFs. Conclusion: This reported cluster of hematemesis illness was due to predisposing conditions and use of Non-Steroidal Anti-inflammatory Drugs (NSAID). Health education should be conducted on the danger of NSAIDs misuse, especially in persons with pre-disposing conditions.


Assuntos
Hematemese/epidemiologia , Febres Hemorrágicas Virais/epidemiologia , Hepatopatias/epidemiologia , Úlcera/epidemiologia , Adolescente , Adulto , Anti-Inflamatórios não Esteroides/administração & dosagem , Anti-Inflamatórios não Esteroides/efeitos adversos , Estudos de Casos e Controles , Surtos de Doenças , Feminino , Educação em Saúde , Hematemese/etiologia , Humanos , Indometacina/administração & dosagem , Indometacina/efeitos adversos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Uganda/epidemiologia , Adulto Jovem
15.
J Infect Dis ; 214(suppl 3): S122-S136, 2016 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-27587635

RESUMO

The Epi Info Viral Hemorrhagic Fever application (Epi Info VHF) was developed in response to challenges managing outbreak data during four 2012 filovirus outbreaks. Development goals included combining case and contact data in a relational database, facilitating data-driven contact tracing, and improving outbreak data consistency and use. The application was first deployed in Guinea, when the West Africa Ebola epidemic was detected, in March 2014, and has been used in 7 African countries and 2 US states. Epi Info VHF enabled reporting of compatible data from multiple countries, contributing to international Ebola knowledge. However, challenges were encountered in accommodating the epidemic's unexpectedly large magnitude, addressing country-specific needs within 1 software product, and using the application in settings with limited Internet access and information technology support. Use of Epi Info VHF in the West Africa Ebola epidemic highlighted the fundamental importance of good data management for effective outbreak response, regardless of the software used.


Assuntos
Busca de Comunicante , Surtos de Doenças/prevenção & controle , Epidemias/prevenção & controle , Sistemas de Informação em Saúde , Doença pelo Vírus Ebola/epidemiologia , Febres Hemorrágicas Virais/epidemiologia , África Ocidental/epidemiologia , Feminino , Recursos em Saúde , Doença pelo Vírus Ebola/virologia , Febres Hemorrágicas Virais/virologia , Humanos , Masculino , Software
16.
Rev Med Virol ; 26(6): 446-454, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27593704

RESUMO

Lujo virus is a novel Old World arenavirus identified in Southern Africa in 2008 as the cause of a viral hemorrhagic fever (VHF) characterized by nosocomial transmission with a high case fatality rate of 80% (4/5 cases). Whereas this outbreak was limited, the unprecedented Ebola virus disease outbreak in West Africa, and recent Zika virus disease epidemic in the Americas, has brought into acute focus the need for preparedness to respond to rare but potentially highly pathogenic outbreaks of zoonotic or arthropod-borne viral infections. A key determinant for effective control of a VHF outbreak is the time between primary infection and diagnosis of the index case. Here, we review the Lujo VHF outbreak of 2008 and discuss how preparatory measures with respect to developing diagnostic capacity might be effectively embedded into existing national disease control networks, such as those for human immunodeficiency virus, tuberculosis, and malaria.


Assuntos
Infecções por Arenaviridae/epidemiologia , Defesa Civil , Surtos de Doenças , Febres Hemorrágicas Virais/epidemiologia , Lujo virus/isolamento & purificação , África Austral/epidemiologia , Infecções por Arenaviridae/transmissão , Infecções por Arenaviridae/virologia , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/transmissão , Infecção Hospitalar/virologia , Transmissão de Doença Infecciosa/prevenção & controle , Febres Hemorrágicas Virais/transmissão , Febres Hemorrágicas Virais/virologia , Humanos , Controle de Infecções/métodos
17.
J Infect Dis ; 214(suppl 3): S137-S141, 2016 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-27651413

RESUMO

The concept of containment care for patients with highly hazardous infectious diseases originated in conjunction with the development of sophisticated biosafety level 4 laboratories at the US Army Medical Research Institute of Infectious Diseases in the late 1960s. Over time, the original containment facility served as a model for the development of other facilities in the United States at government and academic centers. The Ebola outbreak of 2014-2015 brought the issue of containment care into the mainstream and led to the development of such capabilities at strategic points around the country. We describe the original concepts behind development of such facilities, how the concept and acceptance has evolved over time, and how the guidelines for managing patients infected with viral hemorrhagic fevers have evolved as new information has been learned about protecting medical care providers from highly hazardous infectious pathogens.


