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1
Ahmed, Qanta A., and Ziad A. Memish. "Yellow fever from Angola and Congo: a storm gathers." Tropical Doctor 47, no. 2 (April 2017): 92–96. http://dx.doi.org/10.1177/0049475517699726.
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In common with Zika, Chikungunya and Dengue, Yellow Fever (YF) is an arthropod-borne flavivirus. It is transmitted between humans and from monkeys by mosquitoes of the Aedes aegypti (its principal vector), haemogogus and albopictus varieties. Three cycles of transmission may occur: urban; sylvatic; and intermediate. Recently, sub-Saharan Africa has seen the resurgence of this neglected disease. The current YF outbreak in Angola began in December 2015 in the capital Luanda and by October 2016 there had been > 4300 suspected cases, with 376 deaths (case fatality rate = 8.8%). A total of 884 were laboratory confirmed but it is likely that case numbers may be seriously underestimated. YF has subsequently quickly spread to neighbouring Congo and further afield to Kenya and also China, this being of grave concern as this was a first introduction of YF to Asia. YF has recently hit Brazil, with 555 suspected cases and 107 deaths reported by the end of January 2017. Extremely rapid unplanned urban migration in Africa by non-immune rural populations to already densely populated cities, where high densities of mosquitoes co-exist with city dwellers in makeshift flimsy accommodation, poses a ready recipe for an epidemic of massive proportion. In such conditions, with enormously strained public services existing among the most needy and vulnerable populations, mosquito control programmes are nearly impossible. YF in Congo is a tempest barely restrained. However, it is one that can be controlled by focused and committed international collaboration, by intense and united political will and by the marriage of old and trusted techniques: a vaccine almost a century old and some of the most modern technologies available to man.
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Y., Sodipo Olutomi, Gwomson Dauda, and Lar Luret A. "Yellow fever outbreak in Plateau state, Nigeria: A re-emerging disease or a case of misdiagnosis over the years?" International Journal of Biomedical Research 9, no. 5 (May 29, 2018): 192. http://dx.doi.org/10.7439/ijbr.v9i5.4768.
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Background: The first reported Yellow fever outbreak in Nigeria occurred in 1931.The latest outbreak in Nigeria, commenced in September 2017. It is active in seven states and suspected cases have been reported in sixteen states, inclusive of Plateau state. The last reported outbreak in Plateau state occurred in Jos in 1969 with an estimated 100,000 cases.Materials and Methods: The cases and health workers involved in management were interviewed. Hospital records, laboratory and surveillance data were reviewed.Results: Case 1: A 6-year-old girl from Tudun-Wada, Jos Plateau state presented with fever (38.6oC), abdominal pain, sore throat and jaundice. Liver function test (AST: 398U/L, ALT: 96U/L). Treatment included ribavirin, ceftriaxone, anti-oxidants, intravenous fluids, blood transfusion. ELISA-IgM was positive for YF, but negative on PNRT.Case 2: A 10-year-old boy from the same family with case 1 presented with fever (39.0oC), abdominal pain, diarrhoea and jaundice. Liver function test (AST: 315 U/L, ALT: 126U/L). Treatment is same as case 1 plus metronidazole. ELISA-IgM was positive for YF, but negative on PNRT, while PCR was positive for Lassa fever.Twenty-three contacts (17 healthcare workers, 6 family members) were traced and daily monitoring instituted.Conclusion: The potential for a major urban outbreak of Yellow Fever in Plateau state and Nigeria is already present. Advocacy, health education and enforcement of vector control measures need to be intensified by the State Ministry of Health. Surveillance for rapid case finding and proactive vaccination also need to be intensified to forestall a disaster.
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Goldstein, Emily J., David J. Bell, and Rory N. Gunson. "Yellow fever vaccine-associated neurological disease: it is not just the silver generation at risk." BMJ Case Reports 12, no. 5 (May 11, 2019): e229558. http://dx.doi.org/10.1136/bcr-2019-229558.
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A 35-year-old man presented to his optician with sudden onset diplopia and a 1-week history of headaches. He was noted to have sixth nerve palsy. The following day he was admitted to hospital with confusion and expressive dysphasia. He had been due to travel to Ghana on business and had received yellow fever (YF) vaccination 18 days prior to onset of headaches. His initial cerebrospinal fluid (CSF) revealed elevated protein, increased white cell count but was PCR negative for standard viral pathogens. Herpes simplex virus (HSV)-1 was detected by PCR in CSF at a very low level from a second lumbar puncture performed 6 days later, and the patient was treated for HSV meningoencephalitis. However, retrospective investigation for yellow fever vaccine-associated neurological disease revealed increasing titres of YF IgG in three serial CSF samples, and no evidence of HSV antibodies in CSF or plasma, ruling out HSV encephalitis.
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Chambers, Thomas J., Yan Liang, Deborah A. Droll, Jacob J. Schlesinger, Andrew D. Davidson, Peter J. Wright, and Xiaoshan Jiang. "Yellow Fever Virus/Dengue-2 Virus and Yellow Fever Virus/Dengue-4 Virus Chimeras: Biological Characterization, Immunogenicity, and Protection against Dengue Encephalitis in the Mouse Model." Journal of Virology 77, no. 6 (March 15, 2003): 3655–68. http://dx.doi.org/10.1128/jvi.77.6.3655-3668.2003.
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ABSTRACT Two yellow fever virus (YFV)/dengue virus chimeras which encode the prM and E proteins of either dengue virus serotype 2 (dengue-2 virus) or dengue-4 virus within the genome of the YFV 17D strain (YF5.2iv infectious clone) were constructed and characterized for their properties in cell culture and as experimental vaccines in mice. The prM and E proteins appeared to be properly processed and glycosylated, and in plaque reduction neutralization tests and other assays of antigenic specificity, the E proteins exhibited profiles which resembled those of the homologous dengue virus serotypes. Both chimeric viruses replicated in cell lines of vertebrate and mosquito origin to levels comparable to those of homologous dengue viruses but less efficiently than the YF5.2iv parent. YFV/dengue-4 virus, but not YFV/dengue-2 virus, was neurovirulent for 3-week-old mice by intracerebral inoculation; however, both viruses were attenuated when administered by the intraperitoneal route in mice of that age. Single-dose inoculation of either chimeric virus at a dose of 105 PFU by the intraperitoneal route induced detectable levels of neutralizing antibodies against the homologous dengue virus strains. Mice which had been immunized in this manner were fully protected from challenge with homologous neurovirulent dengue viruses by intracerebral inoculation compared to unimmunized mice. Protection was associated with significant increases in geometric mean titers of neutralizing antibody compared to those for unimmunized mice. These data indicate that YFV/dengue virus chimeras elicit antibodies which represent protective memory responses in the mouse model of dengue encephalitis. The levels of neurovirulence and immunogenicity of the chimeric viruses in mice correlate with the degree of adaptation of the dengue virus strain to mice. This study supports ongoing investigations concerning the use of this technology for development of a live attenuated viral vaccine against dengue viruses.
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Duarte‐Neto, Amaro N., Marielton dos P. Cunha, Izabel Marcilio, Alice T. W. Song, Rodrigo B. Martino, Yeh‐Li Ho, Shahab Z. Pour, et al. "Yellow fever and orthotopic liver transplantation: new insights from the autopsy room for an old but re‐emerging disease." Histopathology 75, no. 5 (August 19, 2019): 638–48. http://dx.doi.org/10.1111/his.13904.
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Okwuraiwe, Azuka Patrick, Oumar Faye, Fehintola Anthonia Ige, Ayorinde Babatunde James, Joseph Ojonugwa Shaibu, Martin Faye, Olufemi Samuel Amoo, et al. "Surveillance of Viral Hemorrhagic Fever Viruses in Lassa Fever Suspects in Ondo State, Nigeria." European Journal of Medical and Health Sciences 4, no. 3 (May 30, 2022): 78–81. http://dx.doi.org/10.24018/ejmed.2022.4.3.1245.
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Lassa Fever (LF) continues to be an endemic acute viral hemorrhagic fever (VHF) illness in Nigeria. Many suspected cases of LF infection have subsequently been confirmed negative and raises concerns as to what the diagnosis of such patients could be. Hence this study was to determine the causative agents of unconfirmed LF among initially suspected cases in South Western Nigeria. In this retrospective study, blood samples originally collected from 233 suspected cases of a LF outbreak response at Owo and Ose LGAs of Ondo State, were transported in triple level packaging and stored at -80°C. All samples were screened for LF IgM and IgG markers and LF PCR. Forty-five out of the stored plasma samples were randomly retrieved and analyzed for presence of IgM for seven other VHF viruses; Chikungunya (CHIK), West Nile (WN), Rift Valley fever (RVF), Yellow fever (YF), Dengue fever (DEN), Zika and Crimean-Congo hemorrhagic fever (CCHF). Out of 45 samples screened, 1 (2.2%) was positive for YF IgM antibody. The same sample was previously confirmed LF positive by PCR. This LF and YF co-infection was from a male, 23-year old individual. The presence of co-infections of LF and YF draw to limelight the need to be broad minded in exploring for the presence of other VHF viruses in outbreaks. Further studies are needed to decipher the diagnosis of LF suspected cases.
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Guirakhoo, F., R. Weltzin, T. J. Chambers, Z. X. Zhang, K. Soike, M. Ratterree, J. Arroyo, K. Georgakopoulos, J. Catalan, and T. P. Monath. "Recombinant Chimeric Yellow Fever-Dengue Type 2 Virus Is Immunogenic and Protective in Nonhuman Primates." Journal of Virology 74, no. 12 (June 15, 2000): 5477–85. http://dx.doi.org/10.1128/jvi.74.12.5477-5485.2000.
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ABSTRACT A chimeric yellow fever (YF)-dengue type 2 (dengue-2) virus (ChimeriVax-D2) was constructed using a recombinant cDNA infectious clone of a YF vaccine strain (YF 17D) as a backbone into which we inserted the premembrane (prM) and envelope (E) genes of dengue-2 virus (strain PUO-218 from a case of dengue fever in Bangkok, Thailand). The chimeric virus was recovered from the supernatant of Vero cells transfected with RNA transcripts and amplified once in these cells to yield a titer of 6.3 log10 PFU/ml. The ChimeriVax-D2 was not neurovirulent for 4-week-old outbred mice inoculated intracerebrally. This virus was evaluated in rhesus monkeys for its safety (induction of viremia) and protective efficacy (induction of anti-dengue-2 neutralizing antibodies and protection against challenge). In one experiment, groups of non-YF-immune monkeys received graded doses of ChimeriVax-D2; a control group received only the vaccine diluents. All monkeys (except the control group) developed a brief viremia and showed no signs of illness. Sixty-two days postimmunization, animals were challenged with 5.0 log10focus forming units (FFU) of a wild-type dengue-2 virus. No viremia (<1.7 log10 FFU/ml) was detected in any vaccinated group, whereas all animals in the placebo control group developed viremia. All vaccinated monkeys developed neutralizing antibodies in a dose-dependent response. In another experiment, viremia and production of neutralizing antibodies were determined in YF-immune monkeys that received either ChimeriVax-D2 or a wild-type dengue-2 virus. Low viremia was detected in ChimeriVax-D2-inoculated monkeys, whereas all dengue-2-immunized animals became viremic. All of these animals were protected against challenge with a wild-type dengue-2 virus, whereas all YF-immune monkeys and nonimmune controls became viremic upon challenge. Genetic stability of ChimeriVax-D2 was assessed by continuous in vitro passage in VeroPM cells. The titer of ChimeriVax-D2, the attenuated phenotype for 4-week-old mice, and the sequence of the inserted prME genes were unchanged after 18 passages in Vero cells. The high replication efficiency, attenuation phenotype in mice and monkeys, immunogenicity and protective efficacy, and genomic stability of ChimeriVax-D2 justify it as a novel vaccine candidate to be evaluated in humans.
