Evidence of Sexual Transmission of Zika Virus D’Ortenzio, Eric; Matheron, Sophie; de Lamballerie, Xavier ...
New England journal of medicine/The New England journal of medicine,
06/2016, Letnik:
374, Številka:
22
Journal Article
Recenzirano
Odprti dostop
To the Editor:
Zika virus (ZIKV), an emerging flavivirus, generally causes mild infection in humans but is associated with severe neurologic complications and adverse fetal outcomes. ZIKV is ...transmitted to humans primarily by aedes mosquitoes. However, there is some evidence of sexual transmission.
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Two studies have shown the presence of infectious ZIKV in semen.
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A recent article described detection of ZIKV RNA in semen 62 days after the onset of illness, but infectious virus was not cultured.
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We report a case of ZIKV infection in a previously healthy 24-year-old woman (Patient 1) who was living in Paris and in . . .
Arboviral diseases are an important public health concerns. Vector control remains the sole strategy to fight against these diseases. Because of the important limits of methods currently used to ...assess human exposure to Aedes mosquito bites, much effort is being devoted to develop new indicators. Recent studies have reported that human antibody (Ab) responses to Aedes aegypti Nterm-34kDa salivary peptide represent a promising biomarker tool to evaluate the human-Aedes contact. The present study aims investigate whether such biomarker could be used for assessing the efficacy of vector control against Aedes.
Specific human IgG response to the Nterm-34kDa peptide was assessed from 102 individuals living in urban area of Saint-Denis at La Reunion Island, Indian Ocean, before and after the implementation of vector control against Aedes mosquitoes. IgG response decreased after 2 weeks (P < 0.0001), and remained low for 4 weeks post-intervention (P = 0.0002). The specific IgG decrease was associated with the decline of Aedes mosquito density, as estimated by entomological parameters and closely correlated to vector control implementation and was not associated with the use of individual protection, daily commuting outside of the house, sex and age. Our findings indicate a probable short-term decrease of human exposure to Aedes bites just after vector control implementation.
Results provided in the present study indicate that IgG Ab response to Aedes aegypti Nterm-34kDa salivary peptide could be a relevant short-time indicator for evaluating the efficacy of vector control interventions against Aedes species.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Leptospirosis is a major public health concern in New Caledonia (NC) and in other tropical countries. Severe manifestations of the disease are estimated to occur in 5-15% of all human infections ...worldwide and factors associated with these forms are poorly understood. Our objectives were to identify risk factors and predictors of severe forms of leptospirosis in adults.
We conducted a retrospective case-control study of inpatients with laboratory-confirmed leptospirosis who were admitted to two public hospitals in NC in 2008-2011. Cases were patients with fatal or severe leptospirosis, as determined by clinical criteria. This approach was meant to be pragmatic and to reflect the routine medical management of patients. Controls were defined as patients hospitalized for milder leptospirosis. Risk and prognostic factors were identified by multivariate logistic regression. Among the 176 patients enrolled in the study, 71 had criteria of severity including 10 deaths (Case Fatality Rate = 14.1%). Three risk factors were independently associated with severe leptospirosis: current cigarette smoking (OR = 2.94 CI 1.45-5.96); delays >2 days between the onset of symptoms and the initiation of antibiotherapy (OR = 2.78 CI 1.31-5.91); and Leptospira interrogans serogroup Icterohaemorrhagiae as the infecting strain (OR = 2.79 CI 1.26-6.18). The following post-admission laboratory results correlated with poor prognoses: platelet count ≤50,000/µL (OR = 6.36 CI 1.79-22.62), serum creatinine >200 mM (OR = 5.86 CI 1.61-21.27), serum lactate >2.5 mM (OR = 5.14 CI 1.57-16.87), serum amylase >250 UI/L (OR = 4.66 CI 1.39-15.69) and leptospiremia >1000 leptospires/mL (OR = 4.31 CI 1.17-15.92).
To assess the risk of developing severe leptospirosis, our study illustrates the benefit for clinicians to have: i) the identification of the infective strain, ii) a critical threshold of qPCR-determined leptospiremia and iii) early laboratory results. In New Caledonia, preventative measures should focus on early presumptive antibacterial therapy and on rodent (reservoir of Icterohaemorrhagiae serogroup) control.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Leptospirosis is an endemo-epidemic zoonotic disease associated with potentially fatal renal, cardiovascular or pulmonary failure. Recommended treatment includes antibiotics, which may induce a ...Jarisch-Herxheimer reaction (JHR). Since little information on the importance of this adverse event is available, we performed this review to quantify frequency and impact of JHR in leptospirosis management.
This review systematically summarizes the literature on the JHR in leptospirosis. To approach the broader aspects of the subject, articles considering the treatment of leptospirosis, national leptospirosis guidelines and textbook and technical reports of the World Health Organisation were reviewed. Publications describing JHR in leptospirosis are very limited and consist mainly of single case reports and small case series. A single randomized control trial specifically assessed the JHR occurrence, but it has never been systematically investigated in large trials. Not all guidelines and not all literature on leptospirosis mention this reaction which can be fatal.
Although generally assumed to be a rare event, the true prevalence of JHR in leptospirosis is unknown and the awareness of this event is insufficient. All leptospirosis guidelines and local leptospirosis protocols should stress on systematic monitoring for clinical status early after antibiotic administration. Large well designed studies are required to precise the incidence and the impact of JHR as well as the severity and rates between various antibiotics.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Summary Background Little data on the usefulness of microbiological samples in appendicular peritonitis (AP) are available. The objectives of the study were to document the clinical value of ...systematic peritoneal swabbing in complicated appendicitis, to establish whether they influence postoperative outcome, and to help to optimize empirical preoperative treatment. Methods Charts of all consecutive patients undergoing appendicectomy for acute perforated appendicitis were analyzed over a 7-year period from 2005 to 2011 in a tertiary hospital in New Caledonia. From prospectively recorded data, microbiological culture results, and sensitivity of isolates were obtained in relation to histopathological findings and infective morbidity. Results Overall, 144 cases including 47 (33%) children and 97 (67%) adults with perforated appendicitis were included in the study. Fifty-one (35%) had generalized peritonitis treated laparoscopically in 30 (59%) cases. Peritoneal fluid samples yielded a positive culture in 104 (74%) patients. The most commonly recovered species were Escherichia coli (81%), Streptococcus milleri group (12%), and Pseudomonas aeruginosa (12%). Postoperative infectious complications occurred in 32 (22%) including intra-abdominal abscess ( n = 20) and wound infection ( n = 12). Probabilist antibiotic regimen was less often suitable in children than in adults ( p = 0.003). Infectious complications occurred more often in cases with an unsuitable antibiotic regimen after culture results compared with a suitable antibiotic regimen before culture results ( p = 0.01). Conclusion Although antibiotic use may be considered as an adjunct to surgical intervention of AP, the appropriate use of preoperative antibiotics and modifications according to culture results are essential to prevent infectious complications.
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