SUMMARYIn recent decades, several new diseases have emerged in different geographical areas, with pathogens including Ebola virus, Zika virus, Nipah virus, and coronaviruses (CoVs). Recently, a new ...type of viral infection emerged in Wuhan City, China, and initial genomic sequencing data of this virus do not match with previously sequenced CoVs, suggesting a novel CoV strain (2019-nCoV), which has now been termed severe acute respiratory syndrome CoV-2 (SARS-CoV-2). Although coronavirus disease 2019 (COVID-19) is suspected to originate from an animal host (zoonotic origin) followed by human-to-human transmission, the possibility of other routes should not be ruled out. Compared to diseases caused by previously known human CoVs, COVID-19 shows less severe pathogenesis but higher transmission competence, as is evident from the continuously increasing number of confirmed cases globally. Compared to other emerging viruses, such as Ebola virus, avian H7N9, SARS-CoV, and Middle East respiratory syndrome coronavirus (MERS-CoV), SARS-CoV-2 has shown relatively low pathogenicity and moderate transmissibility. Codon usage studies suggest that this novel virus has been transferred from an animal source, such as bats. Early diagnosis by real-time PCR and next-generation sequencing has facilitated the identification of the pathogen at an early stage. Since no antiviral drug or vaccine exists to treat or prevent SARS-CoV-2, potential therapeutic strategies that are currently being evaluated predominantly stem from previous experience with treating SARS-CoV, MERS-CoV, and other emerging viral diseases. In this review, we address epidemiological, diagnostic, clinical, and therapeutic aspects, including perspectives of vaccines and preventive measures that have already been globally recommended to counter this pandemic virus.
Objective
To determine the percentage of patients who would develop chronic inflammatory rheumatism (CIR) following chikungunya (CHIK) virus disease.
Methods
We conducted a systematic review of the ...literature in 3 databases (PubMed, Science Citation Index, and Scopus) to identify studies assessing the proportion of patients who progress to CHIK‐CIR. We performed a random‐effects model meta‐analysis to calculate the pooled prevalence and 95% confidence intervals (95% CIs). A 2‐tailed alpha level of 5% was used for hypothesis testing. Measures of heterogeneity, including Cochran's Q statistic, the I2 index, and the tau‐squared test, were calculated and reported. Subgroup analyses were conducted by type of study and country, by studies evaluating chronic arthritis, and by studies with ≥200 patients and followup ≥18 months. Publication bias was assessed using a funnel‐plot.
Results
Up to June 15, 2015, our literature search yielded 578 citations. The pooled prevalence of CHIK‐CIR in 18 selected studies among 5,702 patients was 40.22% (95% CI 31.11–49.34; τ2 = 0.0838). From studies derived from India, prevalence was 27.27% (95% CI 15.66–38.88; τ2 = 0.0411), while from France, prevalence was 50.25% (95% CI 25.38–75.12; τ2 = 0.1797). The prevalence of CHIK chronic arthritis was 13.66% (95% CI 9.31–18.00; τ2 = 0.0060). Considering just those studies with ≥200 patients assessed, prevalence was 34.14% (95% CI 23.99–44.29; τ2 = 0.0525). In studies with a followup ≥18 months, prevalence was 32.13% (95% CI 22.21–42.04; τ2 = 0.0453).
Conclusion
According to our results in the most conservative scenario, approximately 25% of CHIK cases would develop CHIK‐CIR (34% if we just consider the most representative studies), and 14% would develop chronic arthritis.
Going global – Travel and the 2019 novel coronavirus Rodríguez-Morales, Alfonso J.; MacGregor, Kirsten; Kanagarajah, Sanch ...
Travel medicine and infectious disease,
January-February 2020, 2020 Jan - Feb, 2020-01-00, 20200101, Letnik:
33
Journal Article
Recenzirano
Odprti dostop
Since 2009, the World Health Organization (WHO) has made five declarations of disease outbreaks considered Public Health Emergencies of International Concern (PHEIC): the 2009H1N1 (or swine flu) ...pandemic, the 2014 polio declaration, the 2014 outbreak of Ebola in Western Africa, the 2015–16 Zika virus epidemic and, as of 17 July 2019, the Kivu Ebola epidemic which began in 2018 1,2. ...the PHEIC designation was created following an update to the International Health Regulations (2005) after that outbreak. The ECDC has developed multiple documents in response, including technical reports, statements, risk assessments, algorithms, among others, related to diagnosis, management, and prevention 25–30.2 United Kingdom Travel patterns between the UK and China are well established; in an analysis of air travel from cities in China to international destinations in 2019, nine of the ten cities receiving the highest volumes of arriving passengers were in Asia, with London (UK), ranking 10th 18. ...the outbreak of 2019-nCoV with the evolving epidemiological picture has added some complexities; rapidly changing case numbers, travellers exporting cases, shifting government advice based on logistics rather than public health risk, and media scare stories to name but a few.