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Awoyale, Oladayo D., Olayinka S. Ilesanmi, Aanuoluwapo A. Afolabi, and Oluwatosin E. Fakayode. "An investigation of the resurgence of yellow fever outbreak in Kwara State, Nigeria, 2018." International Journal Of Community Medicine And Public Health 8, no. 12 (November 24, 2021): 6064. http://dx.doi.org/10.18203/2394-6040.ijcmph20214616.
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The frequent occurrence of yellow fever (YF) outbreaks in Nigeria affirms that YF is a re-emerging public health threat. This case report therefore aimed to provide a description of a confirmed case of in Ifelodun Local Government Area of Kwara State between January and December 2018. We conducted an outbreak investigation of YF in Kwara state, Nigeria. On 18th December 2018, a 25-year-old man (Mr. A) suspected for YF was reported from Agunjin ward of Ifelodun LGA in Kwara State. Mr. A presented with a history of fever and jaundice. Laboratory investigations were conducted, and Mr. A was confirmed positive to YF Immunoglobin M from the regional World Health Organization laboratory in Dakar, Senegal, but survived the YF illness. Community survey revealed nearly 53% YF vaccination coverage using both card and history. The rapid response team in Kwara State paid courtesy visits to the palace of the Alagunjin of Agunjin who assured of the community’s cooperation. Active case search was encouraged for all healthcare workers who participated in the vaccination activity, and on-the-job trainings were conducted. To ensure 100% YF vaccine coverage in Agunjin and neighboring settlements, a mop-up vaccination program, was conducted, and all persons who received the vaccine were each issued a yellow card. To forestall a recurrence of YF outbreaks, increasing YF vaccination coverage in community settings should be promoted. Increased commitment of the government at all levels towards improving YF surveillance and providing logistics support should be prioritized.
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Kuno, Goro. "The Absence of Yellow Fever in Asia: History, Hypotheses, Vector Dispersal, Possibility of YF in Asia, and Other Enigmas." Viruses 12, no. 12 (November 25, 2020): 1349. http://dx.doi.org/10.3390/v12121349.
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Since the recent epidemics of yellow fever in Angola and Brazil as well as the importation of cases to China in 2016, there has been an increased interest in the century-old enigma, absence of yellow fever in Asia. Although this topic has been repeatedly reviewed before, the history of human intervention has never been considered a critical factor. A two-stage literature search online for this review, however, yielded a rich history indispensable for the debate over this medical enigma. As we combat the pandemic of COVID-19 coronavirus worldwide today, we can learn invaluable lessons from the historical events in Asia. In this review, I explore the history first and then critically examine in depth major hypotheses proposed in light of accumulated data, global dispersal of the principal vector, patterns of YF transmission, persistence of urban transmission, and the possibility of YF in Asia. Through this process of re-examination of the current knowledge, the subjects for research that should be conducted are identified. This review also reveals the importance of holistic approach incorporating ecological and human factors for many unresolved subjects, such as the enigma of YF absence in Asia, vector competence, vector dispersal, spillback, viral persistence and transmission mechanisms.
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Kuo, I.-Ching, Po-Liang Lu, Wei-Ru Lin, Chun-Yu Lin, Yu-Wei Chang, Tun-Chieh Chen, and Yen-Hsu Chen. "Sphingomonas paucimobilis bacteraemia and septic arthritis in a diabetic patient presenting with septic pulmonary emboli." Journal of Medical Microbiology 58, no. 9 (September 1, 2009): 1259–63. http://dx.doi.org/10.1099/jmm.0.009985-0.
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Sphingomonas paucimobilis, a yellow-pigmented, aerobic, glucose non-fermenting, Gram-negative bacillus, is a rare cause of human infection normally associated with immunocompromised hosts. We report a case of bacteraemia and septic arthritis in a 47-year-old diabetic man who presented with septic pulmonary emboli due to S. paucimobilis. The patient had an initial presentation of fever, right knee pain, coughing, dyspnoea and chest pain. The infection was treated successfully by surgical debridement combined with meropenem plus ciprofloxacin, based on the patient's antibiotic susceptibility profile. To our knowledge, this is the first case report for septic pulmonary emboli having arisen from an S. paucimobilis infection.
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Alkan, Cigdem, Sonia Zapata, Laurence Bichaud, Grégory Moureau, Philippe Lemey, Andrew E. Firth, Tamara S. Gritsun, et al. "Ecuador Paraiso Escondido Virus, a New Flavivirus Isolated from New World Sand Flies in Ecuador, Is the First Representative of a Novel Clade in the Genus Flavivirus." Journal of Virology 89, no. 23 (September 9, 2015): 11773–85. http://dx.doi.org/10.1128/jvi.01543-15.
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ABSTRACTA new flavivirus, Ecuador Paraiso Escondido virus (EPEV), named after the village where it was discovered, was isolated from sand flies (Psathyromyia abonnenci, formerlyLutzomyia abonnenci) that are unique to the New World. This represents the first sand fly-borne flavivirus identified in the New World. EPEV exhibited a typical flavivirus genome organization. Nevertheless, the maximum pairwise amino acid sequence identity with currently recognized flaviviruses was 52.8%. Phylogenetic analysis of the complete coding sequence showed that EPEV represents a distinct clade which diverged from a lineage that was ancestral to the nonvectored flaviviruses Entebbe bat virus, Yokose virus, and Sokoluk virus and also theAedes-associated mosquito-borne flaviviruses, which include yellow fever virus, Sepik virus, Saboya virus, and others. EPEV replicated in C6/36 mosquito cells, yielding high infectious titers, but failed to reproduce either in vertebrate cell lines (Vero, BHK, SW13, and XTC cells) or in suckling mouse brains. This surprising result, which appears to eliminate an association with vertebrate hosts in the life cycle of EPEV, is discussed in the context of the evolutionary origins of EPEV in the New World.IMPORTANCEThe flaviviruses are rarely (if ever) vectored by sand fly species, at least in the Old World. We have identified the first representative of a sand fly-associated flavivirus, Ecuador Paraiso Escondido virus (EPEV), in the New World. EPEV constitutes a novel clade according to current knowledge of the flaviviruses. Phylogenetic analysis of the virus genome showed that EPEV roots theAedes-associated mosquito-borne flaviviruses, including yellow fever virus. In light of this new discovery, the New World origin of EPEV is discussed together with that of the other flaviviruses.
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Mulchandani, Ranya, Fekadu Massebo, Fekadu Bocho, Claire L. Jeffries, Thomas Walker, and Louisa A. Messenger. "A community-level investigation following a yellow fever virus outbreak in South Omo Zone, South-West Ethiopia." PeerJ 7 (February 20, 2019): e6466. http://dx.doi.org/10.7717/peerj.6466.
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Background Despite the availability of a highly effective vaccine, yellow fever virus (YFV) remains an important public health problem across Africa and South America due to its high case-fatality rate. This study investigated the historical epidemiology and contemporary entomological and social determinants of a YFV outbreak in South Omo Zone (SOZ), Ethiopia. Methods A YFV outbreak occurred in SOZ, Ethiopia in 2012–2014. Historical epidemiological data were retrieved from the SOZ Health Department and analyzed. Entomological sampling was undertaken in 2017, including mosquito species identification and molecular screening for arboviruses to understand mosquito habitat distribution, and finally current knowledge, attitudes and preventative practices within the affected communities were assessed. Results From October 2012 to March 2014, 165 suspected cases and 62 deaths were reported, principally in rural areas of South Ari region (83.6%). The majority of patients were 15–44 years old (75.8%) and most case deaths were males (76%). Between June and August 2017, 688 containers were sampled across 180 households to identify key breeding sites for Aedes mosquitoes. Ensete ventricosum (“false banana”) and clay pots outside the home were the most productive natural and artificial breeding sites, respectively. Entomological risk indices classified most sites as “high risk” for future outbreaks under current World Health Organization criteria. Adult mosquitoes in houses were identified as members of the Aedes simpsoni complex but no YFV or other arboviruses were detected by PCR. The majority of community members had heard of YFV, however few activities were undertaken to actively reduce mosquito breeding sites. Discussion Study results highlight the potential role vector control could play in mitigating local disease transmission and emphasize the urgent need to strengthen disease surveillance systems and in-country laboratory capacity to facilitate more rapid responses to future YFV outbreaks.
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Han, Xiu-Min, Xue-Yong Zhang, Ying-Na Jian, and Qing-Shan Tian. "Taenia saginata Infection Misdiagnosed as Acute Cholecystitis in a Tibetan Patient, in China." Korean Journal of Parasitology 59, no. 3 (June 21, 2021): 311–17. http://dx.doi.org/10.3347/kjp.2021.59.3.311.
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The present study reports a rare case of Taenia saginata infection, which was initially diagnosed as acute cholecystitis in a Tibetan patient at the Qinghai-Tibetan Plateau pastoral area, China. A 45-year-old female was initially diagnosed with acute cholecystitis at a hospital in China. She had a slight fever, weight loss and constipation and complained of pain in the upper abdomen and left back areas. Increase of monocyte, eosinophil and basophil levels were shown. Taenia sp. eggs were detected in a fecal examination. An adult tapeworm approximately 146 cm in length, whitish-yellow color, was collected from the patient after treatment with traditional Chinese medicine. The adult tapeworm had a scolex and proglottids with genital pores. The scolex was rectangular shape with 4 suckers and rostellum without hooklet. The cox1 gene sequence shared 99.5-99.8% homology with that of T. saginata from other regions in China. The patient was diagnosed finally infected with T. saginata by morphological and molecular charateristics.
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Cavalcanti, Julia Francesca Bonato, Maria Beatriz Almeida Silva, and Alzira Alves de Siqueira Carvalho. "Vaccination as a possible trigger for immune-mediated necrotising myopathy." BMJ Case Reports 14, no. 5 (May 2021): e242095. http://dx.doi.org/10.1136/bcr-2021-242095.
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Immune-mediated necrotising myopathy is a rare autoimmune myopathy characterised by severe progressive muscle weakness, elevated levels of creatine kinase (CK), and necrosis with minimal inflammatory cell infiltration on muscle biopsy. We report a case of a previously healthy 42-year-old woman who presented with progressive muscle weakness 2 weeks after immunisation for yellow fever, tetanus/diphtheria and hepatitis B. Her symptoms started from the lower limbs and progressed to the upper limbs and cervical region associated with dysphagia, making her wheelchair bound. Electromyography showed a myopathic pattern, with a CK level of 12.177 U/L (reference value: 26–190 U/L), and biceps brachial muscle biopsy confirmed necrosis and regeneration fibres. The immunoblot test was positive for antisignal recognition particle. She was successfully treated with prednisone (1 mg/kg/day). Although considered safe, vaccines may cause allergic reactions or trigger autoimmune disorders. Currently, a causal relationship between them cannot be established.
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Abdul-Rahman Alhiti, Hazim, and Manaf Abdulrahman Guma. "A Challenging Case of Pneumonia and Vasculitis." Archives of Medical Case Reports and Case Study 5, no. 3 (April 11, 2022): 01–04. http://dx.doi.org/10.31579/2692-9392/112.