Assuntos
Doenças Transmissíveis/epidemiologia , Contenção de Riscos Biológicos , Surtos de Doenças , Doença pelo Vírus Ebola/epidemiologia , Febres Hemorrágicas Virais/epidemiologia , Animais , Controle de Doenças Transmissíveis , Doenças Transmissíveis/virologia , Doença pelo Vírus Ebola/prevenção & controle , Doença pelo Vírus Ebola/virologia , Febres Hemorrágicas Virais/prevenção & controle , Febres Hemorrágicas Virais/virologia , Humanos , Laboratórios , Quarentena , Estados Unidos/epidemiologia
18.
Cell ; 166(1): 5-8, 2016 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-27368093

RESUMO

Recent infectious disease epidemics illustrate how health systems failures anywhere can create disease vulnerabilities everywhere. We must therefore prioritize investments in health care infrastructure in outbreak-prone regions of the world. We describe how "rooted" research collaborations can establish capacity for pathogen surveillance and facilitate rapid outbreak responses.


Assuntos
Pesquisa Biomédica , Surtos de Doenças , Febres Hemorrágicas Virais/epidemiologia , África Ocidental/epidemiologia , Monitoramento Epidemiológico , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/fisiopatologia , Doença pelo Vírus Ebola/virologia , Febres Hemorrágicas Virais/fisiopatologia , Febres Hemorrágicas Virais/virologia , Cooperação Internacional , Virologia/educação
20.
Ticks Tick Borne Dis ; 7(5): 970-978, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27211914

RESUMO

Ticks play an important role in transmission of arboviruses responsible for emerging infectious diseases, and have a significant impact on human, veterinary, and wildlife health. In the Republic of Korea (ROK), little is known about information regarding the presence of tick-borne viruses and their vectors. A total of 21,158 ticks belonging to 3 genera and 6 species collected at 6 provinces and 4 metropolitan areas in the ROK from March to October 2014 were assayed for selected tick-borne pathogens. Haemaphysalis longicornis (n=17,570) was the most numerously collected, followed by Haemaphysalis flava (n=3317), Ixodes nipponensis (n=249), Amblyomma testudinarium (n=11), Haemaphysalis phasiana (n=8), and Ixodes turdus (n=3). Ticks were pooled (adults 1-5, nymphs 1-30, and larvae 1-50) and tested by one-step reverse transcription polymerase chain reaction (RT-PCR) or nested RT-PCR for the detection of severe fever with thrombocytopenia virus (SFTSV), tick-borne encephalitis virus (TBEV), Powassan virus (POWV), Omsk hemorrhagic fever virus (OHFV), and Langat virus (LGTV). The overall maximum likelihood estimation (MLE) [estimated numbers of viral RNA positive ticks/1000 ticks] for SFTSV and TBEV was 0.95 and 0.43, respectively, while, all pools were negative for POWV, OHFV, and LGTV. The purpose of this study was to determine the prevalence of SFTSV, TBEV, POWV, OHFV, and LGTV in ixodid ticks collected from vegetation in the ROK to aid our understanding of the epidemiology of tick-borne viral diseases. Results from this study emphasize the need for continuous tick-based arbovirus surveillance to monitor the emergence of tick-borne diseases in the ROK.


Assuntos
Vetores Aracnídeos/virologia , Vírus da Encefalite Transmitidos por Carrapatos/genética , Vírus da Encefalite Transmitidos por Carrapatos/isolamento & purificação , Florestas , Ixodes/virologia , Phlebovirus/genética , Phlebovirus/isolamento & purificação , Animais , Vírus da Encefalite Transmitidos por Carrapatos/classificação , Encefalite Transmitida por Carrapatos/epidemiologia , Encefalite Transmitida por Carrapatos/virologia , Febres Hemorrágicas Virais/epidemiologia , Febres Hemorrágicas Virais/transmissão , Febres Hemorrágicas Virais/virologia , Larva/virologia , Funções Verossimilhança , Ninfa/virologia , Filogenia , Reação em Cadeia da Polimerase/métodos , RNA Viral/genética , Análise de Sequência de DNA , Síndrome , Trombocitopenia/epidemiologia , Trombocitopenia/virologia , Doenças Transmitidas por Carrapatos/epidemiologia , Doenças Transmitidas por Carrapatos/transmissão , Doenças Transmitidas por Carrapatos/virologia
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