The current literature shows increasing concerns about potential seminal transmission of monkeypox virus (MPXV). Accordingly, we aimed to understand better the potential presence of MPXV in the ...seminal fluids and others specimens obtained from MPX cases. On June 26, 2022, a systematic search of the literature was conducted to find articles that examine the presence of MPXV in the seminal fluid of confirmed cases. The search was updated once on August 12 and another on October 12, 2022, to include newly published articles. The prevalence of MPXV DNA presence in the seminal fluid and other specimens was pooled in a meta‐analysis (from studies with sample size > 5 to reduce overestimation) and results were presented as effect sizes (ES) and their corresponding 95% confidence intervals (CI). Nine articles were included. Only five studies were eligible for a meta‐analysis, and the pooled prevalence of MPXV DNA in semen specimens was 72.4% (95% CI: 55.7%−84.5%) among 115 patients. The positive rate of MPXV viral polymerase chain reaction (PCR) was higher among skin samples (89%; 95% CI: 78.2%−94.8%; N = 62; studies = 2), followed by anogenital/rectal samples (74.3%; 95% CI: 60.4%−84.5%; N = 54; studies = 2). On the other hand, the positivity rate was lower in nasopharyngeal (62.4%; 95% CI: 20.4%−91.5%; N = 587; studies = 3), urine (21.1%; 95% CI: 4.3%−61.1%; N = 617; studies = 4), and blood/plasma (14.3%; 95% CI: 11.3%−18.1%; N = 609; studies = 3) samples. Besides, MPXV can be detected in semen early from Day 1 and up to 19 days after symptoms onset. Finally, two articles investigated the infectivity of MPXV particles detected in seminal specimens by testing their replication competence. Culturing MPXV was successful in two out of four patients included in these studies. MPXV is highly prevalent in seminal specimens of MPX cases, further corroborating the role of sexual transmission of the disease. However, further evidence is still needed to shed more light on the replication competence of these particles.
Humans encounter mycobacterial species due to their ubiquity in different environmental niches. In many individuals, pathogenic mycobacterial species may breach our first-line barrier defenses of the ...innate immune system and modulate the activation of phagocytes to cause disease of the respiratory tract or the skin and soft tissues, sometimes resulting in disseminated infection. Cutaneous mycobacterial infections may cause a wide range of clinical manifestations, which are divided into four main disease categories: (i) cutaneous manifestations of
infection, (ii) Buruli ulcer caused by
and other related slowly growing mycobacteria, (iii) leprosy caused by
and
, and (iv) cutaneous infections caused by rapidly growing mycobacteria. Clinically, cutaneous mycobacterial infections present with widely different clinical presentations, including cellulitis, nonhealing ulcers, subacute or chronic nodular lesions, abscesses, superficial lymphadenitis, verrucous lesions, and other types of findings. Mycobacterial infections of the skin and subcutaneous tissue are associated with important stigma, deformity, and disability. Geography-based environmental exposures influence the epidemiology of cutaneous mycobacterial infections. Cutaneous tuberculosis exhibits different clinical phenotypes acquired through different routes, including via extrinsic inoculation of the tuberculous bacilli and dissemination to the skin from other sites, or represents hypersensitivity reactions to
infection. In many settings, leprosy remains an important cause of neurological impairment, deformity, limb loss, and stigma.
, a mycobacterial species related to
, is linked to diffuse lepromatous leprosy of Lucio and Latapí.
produces a mycolactone toxin that leads to subcutaneous tissue destruction and immunosuppression, resulting in deep ulcerations that often produce substantial disfigurement and disability.
, a close relative of
, is an important cause of cutaneous sporotrichoid nodular lymphangitic lesions. Among patients with advanced immunosuppression,
, the
complex, and
may cause cutaneous or disseminated disease. Rapidly growing mycobacteria, including the
group,
, and
, are increasingly recognized pathogens in cutaneous infections associated particularly with plastic surgery and cosmetic procedures. Skin biopsies of cutaneous lesions to identify acid-fast staining bacilli and cultures represent the cornerstone of diagnosis. Additionally, histopathological evaluation of skin biopsy specimens may be useful in identifying leprosy, Buruli ulcer, and cutaneous tuberculosis. Molecular assays are useful in some cases. The treatment for cutaneous mycobacterial infections depends on the specific pathogen and therefore requires a careful consideration of antimicrobial choices based on official treatment guidelines.
The main seaport of Brazil is in Rio de Janeiro, where many international cruises also arrive. ...over the course of the next few days, a significant expansion in the region would be possible. The ...healthcare systems in this region are already fragile 7. ...fragmentation and segmentation are ongoing challenges for most of these vulnerable systems. ...there is concern about the availability of intensive care units, that are necessary for at least 20–25% of patients hospitalized with COVID-19—also, the availability of specific diagnostic tests, particularly the real-time RT-PCR is a crucial challenge for early detection of COVID-19 importation and prevention of onward transmission.
Dengue virus and severe acute respiratory syndrome coronavirus 2 coexist in dengue‐endemic countries; therefore, the adoption of preventive measures is essential to control the spread of both ...viruses. We conducted an ecological study to compare the temporal patterns of the incidence of dengue before and during the Coronavirus disease 2019 (COVID‐19) pandemic in Peru. A time‐series analysis comparing the incidence of dengue using a Student's t test with variance correction was performed. Poisson regression was applied to determine the incidence rate ratio (IRR) of dengue before and during the COVID‐19 pandemic. The incidence of dengue was found to be increased in all endemic regions of Peru during the COVID‐19 pandemic, with the highest incidences registered in Ica (IRR = 90.14), Huánuco (IRR = 38.6), and Ucayali (IRR = 23.78), with the exception of Piura (IRR = 0.83). The highest increases in the number of dengue cases per million inhabitants were in Ucayali (393.38), Tumbes (233.19), Ica (166.08), and Loreto (129.93). The gradient of dengue cases was positive in all endemic regions during the COVID‐19 pandemic. The number of dengue cases per million increased during the COVID‐19 pandemic throughout Peru and in several endemic regions, with the exception of Piura.
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