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An elderly (76 years old) immunocompromised Iraqi male had carcinoma of colon stage 3c without metastasis operated for seven years before, plus chemotherapy for one year. In winter 2022, this man sorrowed from a sore throat, voice change, and a rise in temperature (37.4 C). Later, dry cough developed in subsequent hours and deteriorated quickly to yellow-colored sputum, plus an increment in his temperature (37.8 C). After that, the patient had non-specific, non-itchy, follicular erythematous papules. The rash varies in size and shape, distributed in the abdomen, lower back, and legs. Two physicians proved pneumonia by clinical means, plus two successive chest x-rays, but the patient refused the laboratory investigations for Covid. He took two doses of the Chinese vaccine (Sinopharm) six months before recent symptoms. After strict treatment, the cough became less frequent, white-colored sputum, fever dropped gradually, at the end of the week. On the tenth day from the beginning of the man's symptoms, the skin rash faded slowly due to prednisolone usage.
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Kiani, Pantea, Jacqueline M. Iversen, Andrew Scholey, and Joris C. Verster. "The Efficacy of the Combination of Naproxen and Fexofenadine (SJP-003) to Prevent or Reduce Side Effects of Receiving Multiple Travel Vaccines: A Case Report." Vaccines 10, no. 7 (July 15, 2022): 1128. http://dx.doi.org/10.3390/vaccines10071128.
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A considerable number of travelers receive multiple travel vaccinations before going on holiday. Here, we present a case report of a 56-year-old male traveler. On day 1, he received vaccinations against influenza, Tdab (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis), MMR (measles, mumps, and rubella), yellow fever, and cholera. On days 1,3, 5, and 7, he self-administered an oral vaccine against typhoid. Treatment comprised the combination of 220 mg naproxen and 180 mg fexofenadine (SJP-003), to be taken 4h before and 6h after the vaccinations on day 1, and every 12 h thereafter until the end of day 7. Side effects were noted daily, and their severity was scored on a scale ranging from 0 (absent) to 10 (severe). These reports revealed that, except from a slight bruising at the injection site, no side effects were experienced from day 1 to day 4. After the second dose on day 3, treatment was discontinued. Two hours after taking the typhoid vaccine on Day 5, various flu-like symptoms were reported of moderate to high severity, including fever, muscle aches (both with severity score of 8), headache (severity score 7), and nausea (severity score 6). Therefore, at 2 h after typhoid vaccination on day 5, naproxen and fexofenadine were self-administered. At 4 h thereafter, all symptoms were resolved. Treatment was continued at the 12 h schedule. On day 6 and 7, no side effects were reported. Taken together, this case study suggests that the combination of naproxen and fexofenadine was effective in preventing or reducing vaccination side effects. Therefore, more research is warranted to further evaluate the efficacy of SJP-003.
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Singh, Scott Arockia, D. Devaprasath Jeyasekharan, S. Sabu Jeyasekharan, P. Bala Vidhyasagar, C. Nithila, Renu Devaprasath, S. Nishal Perumal, and Katla Vishnu Chandrika. "Concomitant primary peritonitis, septic shock and empyema thoracis in a young girl: a rare case report." International Surgery Journal 6, no. 11 (October 24, 2019): 4156. http://dx.doi.org/10.18203/2349-2902.isj20195144.
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Primary peritonitis is a condition in which there is no intraabdominal source of infection demonstrated during laparotomy. It is uncommon and can affect any age group from childhood to the elderly. We report here a case of Primary peritonitis with septic shock as a presenting feature, associated with empyema thoracis. This combination was not reported previously in the literature. Our patient was a 15-yr old girl with a ten day history of fever, cough, dyspnea, abdominal pain and loose stools initially treated elsewhere. She was brought to the emergency in a gasping state, bradycardia, hypotension, tachypnoea and a distended abdomen. She was intubated, resuscitated and a bedside ultrasound revealed free fluid present all over peritoneal cavity. Emergency laparotomy under general anesthesia showed extensive thick yellow coloured nonfoul-smelling purulent fluid all over the peritoneal spaces with distended bowel loops. A thorough search confirmed no evidence of hollow-viscus perforation, peritoneal lavage, appendicectomy and laparostomy were done. Postoperatively she was ventilated electively and managed in a high dependency care unit with broad spectrum antibiotics and respiratory supportive measures. However she continued to have high fever, tachycardia, tachypneic and developed left massive pyothorax. Thoracoscopic drainage of the flakes of pus in the pleural cavity with extensive decortication done. Then, once her sepsis was well controlled, underwent laparostomy closure. However, post laparostomy-closure had signs of LV dysfunction with respiratory failure and managed with cardiac drugs. She had a turbulent postoperative course, gradually recovered, and was discharged home after nine weeks of admission.
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Miller, David C. "Infection and Imagination: The Atmospheric Analogy and the Problem of Romantic Culture in America." Prospects 13 (October 1988): 37–60. http://dx.doi.org/10.1017/s0361233300005238.
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The crucial twenty-third chapter of Melville's The Confidence-Man (1857) develops an arresting analogy between the linguistic wiles of the latest avatar of the Confidence-Man (or Devil) and the imagery of infectious atmosphere. The chapter opens with a flood of allusions to the notion of an insidious agent hidden in the air, carrying infection and threatening death: “At Cairo, the old established firm of Fever & Ague is still settling up its unfinished business; that Creole grave-digger, Yellow Jack—his hand at the mattock and spade has not lost its cunning; while Don Saturninus Typhus taking his constitutional with Death, Calvin Edson and three undertakers, in the morass, snuffs up the mephitic breeze with zest.” Eyeing from the boat rail the “swampy and squalid domain” that lies before Cairo, the Missourian, Pitch, peers through the “dubious medium” of a “dank twilight, fanned with mosquitoes, and sparkling with fire-flies” and revolves in his mind a foregoing conversation with the P.I.O. man, who, only moments before, had induced him to pay money for a promised boy servant. He begins to suspect he has been conned.
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Miller, David C. "Infection and Imagination: The Atmospheric Analogy and the Problem of Romantic Culture in America." Prospects 13 (October 1988): 37–60. http://dx.doi.org/10.1017/s0361233300006682.
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The crucial twenty-third chapter of Melville's The Confidence-Man (1857) develops an arresting analogy between the linguistic wiles of the latest avatar of the Confidence-Man (or Devil) and the imagery of infectious atmosphere. The chapter opens with a flood of allusions to the notion of an insidious agent hidden in the air, carrying infection and threatening death: “At Cairo, the old established firm of Fever & Ague is still settling up its unfinished business; that Creole grave-digger, Yellow Jack—his hand at the mattock and spade has not lost its cunning; while Don Saturninus Typhus taking his constitutional with Death, Calvin Edson and three undertakers, in the morass, snuffs up the mephitic breeze with zest.” Eyeing from the boat rail the “swampy and squalid domain” that lies before Cairo, the Missourian, Pitch, peers through the “dubious medium” of a “dank twilight, fanned with mosquitoes, and sparkling with fire-flies” and revolves in his mind a foregoing conversation with the P.I.O. man, who, only moments before, had induced him to pay money for a promised boy servant. He begins to suspect he has been conned.
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Velasco, Henry, Henry Laniado, Mauricio Toro, Alexandra Catano-López, Víctor Leiva, and Yuhlong Lio. "Modeling the Risk of Infectious Diseases Transmitted by Aedes aegypti Using Survival and Aging Statistical Analysis with a Case Study in Colombia." Mathematics 9, no. 13 (June 24, 2021): 1488. http://dx.doi.org/10.3390/math9131488.
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Many infectious diseases are deadly to humans. The Aedes aegypi mosquito is the principal vector of infectious diseases that include chikungunya, dengue, yellow fever, and zika. Some factors such as survival time and aging are vital in its development and capacity to transmit the pathogens, which in turn are affected by environmental factors such as temperature. In this paper, we consider aging as the biological wear and tear presented in some mosquito populations over time, whereas survival is considered as the maximum time that a mosquito lives. We propose statistical methods that are commonly used in engineering for reliability analysis to compare transmission riskiness among different mosquitoes. We conducted a case study in three Colombian cities: Bello, Riohacha, and Villavicencio. In this study, we detected that the Aedes aegypi female mosquitoes in Bello live longer than in Riohacha and Villavicencio, and the females in Riohacha live longer than those in Villavicencio. Regarding aging, the females from Riohacha age slower than in Villavicencio and the latter age slower than in Bello. Mosquito populations that age slower are considered young and the other ones are old. In addition, we detected that the females from Bello in the temperature range of 27 ∘C–28 ∘C age slower than those in Bello at higher temperatures. In general, a young female has a higher risk of transmitting a disease to humans than an old female, regardless of its survival time. These findings have not been previously reported in studies of this type of infectious diseases and contributed to new knowledge in biomedicine.
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Kiran, F., I. M. Asuzu, and S. Noreen. "Submucosal Lipoma at the lead point of Small bowel Intussusception in an Adult." American Journal of Clinical Pathology 156, Supplement_1 (October 1, 2021): S59. http://dx.doi.org/10.1093/ajcp/aqab191.121.
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Abstract Introduction/Objective Morbidity and mortality among adult patients presenting with acute abdominal pain are high, and these patients often require hospitalization with prompt surgical consultation Important differentials include small bowel obstruction from previous surgeries and hernias, acute mesenteric ischemia, and ruptured abdominal aortic aneurysm. Intussusception in adults is rare accounting for about 1% - 5% of small bowel obstructions and thus requiring a high index of suspicion for early detection. In most cases, the lead point is a benign mass, commonly a lipoma, but histopathologic examination of the resected segment is required to rule out malignancy. Methods/Case Report We present a case of a 50-year old male with a medical history of psoriasis and hypertension who was admitted on account of a 1-day history of sudden onset persistent abdominal pain with associated nausea non-bilious emesis. Physical examination reveals no fever and soft non-distended abdomen with diffuse tenderness. CT scan demonstrated long segment small bowel-small bowel intussusception with markedly edematous and dilated bowel, compatible with obstruction. The lead-point was suspected to be a 3.9cm lipoma. Segmental resection and primary re-anastomosis were performed. Gross examination revealed a 13cm segment of bowel telescoping into a distal segment with a lead-point demonstrating mucosal congestion and submucosal thickening corresponding to a well-circumscribed 3.5cm tan yellow soft lobulated mass with yellow cut surface. Histopathology was consistent with lipoma. The patient made an uneventful postoperative recovery. Results (if a Case Study enter NA) N/A Conclusion Intussusception should be kept in the differential diagnosis of adults presenting with sudden onset abdominal pain and pathologic examination of the resected segment is necessary to rule out malignancy.
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Modesto dos Santos, Vitorino, Diana Aristótelis Rocha de Sá, Thiago Zavascki Turra, Nancy Mendonça Ferreira Borges, Ulisses Mariano Nascimento, and Emanuel Adelino Medeiros Damasceno. "Hantavirus pulmonary syndrome in Brasilia periphery: a diagnostic challenge." Journal of Infection in Developing Countries 3, no. 08 (September 15, 2009): 639–43. http://dx.doi.org/10.3855/jidc.558.
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BACKGROUND: Hantavirus pulmonary syndrome (HPS) is an emerging rodent-borne disease in the American continent, characterized by acute respiratory distress and a high case-fatality ratio. The present work describes a case of HPS, with favorable outcome, whose initial features were mistaken for leptospirosis or other less severe acute infections. METHODOLOGY: The case of a 32-year-old male with an uneventful course of HPS is reported. He was inadvertently infected at work by exposure to a rodent-contaminated environment in Brasília, Federal District vicinity, during May 2008. RESULTS AND CONCLUSIONS: Fever, headache and myalgia after exposure to a rodent-contaminated environment raised clinical suspicion. Non-cardiac pulmonary edema, hydrothorax, neutrophilia with band forms 26%, high hematocrit, thrombocytopenia, and elevated liver enzymes were observed. Leptospirosis and dengue were the main differential diagnoses because both pathogens are endemic in the area. Hantavirus IgM antibody-capture ELISA was positive, while tests for dengue, leptospirosis and yellow fever were negative. The prognosis for HPS is ominous and misdiagnoses may increase mortality. Better chances of survival depend on prompt intensive care support. Reports of moderate or less typical cases can raise the suspicion index among primary care and hospital-based physicians about this uncommon but severe condition that often affects previously healthy young individuals from developing countries, and subjects who interact with rodent-infested environments in North America. High awareness of HPS allowed successful management of the patient, even before establishing the diagnosis, by serological tests at the reference laboratory of the Ministry of Health. Clinical suspicion favored warning local health authorities about a new case of HPS.
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Sinclair, James B., and Sassan Asgari. "Ross River Virus Provokes Differentially Expressed MicroRNA and RNA Interference Responses in Aedes aegypti Mosquitoes." Viruses 12, no. 7 (June 27, 2020): 695. http://dx.doi.org/10.3390/v12070695.
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Alphaviruses are globally distributed and predominately transmitted by mosquitoes. Aedes species are common vectors for the clinically important alphaviruses—Chikungunya, Sindbis, and Ross River (RRV) viruses—with Aedes aegypti also being a vector for the flaviviruses dengue, Yellow Fever, and Zika viruses. Ae. aegypti was putatively implicated in the large 1979–1980 South Pacific Islands outbreak of RRV—the leading cause of arboviral disease in Australia today. The RNA interference (RNAi) defense response in mosquitoes involves a number of small RNAs, with their kinetics induced by alphaviruses being poorly understood, particularly at the tissue level. We compared the small RNA profiles between RRV-infected and non-infected Ae. aegypti midgut and fat body tissues at 2, 6, and 12 days post-inoculation (dpi). RRV induced an incremental RNAi response, yielding short interfering and P-element-induced-wimpy-testis (PIWI)-interacting RNAs. Fourteen host microRNAs were differentially expressed due to RRV with the majority in the fat body at 2 dpi. The largely congruent pattern of microRNA regulation with previous reports for alphaviruses and divergence from those for flaviviruses suggests a degree of conservation, whereas patterns of microRNA expression unique to this study provide novel insights into the tissue-specific host-virus attributes of Ae. aegypti responses to this previously unexplored old-world alphavirus.
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Almasy, Emoke, Janos Szederjesi, Paul Rad, and Anca Georgescu. "A Fatal Case of Community Acquired Cupriavidus Pauculus Pneumonia." Journal of Critical Care Medicine 2, no. 4 (October 1, 2016): 201–4. http://dx.doi.org/10.1515/jccm-2016-0027.
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Abstract Introduction: Cupriavidus pauculus is a rarely isolated non-fermentative, aerobic bacillus, which occasionally causes severe human infections, especially in immunocompromised patients. Strains have been isolated from various clinical and environmental sources. Case presentation: A 67-year-old man was admitted to the Intensive Care Unit with acute respiratory failure. The patient was diagnosed with bilateral pneumonia, pulmonary sepsis and underwent invasive mechanical ventilation. Examination revealed diminished bilateral vesicular breath sounds, fever, intense yellow tracheal secretions, a respiratory rate of 24/minute, a heart rate of 123/minute, and blood pressure of 75/55 mmHg. Vasoactive treatment was initiated. Investigations revealed elevated lactate and C-reactive protein levels. A chest X-ray showed bilateral infiltration. Parenteral ciprofloxacin and ceftriaxone were administered. Tracheal aspirate culture and blood culture showed bacterial growth of Cupriavidus pauculus. Colistin was added to the treatment. There was a poor clinical response despite repeated blood culture showing negative results. The diagnosis of multiple organ dysfunction syndrome (MODS) caused by C. pauculus was made. The patient died eleven days after admission. Conclusions: Clinical improvement cannot always be expected in spite of targeted antibiotic therapy. This pathogen should be considered responsible for infections that usually develop in immunocompromised patients.
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Mbanzulu, Kennedy M., Leonard E. G. Mboera, Roger Wumba, Josué K. Zanga, Flory K. Luzolo, Gerald Misinzo, and Sharadhuli I. Kimera. "Community Knowledge, Attitude, and Practices Regarding Mosquitoes and Mosquito-Borne Viral Diseases in Kinshasa, Democratic Republic of the Congo." Epidemiologia 4, no. 1 (December 30, 2022): 1–17. http://dx.doi.org/10.3390/epidemiologia4010001.
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Background and Objectives: Mosquito-borne viral diseases (MBVDs) create a dramatic health situation worldwide. There is a need to improve the understanding of factors to be addressed in intervention programmes. This study explored community knowledge, attitudes, and practices (KAP) regarding MBVD in Kinshasa. Materials and Methods: A cross-sectional survey was carried out between January and April 2019. The socio-demographic and KAP data collected through a questionnaire were analysed using Epi Info 7. Results: The study included 1464 male and female respondents aged from 18 to 70 years old. Open garbage cans and outdoor water storage units were found in 61.2% and 33.4% of respondent residences, respectively. Polluted water bodies (80.3%) were the most mentioned as mosquito breeding places. Among 86.6% of the respondents that had heard about yellow fever, 12% knew that it is an MBVD. The majority of respondents (72.5%) were perceived to be at risk of contracting MBVD. Environment sanitation (58%) and insecticide use (25%) were among the measures implemented to control mosquitoes. The greater overall knowledge score and attitude were not associated with good practice. Conclusion: The residents of Kinshasa had limited knowledge of MBVD. Raising awareness and educational sessions are essential in empowering the community regarding the correct attitudes and practices to effectively manage the risk posed by MBVD.
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Leblebisatan, Goksel, Ilgen Sasmaz, Kurthan Mert, Ebru Ozates, Bulent Antmen, and Yurdanur Kilinc. "Management of Refractory Intracranial Hemorrhage in a Coagulopathic Patient with Liver Disease by Using Recombinant Factor VIIa (rFVIIa)." Blood 106, no. 11 (November 16, 2005): 4088. http://dx.doi.org/10.1182/blood.v106.11.4088.4088.
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Abstract Objective: Coagulopathy resulting from liver pathologies and the hemorrhages secondary to this are the complications observed in chronic liver diseases, fulminant hepatitis, hepatocellular cancer, liver transplantation and other similar conditions. The literature on the use of rFVIIa which was initially used in hemophiliac patients with inhibitors for hemorrhages that can not be managed with conventional methods or operations that can not be performed safely, is increasingly growing. Here we will present a patient that was successfully operated by using rFVIIa for recurrent intracranial hemorrhage secondary to liver disease. Case: The 7 months old female infant was brought to our clinic due to abdominal distention and bleeding from anus. Her medical history included a treatment by hospitalization in the Regional Hospital when two months old due to high fever, forceful vomiting, foaming at mouth and yellow coloring of skin (convulsion?), operation due to hemorrhage detected at cerebral imaging, two subsequent operations at the same hospital due to hemorrhage upon sudden purple coloring of skin observed 1.5 months later and finally, dismission from hospital following a 25-day monitoring under conditions of intensive care. Following the yellow coloring of eyes, hematemesis, abdominal distention, echhymoses in the back and chest observed in the patient, she was referred to our clinic and her cerebral CT findings revealed pressure effect and subdural hematoma extending from temporal localization to frontoparietal cranium at left and to tentorium superior section and anterior interhemispheric fissure in cranium at posterior, with the widest part reaching 1.5 cm. The patient, for whom an operation was planned, was twice supplemented with platelet suspension at a dose of 10 cc/kg (53000/mm3) for her thrombocytopenia. Despite the administration of Frozen Plasma supplement, PT, PTT and Fibrinogen was detected as 18, 42.8 and 117 mg/dl, respectively and 1.2 mg of Novoseven was administered to the patient once preoperatively and twice postoperatively at a two-hour interval due to her history of postoperative hemorrhage. Upon the preoperative detection of PT, PTT, Fibrinogen as 12.1, 43.1 and 145 mg/dl and KZ and PZ as 6 and 5 minutes respectively, the patient was operated. No new postoperative hemorrhages or other complications were observed. The diagnosis of Gaucher disease was made at the bone marrow examination and the relevant treatment was planned. Conclusion: rFVIIa can be safely used in high-risk patients with a history of recurrent hemorrhage, for whom no improvement can be achieved in the hemostasis tests.
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Kabir, Iqbal Murshed, Ahmid Minhas Shumon, Kazi Atikuzzaman, Yeahyea Zaman, and Atiqur Rahman. "Simultaneous involvement of lungs, larynx and middle ear by tuberculosis -a rare case." Journal of Dhaka National Medical College & Hospital 17, no. 1 (October 16, 2012): 53–55. http://dx.doi.org/10.3329/jdnmch.v17i1.12195.
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Simultaneous involvement of lungs, larynx and middle ear by tuberculosis is very rare. We present a rare case of simultaneous involvement of larynx and ear in a patient with pulmonary tuberculosis. A 17 years old male presented with fever and cough for 8 months, bilateral deafness for 5 months and hoarseness of voice for 3 months. The patient gave history of anorexia and progressive weight loss and history of close contact with tuberculosis patient. There were coarse crepitations on auscultation of both lungs. Indirect laryngoscopy revealed diffuse nodular swelling as well as thickening of the vocal cords. Examination of both ears revealed pale-yellow granulation tissue. ESR was 94 mm in 1st hour and chest radiograph showed diffuse patchy opacities extending over both lung fields. The results of two sputum examinations showed numerous acid-fast bacilli Histopathologic examination of punch biopsy from right and left ear lesions and biopsy tissue from laryngeal lesion taken by endoscopic instrument revealed granulomatous inflammation histologically consistent with tuberculosis.The patient responded well and promptly to the antituberculous therapy. The aim of this article is to create an awareness of Ear Nose Throat tuberculosis and to consider tuberculosis in the differential diagnosis of ear and laryngeal diseases and to emphasize the need for prompt recognition and treatment. DOI: http://dx.doi.org/10.3329/jdnmch.v17i1.12195 J. Dhaka National Med. Coll. Hos. 2011; 17 (01): 53-55
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Kawano, Tatsuya, Naoki Shinojima, Satoko Hanatani, Eiichi Araki, Yoshiki Mikami, and Akitake Mukasa. "Atypical pituitary abscess lacking rim enhancement and diffusion restriction with an unusual organism, Moraxella catarrhalis: A case report and review of the literature." Surgical Neurology International 12 (December 20, 2021): 617. http://dx.doi.org/10.25259/sni_835_2021.
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Background: Pituitary abscess (PA) can be fatal if diagnosed late. Rim enhancement is a typical radiological finding of PA on postgadolinium T1-weighted magnetic resonance imaging (MRI). Diffusion-weighted imaging is helpful in distinguishing PA from other sellar cystic lesions. Herein, we report the first atypical case of PA showing neither rim enhancement nor diffusion restriction with an unusual organism, Moraxella catarrhalis. Case Description: A 77-year-old woman presented with headache, polyuria, polydipsia, and fatigue for a month before presenting to a local hospital. MRI showed pituitary enlargement with contrast enhancement. She had neither fever nor visual deficits and was followed up with hormonal replacement. Six months later, she complained of visual impairment, and MRI showed further pituitary enlargement with a thickened stalk compressing the optic chiasma. Neither rim enhancement nor diffusion restriction was observed. Endoscopic endonasal transsphenoidal surgery was performed based on the radiological diagnosis of lymphocytic hypophysitis or pituitary tumors. A thick, creamy yellow pus was drained from the sellar lesion. Intraoperative rapid histopathological findings revealed polymorphonuclear leukocytes infiltrating the pituitary gland. PA was diagnosed, and irrigation and open drainage of the abscess was performed. Bacterial culture of the pus detected M. catarrhalis by mass spectrometer, confirming the diagnosis. She underwent appropriate antibiotic administration, and her visual deficits improved. Conclusion: We report the first atypical case of PA showing neither rim enhancement nor diffusion restriction with M. catarrhalis. Even if preoperative findings are not suggestive of PA, it should be considered as a differential diagnosis. Intraoperative rapid histopathological findings are useful for accurately diagnosing PA and initiating appropriate surgical treatment.
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Iwen, Peter C., Lynne Sigler, Stefano Tarantolo, Deanna A. Sutton, Michael G. Rinaldi, Rudy P. Lackner, Dora I. McCarthy, and Steven H. Hinrichs. "Pulmonary Infection Caused by Gymnascella hyalinospora in a Patient with Acute Myelogenous Leukemia." Journal of Clinical Microbiology 38, no. 1 (January 2000): 375–81. http://dx.doi.org/10.1128/jcm.38.1.375-381.2000.
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ABSTRACT We report the first case of invasive pulmonary infection caused by the thermotolerant ascomycetous fungus Gymnascella hyalinospora in a 43-year-old female from the rural midwestern United States. The patient was diagnosed with acute myelogenous leukemia and treated with induction chemotherapy. She was discharged in stable condition with an absolute neutrophil count of 100 cells per μl. Four days after discharge, she presented to the Cancer Clinic with fever and pancytopenia. A solitary pulmonary nodule was found in the right middle lobe which was resected by video-assisted thoracoscopy (VATHS). Histopathological examination revealed septate branching hyphae, suggesting a diagnosis of invasive aspergillosis; however, occasional yeast-like cells were also present. The culture grew a mold that appeared dull white with a slight brownish tint that failed to sporulate on standard media. The mold was found to be positive by the AccuProbe Blastomyces dermatitidis Culture ID Test (Gen-Probe Inc., San Diego, Calif.), but this result appeared to be incompatible with the morphology of the structures in tissue. The patient was removed from consideration for stem cell transplant and was treated for 6 weeks with amphotericin B (AmB), followed by itraconazole (Itr). A VATHS with biopsy performed 6 months later showed no evidence of mold infection. In vitro, the isolate appeared to be susceptible to AmB and resistant to fluconazole and 5-fluorocytosine. Results for Itr could not be obtained for the case isolate due to its failure to grow in polyethylene glycol used to solubilize the drug; however, MICs for a second isolate appeared to be elevated. The case isolate was subsequently identified as G. hyalinospora based on its formation of oblate, smooth-walled ascospores within yellow or yellow-green tufts of aerial hyphae on sporulation media. Repeat testing with the Blastomyces probe demonstrated false-positive results with the case isolate and a reference isolate of G. hyalinospora . This case demonstrates that both histopathologic and cultural features should be considered for the proper interpretation of this molecular test and extends the list of fungi recognized as a cause of human mycosis in immunocompromised patients.
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Ding, Qiang, Jenna M. Gaska, Florian Douam, Lei Wei, David Kim, Metodi Balev, Brigitte Heller, and Alexander Ploss. "Species-specific disruption of STING-dependent antiviral cellular defenses by the Zika virus NS2B3 protease." Proceedings of the National Academy of Sciences 115, no. 27 (June 18, 2018): E6310—E6318. http://dx.doi.org/10.1073/pnas.1803406115.
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The limited host tropism of numerous viruses causing disease in humans remains incompletely understood. One example is Zika virus (ZIKV), an RNA virus that has reemerged in recent years. Here, we demonstrate that ZIKV efficiently infects fibroblasts from humans, great apes, New and Old World monkeys, but not rodents. ZIKV infection in human—but not murine—cells impairs responses to agonists of the cGMP-AMP synthase/stimulator of IFN genes (cGAS/STING) signaling pathway, suggesting that viral mechanisms to evade antiviral defenses are less effective in rodent cells. Indeed, human, but not mouse, STING is subject to cleavage by proteases encoded by ZIKV, dengue virus, West Nile virus, and Japanese encephalitis virus, but not that of yellow fever virus. The protease cleavage site, located between positions 78/79 of human STING, is only partially conserved in nonhuman primates and rodents, rendering these orthologs resistant to degradation. Genetic disruption of STING increases the susceptibility of mouse—but not human—cells to ZIKV. Accordingly, expression of only mouse, not human, STING in murine STING knockout cells rescues the ZIKV suppression phenotype. STING-deficient mice, however, did not exhibit increased susceptibility, suggesting that other redundant antiviral pathways control ZIKV infection in vivo. Collectively, our data demonstrate that numerous RNA viruses evade cGAS/STING-dependent signaling and affirm the importance of this pathway in shaping the host range of ZIKV. Furthermore, our results explain—at least in part—the decreased permissivity of rodent cells to ZIKV, which could aid in the development of mice model with inheritable susceptibility to ZIKV and other flaviviruses.
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Demina, Anna Vladimirovna, Julius J. Lutwama, Tomer Hertz, and Leslie Lobel. "Assessing the serological antibody repertoire to Flaviviruses in the endemic population of the Zika forest in Uganda." Journal of Immunology 198, no. 1_Supplement (May 1, 2017): 122.12. http://dx.doi.org/10.4049/jimmunol.198.supp.122.12.
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Abstract While the Zika virus has been suspected to cause complications in newborns of women infected during pregnancy, it has circulated in Africa for more --than half a century without any reported cases of microcephaly in children. To assess the prevalence of Zika infections in the Zika forest region we collected human sera samples from 81 people (17–56 years old), who live in Zika forest region, Entebbe, Uganda in 2016, and included both individuals hospitalized with acute febrile illness, as well as health individuals. Elisa assays were used to profile the IgM, IgG serological repertoire to Zika, Dengue 1-4 (DENV1-4) and Yellow Fever (YFV) viruses. We found that 17 individuals (21%) were positive for Zika, 7 of which were hospitalized with acute infection. The hospitalized patients had overall higher antibody titers to Zika. There also were serologically positive samples for: DENV1 n=11 (13.5%); DENV2 n=9 (11%), DENV3 n=4 (5%); DENV 4 n=4 (5%). 11 subjects (13.5%) were positive for YFV. Overall, 49% of the subjects had antibodies to at least one of these Flaviviruses, and 17% had antibodies to two or more Flaviviruses. While serological responses cannot accurately diagnose the specific Flavirvirus infections in these individuals due to significant cross reactivity within this viruses our data suggests that Flavivirus infections are very common in the Zika forest region. While a recent study reported that previous dengue infections may cause antibody dependant enhancement upon subsequent Zika infection, our data suggests that the Zika forest region in which many different Flaviviruses have been circulating for over 50 years may an important region to study such effects in the human population.
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Miller, Mark A. "Pondering Parotid Masses." Canadian Journal of Infectious Diseases 12, no. 2 (2001): 107. http://dx.doi.org/10.1155/2001/162071.
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A49-year-old, human immunodeficiency virus (HIV)- infected, Haitian-born woman presented with a left facial mass that she had noticed for the previous eight weeks. She was known to have been HIV-seropositive for the previous 11 years and had been on multiple antiretroviral therapies. Her past medical history was also significant for hypertension, disseminated varicella zoster virus and recurrent oral and buttock Herpes simplex episodes. She was taking the following medications at the time of her presentation with the facial mass: stavudine, lamivudine, didanosine, nelfinavir mesylate, famciclovir, hydrochlorothiazide and cotrimoxazole. She had no complaints of fever, chills, sweats, weight loss or anorexia. She denied any pain, redness or warmth at the site of the facial swelling. Her most recent CD4 lymphocyte count was 336 cells/µL, with an HIV viral load of log102.6 copies/mL. Physical examination revealed a 4 cm fluid-filled mass in the left parotid gland. There was no detectable induration, redness, warmth or tenderness, and no associated adenopathy. The rest of the examination was unremarkable. An aspirate of the mass was performed under sterile conditions and yielded 30 mL of turbid, yellow liquid. A Gram stain revealed no neutrophils, scant mononuclear cells and no visible organisms. An acid-fast stain was negative as well. Routine, mycobacterial and fungal cultures showed no growth. Cytological analysis showed scant reactive lymphocytes and no malignant cells. The patient was not given therapy and was observed for another two months. The fluid reaccumulated in the left parotid gland, and the patient?s only complaint concerned the unsightly appearance of the mass. The lesion was again aspirated for 30 mL of fluid and this time, the fluid had a turbid, brown appearance. All laboratory results were identical to the results from the first aspirate. What is your diagnosis, and how would you treat this patient?
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Lichtenberger, Paola, Mike Ricciardi, Dalhila Solorzano, Patricia Raccamarich, Ana R. Leda, Mark Sharkey, David Walkins, et al. "2802. Occupational Exposure to the Ugandan Strain of Zika Virus in a Laboratory Worker in the United States: Clinical Presentation, Viral Persistence, and Antibody Response." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S991—S992. http://dx.doi.org/10.1093/ofid/ofz360.2479.
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Abstract Background A laboratory worker suffered an accidental needle stick resulting in infection with the Ugandan strain (MR766) of Zika virus (ZIKV), a strain that has rarely been studied in humans. We report the clinical presentation and outcomes, molecular and serological diagnostic results, and immunological response. A 34-year-old Brazilian-born female laboratory researcher, presented with malaise, skin rash, myalgia and joint pain 10 days after an accidental needle stick while inoculating a mouse with ZIKV-MR766. On physical examination she had bilateral maculopapular rash on the cheeks, and tender effusions at the metacarpal and proximal interphalangeal joints and ankles. Symptoms and signs resolved within 3 weeks. ZIKV infection was confirmed by Nucleic Acid Amplification Test (Lab Corp®) in urine. Serological testing using the ZIKV IgM ELISA test from Lab Corp®, and a confirmatory plaque reduction neutralization test (PRNT) in accordance with the Centers for Disease Control and Prevention (CDC), results were negative. Methods Whole blood, plasma, urine, saliva, and a vaginal swab were collected from day (D) 14 post exposure (PE) to D104 PE. A novel, antibody competition-based ZIKV diagnostic test (highly specific for ZIKV antibodies) was performed in serum, and detection of ZIKV-MR766 genomic RNA was performed in all body fluids longitudinally. Results Antibody response revealed broad IgM response to both ZIKV-Paraiba (strain from the 2015 outbreak) and ZIKV-MR766 during the acute phase of the infection, suggesting cross-reactivity. There was no cross-reactivity against dengue or yellow fever viruses. An IgG response was detected against both ZIKV strains and increased until D104 PE. ZIKV RNA was detected in whole blood, saliva, urine, and the vaginal swab at D14 PE. At D20 PE, virus was only detectable in whole blood at a value of less than 37 copies per mL. At D23 PE, there was no detectable virus. (figure). Conclusion This case highlights the potential for ZIKV occupational exposure. Findings may be useful for the development of diagnostic tests against ZIKV as we were able to accurately determine time of exposure, presence of virus in body fluids, development of symptoms, and antibody responses after a well-documented infection. Disclosures All authors: No reported disclosures.
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Rahman, Shah Md Mahfuzar, Shah Monir Hossain, and Mahmood Uz Jahan. "Dengue prevention and control: Bangladesh context." Bangladesh Medical Research Council Bulletin 45, no. 2 (August 7, 2019): 66–67. http://dx.doi.org/10.3329/bmrcb.v45i2.42533.
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Dengue is the most common mosquito-borne, viral disease in the world. Dengue virus is a single stranded positive polarity RNA virus, belongs to the family Flaviviridae. It is transmitted through the bite of an infected female mosquito of Aedes species - mainly the species Aedes aegypti and, to a lesser extent, Aedes albopictus. This mosquito also transmits Chikungunya, Zika and Yellow fever viruses.1-4
There are 4 distinct, but closely related, serotypes of the virus (DEN-1, DEN-2, DEN-3 and DEN-4). Recovery from infection by one serotype provides heterotypic or cross-immunity to the other serotypes. This is only partial and temporary, lasts only a few months, but homotype immunity is lifelong. For this reason, a person can be infected with a dengue virus as many as four times in his or her lifetime. Subsequent infections (secondary infection) by other serotypes increase the risk of developing severe dengue.1-5 The fifth variant DENV-5 has been isolated in October 2013. DENV-5 has been detected during screening of viral samples taken from a 37 year old farmer admitted in a hospital in Sarawak state of Malaysia in the year 2007.6
The first record of a case of probable dengue fever reported in a Chinese medical encyclopedia from the Jin Dynasty (265–420AD).The first recognized dengue epidemics occurred almost simultaneously in Asia, Africa, and North America in the 1780s, shortly after the identification and naming of the disease in 1779. The first confirmed case report dates from 1789 and is by Benjamin Rush, who coined the term "breakbone fever" because of the symptoms of myalgia and arthralgia.7 Haemorrhagic dengue was first recognised in the 1950s during dengue epidemics in the Philippines and Thailand. 8
The incidence of dengue has grown dramatically around the world in recent decades. A vast majority of the cases are asymptomatic and hence the actual numbers of dengue cases are underreported and many cases are misclassified. Dengue is common in more than 100 countries around the globe, with its endemicity in Asia, the Pacific, Africa and the Latin American countries. Forty percent of the world’s population, about 3 billion people live in the areas with a risk of dengue. Annually, some 400 million people get infected with dengue, with an occurrence of 100 million clinically apparent infections, and 22,000 die from severe dengue across the globe. The increasing incidence, severity and frequency of dengue epidemics are linked to trends in human ecology, demography and globalisation, and may have been influenced by climate change. 8,9
In Bangladesh, dengue occurred sporadically since 1964.10 Literature shows, the first documented case of dengue like fever occurred in 1964, popularly known as "Dacca fever" which later on serologically proved as dengue fever.11
Bangladesh has been experiencing episodes of dengue fever in every year since 2000. All four serotypes have been detected, with DENV-3 predominance until 2002.12,13
After that, no DENV-3 or DENV-4 was reported from Bangladesh. During 2013-2016, DEN2 was predominant followed by DEN-1 in circulation. Institute of Epidemiology, Disease Control & Research (IEDCR) predicted that as the serotypes DENV-3 and DENV-4 are in circulation in the neighbouring countries, they may create epidemics of secondary dengue in the near future in Bangladesh.14 In 2017, reemergence of DENV-3 was identified; subsequently there was a sharp rise in dengue cases from the beginning of the monsoon season in 2018.15
In 2000, dengue attacked 5,551 individuals and the number of deaths was 93. Since 2003, the death rate has declined gradually, with zero fatalities in subsequent couple of years, but a devastating turn with 10,148 cases and 26 deaths in 2018. In 2019, during January to July, number total cases were 18,484, with 57 deaths.16
Directorate General of Health Services conducts periodical (Pre-monsoon, Monsoon and Post- monsoon) Aedes survey to estimate the vector density of the mosquito. The monsoon survey (18-27 July 2019) of 100 sites of 98 wards in Dhaka city both North and South revealed that the number of adult aedes mosquito was increased by 13.52 folds, in compare to the pre-monsoon (3-12 March 2019) survey.17
The aedes larvae were also increased by 12.5 folds in this period. Breteau Index (BI) was considered in the study. Report shows that the BI was more than 20 in 57% and 64% of total wards in Dhaka North and Dhaka South respectively. Furthermore, in terms of House Index (HI) or percentage of houses infested, 75% and 83% of total wards in North and South city respectively having HI more than 5.17 Furthermore, recent studies show that mosquitoes have grown resistant, and how certain insecticides are completely ineffective against them.18
Considering the situation, the Ministry of Health and Family Welfare, has taken commendable steps including training on case management for nurses and doctors across the country, review of the national guidelines on case management, expansion of dengue services along with increasing bed capacities in hospitals, strengthened mass awareness with special attention to the school children and the community people, ensuring availability of dengue diagnostic kits, diagnostic services at free of cost in public health facilities and fixed and reduced rate in private sectors, strengthening collaboration with city corporations, municipalities and other agencies both in public and private sectors and development partners.
Prevention and control of dengue in Bangladesh, is not a sole responsibility for any single ministry and or its agencies. It needs effective and timely coordination, collaboration and partnership, among all the concerned ministries and their agencies, led by the Ministry of Health and Family Welfare. Furthermore, strengthening of the existing efforts including capacity building and resource mobilisation, and integrated surveillance, sustainable vector control, optimum and active community participation, and adequate monitoring and periodic evaluation throughout the year across the country, considering it an endemic disease, are strongly recommended.
Bangladesh Med Res Counc Bull 2019; 45: 66-68
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Olinda, Roberio Gomes, Joseney Maia Lima, Ricardo Barbosa De Lucena, André Menezes Do Vale, Jael Soares Batista, Claudio Severo lombardo De Barros, Franklin Riet Correa, and Antônio Flávio Medeiros Dantas. "Acute Aflatoxicosis in Swines in Northeastern Brazil." Acta Scientiae Veterinariae 44, no. 1 (January 16, 2016): 6. http://dx.doi.org/10.22456/1679-9216.84459.
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Background: Aflatoxins are hepatotoxic mycotoxins derived from the secondary metabolism of toxigenic fungi belonging to the genus Aspergillus, especially A. flavus and A. parasiticus. Aflatoxin B1 is the most important metabolite, because of its deleterious effect mainly to the liver, especially for its carcinogenic, mutagenic and haemorrhagic properties, and usually is detected in higher concentrations in contaminated substrates. This paper reports the epidemiological, clinical, pathological and toxicological aspects of an outbreak of acute aflatoxicosis in pigs raised in Northeastern Brazil.Case: The cases occurred in a complete cycle farm, in the city of Mossoró, Rio Grande do Norte, Northeastern Brazil, in pigs ingesting low quality (moldy) corn being produced and processed on the farm. Sixty (73.1%) out of 82 two to five-months old pigs were clinicaly affected and 54 (65.8%) died. All animals showed fever, weight loss, tachycardia, tachypnea, lethargy, muscle tremors, muscle weakness and diarrhea. The clinical course ranged from five to 48 hours. Adult pigs were not affected. At necropsies, generalized jaundice, ascites, hydropericardium, petechial hemorrhages in the mesentery, subcutaneous edema and mesocolon were observed. The liver was yellow-orange with reddish diffuse multifocal areas, enlarged and extremely friable. Histologically there was swelling of hepatocytes with severe diffuse hepatocellular fatty degeneration, centrilobular hepatocellular necrosis, proliferation of bile ducts and cholestasis. High concentrations of aflatoxin B1 were determined in the corn (3400 μg/kg) and ration (1460 μg/kg).Discussion: The diagnosis of aflatoxicosis was based on epidemiological investigation associated with clinical and pathological findings and confirmed by high levels of aflatoxin B1 found in samples of corn and feed. Of the numerous types of aflatoxin reported, the most common is the B1, which is typically produced by Aspergillus fungi. In intensive pig farms, management conditions increase the chances of occurrence of intoxications caused by the poor quality of the grain (especially maize) by the poor quality of the grain (especially maize) used in the diet formulation. In the present report the corn was severely degraded and kept in physical conditions that favor the proliferation of aflatoxins. In addition, young animals, which are more suseptible, were the only ones affected with 73% morbidity and 65.8% mortality. In cases of spontaneous aflatoxicosis morbidity in pigs can vary from 10 to 100% and mortality is high when the diet has a high concentration of aflatoxins as observed in this outbreak (3400 and 1460 μg/kg of B1 in corn and food, respectively) . Increases in sérum ALT levels indicate hyperacute, acute or chronic active hepatocellular damage; a toxic hepatitis in this case. Furthermore, the increased serum AST suggest the existence of extensive and progressive hepatocellular damage, because this enzyme is synthesized mitochondrial level. Legislation in Brazil, determines that the maximum tolerated aflatoxin concentrations are 50 parts per million (ppm) or 50 μg/kg in food included in the diet formulation for animal consumption and 20 ppb in corn grain for human consumption. Differential diagnosis of aflatoxicosis include leptospirosis and intoxication by Crotalaria retusa or other pyrrolizidine alkaloids-containing plants.Keywords: aflatoxicosis, mycotoxins, toxic hepatitis, swine.
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Bhattacharyya, Kumkum. "WHY MUCORMYCOSIS(BLACK FUNGUS) CAN NOT BE DECLARED AS EPIDEMIC IN INDIA." International Journal of Advanced Research 9, no. 5 (May 31, 2021): 860–63. http://dx.doi.org/10.21474/ijar01/12914.
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While the whole world is under attack of a second wave and of a more severe potent mutant form of SARS CoV-2 virus causing SEVERE COVID 19 PNEUMONIA pandemic ,a new disease is on the verge of getting declared as an epidemic named MUCORMYCOSIS OR BLACK FUNGUS (in common term). MUCORMYCOSIS is an umbrella term used for an opportunistic infection caused by several fungi belong to GLOMEROMYCOTAFAMILY(mucor, zygomucor,lichtheimia,syncephalastrumetc) these saprophytic fungi can be found in soil,food damped walled in the environment which were actually considered as an non pathogenic organism to human. In current days it has become an emerging disease in the world especially in india. Now the COVID ASSOCIATED MUCORMYCOSIS has raised a severe threat and fear in india during these second wave of CORONAVIRUS INFECTION.Due to irrational use of the drug PREDNISOLON OR DEXAMETHSONE(which basically belong to steroid group of drugs) for the management of COVID 19 AQUIRED PNEUMONIAMOR,ESPECIALLY FOR THOSE WHO ARE ON HIGH O2 REQUIREMENT has raise 2 issuesone is improper glycemic control,second is severe immunosupressant stage HERE IS A CASE REPORT THAT CAN PROVE THAT CASES OF MUCORMYCOSIS WERE INEVIDENTLY PRESENT IN INDIA EVEN BEFORE THIS PANDEMIC STARTED. A 40 years old male,a cotton mill worker ,was admitted in the emergency observation ward OF IPGME&R AND SSKM HOSPITAL,KOLKATA AROUND THE MONTH OF OCTOBER IN 2018 with random blood glucose level(RBS) 702 gm/dl along with a history of necrotic oral ulcer over the hard pallete extending posteriorly along with left sided nasal blockage with complaint of difficulty to eat and swallow both liquid and solid and rhinolalia since 45 days. There was no history of fever,cough,haemoptysis,no history of trauma to the affected site or tuberculosis. At this point with a high RBS and elevated urea creatinin level patient was diagnosed to be in diabetic ketoacidosis and he was managed with iv. Insuline and hence forth his blood glucose level was kept under control with insulin therapy. While taking the history it came into our notice that the patient is a known case of type 2 diabetes mellitus and CKD-STAGE V due to IgA Nephropathy for which he was receiving Prednisolon which he suddenly discontinued 15 days before admission and he also underwent haemodialysis twice. On local examination he had a necrotic ulcer over the hard palate and necrotic debris in the nasal cavity(as evident in the nasal endoscopy).CT —nose+PNS showed left sided maxi antrum opacity suggestive of pansinusitis . All broad spectrum antibiotics along with iv voriconazol was started as the patient was immune compromised. After 2 days of his admission though his diabetes was under control patient suddenly showed orbital involvement and visual impairement on the left eye.A repeat CT showed progression of the sinusoidal opacity toward the retro orbital space and a bulky oedematous left inferior rectus due to inflammation and then he was refered to microbiology department with a suspection of mucormicosis?.scrapping material was collected from the oral ulceration site and KOH mount was done ? broad aseptate hyphae with acute angle branching? Suggestive of mucormicosis and culture was done in SDA and SDCA media. Culture growth revealed abundant, erected mycelium(around 0.5cm tall) .the surface colour of the colony was at first white to yellow,after a few days the centre tured black?.Lactophenol cotton blue(LPCB) stain from the growth showed wide ribbon like aseptate hyphae with sporangiophores terminated in swollen vesicles with radial merosporangiae with spores A confirmed diagnosis of Rhino orbital zygomycosis due to Syncephalastrum racemosum was made. The patient was put on intensive short acting insulin to achieve optimum glycemic control.As there was high risk of vascular invasion of mucormicosis(which is the most common mode of pathogenecity of these group of fungi) leading to sudden stroke following ischemia a surgical debridement was done and infected tissue was removed. He was put on intravenous liposomal Amphotricine B 300mg daily OD and later shifted to take voriconazole 200 BD.the patient got discharged in favourable condition. Now literature shows Fluconazole, voriconazole, and itraconazole do not have reliable activity against mucormycosis.DRUGS OF CHOICE should be Liposomal amphotericin, Amphotericin B lipid complex, Posaconazole, Echinocandins, Deferasirox. In recent senario during the pandemic many COVID 19 positive patients are getting advices from tele medicine or vedio consultation or many patients are self medicating themseleves learning from various social media in india.Now the taking drugs like prednisolon with out proper monitoring and sudden discontinuation the drug once the patient is feeling better is giving rise to stage of absolute lack of circulating neutrophils causing either pulmonary ,or rhinocerebral or rhino orbital mucormycosis in those patients even after recovering from COVID 19 INFECTION.The HRCT CHEST of those patients with pulmonary mucormycosis is very difficult to differentiate from the ground glass opacity formed in the lungs caused by COVID 19 PNEUMONIA So unsupervised intake of steroids or prolonged use of steroids along with improper use of antifungals are causing the rise of the this opportunistic infection in india which is increasing rate of fatality.
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Silva, Natalia Ingrid Oliveira, Lívia Sacchetto, Izabela Maurício de Rezende, Giliane de Souza Trindade, Angelle Desiree LaBeaud, Benoit de Thoisy, and Betânia Paiva Drumond. "Recent sylvatic yellow fever virus transmission in Brazil: the news from an old disease." Virology Journal 17, no. 1 (January 23, 2020). http://dx.doi.org/10.1186/s12985-019-1277-7.
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Gaythorpe, Katy AM, Kaja Abbas, John Huber, Andromachi Karachaliou, Niket Thakkar, Kim Woodruff, Xiang Li, et al. "Impact of COVID-19-related disruptions to measles, meningococcal A, and yellow fever vaccination in 10 countries." eLife 10 (June 24, 2021). http://dx.doi.org/10.7554/elife.67023.
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Background:Childhood immunisation services have been disrupted by the COVID-19 pandemic. WHO recommends considering outbreak risk using epidemiological criteria when deciding whether to conduct preventive vaccination campaigns during the pandemic.Methods:We used two to three models per infection to estimate the health impact of 50% reduced routine vaccination coverage in 2020 and delay of campaign vaccination from 2020 to 2021 for measles vaccination in Bangladesh, Chad, Ethiopia, Kenya, Nigeria, and South Sudan, for meningococcal A vaccination in Burkina Faso, Chad, Niger, and Nigeria, and for yellow fever vaccination in the Democratic Republic of Congo, Ghana, and Nigeria. Our counterfactual comparative scenario was sustaining immunisation services at coverage projections made prior to COVID-19 (i.e. without any disruption).Results:Reduced routine vaccination coverage in 2020 without catch-up vaccination may lead to an increase in measles and yellow fever disease burden in the modelled countries. Delaying planned campaigns in Ethiopia and Nigeria by a year may significantly increase the risk of measles outbreaks (both countries did complete their supplementary immunisation activities (SIAs) planned for 2020). For yellow fever vaccination, delay in campaigns leads to a potential disease burden rise of >1 death per 100,000 people per year until the campaigns are implemented. For meningococcal A vaccination, short-term disruptions in 2020 are unlikely to have a significant impact due to the persistence of direct and indirect benefits from past introductory campaigns of the 1- to 29-year-old population, bolstered by inclusion of the vaccine into the routine immunisation schedule accompanied by further catch-up campaigns.Conclusions:The impact of COVID-19-related disruption to vaccination programs varies between infections and countries. Planning and implementation of campaigns should consider country and infection-specific epidemiological factors and local immunity gaps worsened by the COVID-19 pandemic when prioritising vaccines and strategies for catch-up vaccination.Funding:Bill and Melinda Gates Foundation and Gavi, the Vaccine Alliance.
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Fagbohun, Ifeoluwa Kayode, Emmanuel Taiwo Idowu, Abiodun Kanmi Olakiigbe, Amos Tolulope Oyeniyi, Olubunmi Adetoro Otubanjo, and Taiwo Samson Awolola. "Metabolic resistance mechanism in Aedes aegypti from Lagos State, Nigeria." Journal of Basic and Applied Zoology 81, no. 1 (September 29, 2020). http://dx.doi.org/10.1186/s41936-020-00194-8.
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Abstract Background Aedes aegypti transmits several arboviral diseases of global public health threat such as dengue, zika, and yellow fever. Recently, a series of yellow fever outbreaks have been reported in different parts of the country. Globally, the control of mosquito-borne diseases has relied heavily on insecticides based vector control efforts. Therefore, we assessed the susceptibility status to three different classes of WHO approved insecticides and evaluated the importance of detoxifying enzymes on insecticides resistance in Aedes aegypti collected from Lagos State, Nigeria. Aedes aegypti immature stages were collected from suitable habitats in peri-domestic areas of Alimosho, Kosofe, Badagry, and Ibeju-Lekki Local Government Areas (LGAs) of Lagos State, 2–5 days old glucose-fed adult female mosquitoes were exposed to discriminating doses of DDT, permethrin, bendiocarb, and PBO synergist using WHO standard procedure and kits. Identification was through morphological means only. Results Resistance to DDT and permethrin was recorded in all the LGAs, suspected resistance to bendiocarb was recorded in Aedes aegypti from Alimosho while full susceptibility was recorded in other LGAs. PBO synergist significantly increases the 24 h mortality of DDT and permethrin-resistant Aedes aegypti in all the LGAs. The activities of both GSTs and cytochrome P450s increase with decreasing mortality for Aedes aegypti, regression value (R2) ranges from 0.8889 to 0.6224 for GSTs and 0.4379 to 0.616 for cytochrome P450s. Conclusions Aedes aegypti population from Lagos State, Nigeria, have developed resistance to DDT and permethrin, the activities of P450s and GST were implicated in DDT and permethrin resistance in this study. Therefore, a need for regular insecticides monitoring and PBO should be incorporated into Aedes aegypti insecticides control strategies to forestall development of resistance to DDT and pyrethriods.
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"The Analysis of Yellow Fever Virus Antigen in Human Serum from Epidemic Areas of Tianjin Port, China, 2013." Archives of Infectious Diseases & Therapy 2, no. 1 (May 10, 2018). http://dx.doi.org/10.33140/aidt.02.01.11.
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Objective: To investigate the prevalence and distribution characteristics ofyellow fever virus(YFV) antigen in human serum from epidemic areas in 2013. Methods: The people from the yellow fever epidemic areas of Tianjin port were selected as study object.260 samples were collected together with detailed personal information. And each sample contained 5ml venous blood. Indirect ELISA was used to detect YFV antigen. The dengue virus antigen and west nile virus antigen were also detected in positive samples to reduced cross reactivity. Positive rate was calculated. Statistical methods were used to compare the differences of the positive rates between different countries, genders, ages, occupations and entry time. Results: All respondents came from Africa and South America. The total positive rate of serum antigenofYFV was 11.54%(30/260). Of which, the positive rates of African and South American people were 12% and 10.91%, respectively. The positive rates of male and female were 11.88% and 10.34%, respectively. The positive rate of >40 year old age group was the highest, up to 14%. In the time distribution, the positive rate of fourth-quarter entry personnel was up to 15.91%. There was no significant difference in positive rate between different countries, genders, ages, and entry time, except occupations. Workers engaged in labor service positive rate was 35.71%. Conclusion: TheYFVantigen positive rate of people from epidemic areas in 2013 was high. These people carrying pathogens pose a threat to public health security of China as a potential source of infection. There was a significant difference in the detection rate of YFV antigen among people with different occupations.
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Eromosele, Oseiwe, Ademola Ajibade, Divine Dele, Adedayo Adeboye, Abdul Lukan, and Habeeb Sanni. "Miliary Tuberculosis Following an Appendectomy, a Case Report." International Journal of Medical Reviews and Case Reports, 2022, 1. http://dx.doi.org/10.5455/ijmrcr.172-1621701325.
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Background Miliary tuberculosis (MTB) is a type of disseminated and active tuberculosis that presents with radiopathologic signs of tuberculous micronodules, as well as microbiologic evidence from detection of Mycobacterium tuberculosis or other Mycobacterium strains in PCR or culture [1]. Case Presentation A 21 year-old student presented with weight loss, fever, cough productive of yellow sputum without hemoptysis, and anorexia of 5 weeks duration. 7 weeks prior to presentation, she had an appendectomy on account of acute appendicitis. Following surgery, there was resolution of symptoms of acute appendicitis. Histopathologic report of the resected appendix showed foci of caseating granulomas. She was immediately commenced on a fixed drug combination of rifampicin, isoniazid, pyrazinamide, and ethambutol for treatment of military tuberculosis and showed clinical and radiologic improvement. Conclusion Miliary tuberculosis following an appendectomy can be due to dissemination of tuberculous foci from the appendix during surgery and surgical stress.
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W, Lijie, Feng J, Qian Z, Hui J, Jie B, Yang L, Kaiping B, et al. "Primary Cutaneous Extranodal NK/T Cell Lymphoma (Nasal Type): A Case Report and Review of Literatures." Journal of Clinical Case Studies 6, no. 6 (2021). http://dx.doi.org/10.16966/2471-4925.240.
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A case of extranodal NK/T cell lymphoma (nasal type) with skin lesion as the first manifestation is reported. A 82 year old female presented with fever for 10 days, and mass with ulceration on right shoulder for 4 days. Clinically, a walnut-sized red mass with local ulceration and scab can be seen on the right shoulder. Part of the lesion had rupture scab. A circular-like infiltrated dark red plaque with a diameter of about 4cm can be seen on the right chest, with yellow and white dry secretion in the center. Multiple patches of dark red spots from coins to walnuts can be seen on the trunk and limbs. Based on skin lesions, histological, immunohistochemical staining and EBER in situ hybridization, a diagnose of primary cutaneous extranodal NK/T cell lymphoma, nasal type was made.
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Okonofua, Friday. "Effects of New Biological Threats on Health Security and Safety in Nigeria: Looking Back and Looking Forward." Proceedings of the Nigerian Academy of Science, October 30, 2021. http://dx.doi.org/10.57046/rqob1598.
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Over the past decades, several old and new infectious diseases have featured as major contributors to Nigeria’s health vulnerability, with evidence indicating that sufficient gains are yet to be made in tackling their dominance. Since the colonial and post-colonial periods, Nigeria has witnessed several episodes of serious biological threats from small pox, yellow fever, poliomyelitis, rabies, measles, plaque and several others – and it took years of sustained efforts to reduce their prevalence. Indeed, over the succeeding years, infectious diseases such as dengue fever, lymphatic filariasis, trachoma, leishmaniosis, buruli ulcer, leprosy, dracunculiasis (guinea worm) and Chagas disease became so dominant and sustained within the African region that for lack of a better definition, they have been collectively referred to as “neglected tropical diseases” (NTD) (WHO, 2010). NTD became a dominant lexicon for describing about 20 diseases that had been “neglected” within international programmatic focus and the fact that they affect the world’s largest communities and individuals. To date, the World Health Organization (WHO, 2021) estimates that NTDs affect about one billion persons worldwide, with the majority being residents in sub-Saharan African countries and other low-income countries around the world. Despite the continued expansion of the spheres of these infections, very limited progress has yet been made in restraining the health and social impact of the NTDs, especially in low and middle-income countries.
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Stewart, Alexander, Emma Sinclair, Joseph Chi-Fung Ng, Joselli Silva O’Hare, Audrey Page, Ilaria Serangeli, Christian Margreitter, et al. "Pandemic, Epidemic, Endemic: B Cell Repertoire Analysis Reveals Unique Anti-Viral Responses to SARS-CoV-2, Ebola and Respiratory Syncytial Virus." Frontiers in Immunology 13 (May 3, 2022). http://dx.doi.org/10.3389/fimmu.2022.807104.
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Immunoglobulin gene heterogeneity reflects the diversity and focus of the humoral immune response towards different infections, enabling inference of B cell development processes. Detailed compositional and lineage analysis of long read IGH repertoire sequencing, combining examples of pandemic, epidemic and endemic viral infections with control and vaccination samples, demonstrates general responses including increased use of IGHV4-39 in both Zaire Ebolavirus (EBOV) and COVID-19 patient cohorts. We also show unique characteristics absent in Respiratory Syncytial Virus or yellow fever vaccine samples: EBOV survivors show unprecedented high levels of class switching events while COVID-19 repertoires from acute disease appear underdeveloped. Despite the high levels of clonal expansion in COVID-19 IgG1 repertoires there is a striking lack of evidence of germinal centre mutation and selection. Given the differences in COVID-19 morbidity and mortality with age, it is also pertinent that we find significant differences in repertoire characteristics between young and old patients. Our data supports the hypothesis that a primary viral challenge can result in a strong but immature humoral response where failures in selection of the repertoire risk off-target effects.
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Narnaware, Shirish Dadarao, Basanti Jyotsana, Rakesh Ranjan, Ved Prakash, Shyam Sundar Choudhary, and Artabandhu Sahoo. "Case Report: Congenital tuberculosis in an aborted dromedary camel fetus." Frontiers in Veterinary Science 9 (July 28, 2022). http://dx.doi.org/10.3389/fvets.2022.956368.
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Tuberculosis (TB) is a serious public health problem worldwide, especially in tropical developing countries. Nevertheless, reports on congenital TB in humans and animals are extremely rare. In this study, abortion was reported in an 8-year-old she-camel at the 9th month of gestation. The she-camel appeared healthy in clinical examination, had a good body condition score, normal appetite, and had no signs of respiratory disease and fever. The expelled placenta was dark red-colored, thickened, and edematous with multifocal to coalescing ecchymotic hemorrhages on the allantoic surface. The striking finding was multiple, white-yellow, solid nodular lesions in the fetal lung, the pleura, and the liver. On histopathology, typical granulomatous lesions were detected in the lung and the liver characterized by caseous necrosis surrounded by lymphocyte and macrophage infiltration and concentric layers of fibrosis. The Ziehl-Neelsen staining detected scarce acid-fast bacilli in lung and liver tissues. The DNA extracted from tubercular lesions from the lung and liver showed amplification of the IS6110 region of the Mycobacterium tuberculosis complex by PCR. The sequencing and phylogenetic analysis revealed a close association of these sequences with Mycobacterium tuberculosis. The she-camel was detected positive for a single intradermal tuberculin test performed 24 h after abortion. This is the first report on congenital TB caused by M. tuberculosis in a dromedary camel fetus with a possible vertical transmission.
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Shin, Minna, Kiju Kim, Hyo-Ji Lee, Yu-Jin Jung, Jeongho Park, and Tae-Wook Hahn. "Vaccination with a Zika virus envelope domain III protein induces neutralizing antibodies and partial protection against Asian genotype in immunocompetent mice." Tropical Medicine and Health 50, no. 1 (December 5, 2022). http://dx.doi.org/10.1186/s41182-022-00485-6.
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Abstract Background Zika virus (ZIKV) is a mosquito-borne flavivirus classified in Flaviviridae family such as dengue (DENV), yellow fever, and West Nile virus. An outbreak of ZIKV infection can pose a major public health risk because the contagion is unpredictable and induces severe pathology such as Guillan-Barre syndrome and neonatal microcephaly. However, an authorized ZIKV vaccine is not yet available, while several vaccine candidates are under development. Methods In this study, we constructed a recombinant ZIKV vaccine (Z_EDIII) that includes ZIKV envelope protein domain III using E. coli expression system. Then both humoral and cellular immunity were examined in C57BL/6 (female, 8-weeks-old) mice via Indirect ELISA assay, PRNT, ELISpot and cytokine detection for IFN-γ, TNF-α, and IL-12. In addition, the cross protection against DENV was evaluated in pups from Z_EDIII vaccinated and infected dam. Results Mice immunized by Z_EDIII produced a significant amount of ZIKV EDIII-specific and neutralizing antibodies. Together with antibodies, effector cytokines, such as IFN-γ, TNF-α, and IL-12 were induced. Moreover, vaccinated females delivered the adaptive immunity to neonates who are protective against ZIKV and DENV challenge. Conclusions This study observed Z-EDIII-induced humoral and cellular immunity that protected hosts from both ZIKV and DENV challenges. The result suggests that our ZIKV EDIII recombinant vaccine has potential to provide a new preventive strategy against ZIKV infection.
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Dassi, Manisha, Anil JhaJhria, Neeru Aggarwal, and Lakshmikant Jha. "MO697TUBERCULOUS PERITONITIS WITH HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS IN A PATIENT ON CONTINUOUS AMBULATORY PERITONEAL DIALYSIS: A CASE REPORT." Nephrology Dialysis Transplantation 36, Supplement_1 (May 1, 2021). http://dx.doi.org/10.1093/ndt/gfab101.0019.
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Abstract Background and Aims Tuberculosis is a leading cause of morbidity and mortality worldwide. Tuberculous peritonitis in patients on Continuous Ambulatory Peritoneal Dialysis (CAPD), though uncommon, has been reported from different parts of the world. Hemophagocytic lymphohistiocytosis (HLH) is a rare systemic inflammatory disorder characterized by uncontrolled proliferation of lymphocytes & histiocytes and is reported to have high mortality. Secondary forms of HLH have been described for various diseases. Here, we report a case of HLH secondary to Tuberculous peritonitis in a patient of End Stage Renal Disease (ESRD) on CAPD. Method A 49 years old male ESRD patient, on CAPD presented with peritonitis and was initially managed with antibiotics. He required catheter explantation in view of refractory peritonitis and was switched to haemodialysis. The patient continued to have low grade fever, yellowish discharge from infra-umbilical CAPD catheter explantation surgical wound along with lower abdominal pain & tenderness. He was lost to follow up and presented again after 1 month with fever, weight loss, multiple cutaneous ecchymotic spots and copious amount of yellowish discharge from infra-umbilical surgical wound. On examination, he had fever, conjunctival pallor, hepatosplenomegaly and a 5 cm infra-umbilical midline poorly healed discharging surgical scar with surrounding skin erythema and induration. Blood investigations revealed Hb 5.1 gm/dl, TLC 1500/uL, Plts 32000/uL, Ferritin 1053 ng/ml, TG 350 mg/dl, LDH 650 U/l, Bil T/D 1.3/1.0 mg/dl, OT/PT 160/174 IU/l, ALP 219 U/l, GGT 238 U/l, TP/Alb 5.2/2.5 gm/dl, APTT C/T 27.9/63.0, INR 1.27. NCCT abdomen revealed hepatosplenomegaly, loculated collection in right subphrenic region extending into the abdominal and pelvic cavity, anterior abdominal wall defect infero-right lateral to the umbilicus and generalised increased density in mesenteric fat. Diagnostic sub-phrenic fluid Aspirate analysis revealed a yellow turbid fluid with TLC 22300, ADA 106 U/L and positive Real Time PCR for Mycobacterium tuberculosis complex. Aspirate pyogenic and fungal cultures were sterile. Bone marrow evaluation revealed marked degree of histiocytic hemophagocytosis. Patient fulfilled six out of eight criteria for diagnosis of HLH. He was started on Anti Tubercular Treatment along with dexamethasone. He gradually became afebrile with resolution of infra-umbilical wound discharge, improvement in clinical and laboratory parameters. Results We report a case of HLH secondary to Tuberculous peritonitis in a patient of ESRD. The patient was on CAPD and required catheter explantation in view of Refractory peritonitis. Despite explantation and adequate antibiotics, he continued to have fever, discharge from surgical wound, pain abdomen, weight loss and poor appetite. Further evaluation revealed evidence of Tuberculous Peritonitis. In addition, the patient fulfilled six out of eight criteria for diagnosis of HLH. The patient was managed with Anti Tubercular Treatment along with Dexamethasone and he showed a gradual improvement in overall clinical and laboratory parameters. Conclusion Secondary HLH may occur after Tuberculous peritonitis in patient of ESRD on CAPD. Refractory peritonitis with hyperferritenemia, cytopenias, hypertriglyceridemia should raise the suspicion for HLH. Timely identification and treatment of HLH may improve patient outcomes.
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Bielach – Bazyluk, Angelika, Agnieszka B. Serwin, Agata Pilaszewicz – Puza, and Iwona Flisiak. "Cutaneous Rosai – Dorfman disease in a patient with late syphilis and cervical cancer – case report and a review of literature." BMC Dermatology 20, no. 1 (December 2020). http://dx.doi.org/10.1186/s12895-020-00115-w.
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Abstract Background Cutaneous Rosai – Dorfman disease (CRDD) is extremely rare variant of idiopathic histiocytic proliferative disorder, which may manifest as a non-specific macules, papules, plaques or nodules ranging in size and colour from yellow – red to red -brown. Case presentation A 52-year-old female presented with three gradually enlarging, reddish - brown nodules on the right upper extremity lasting six months. The patients denied fever, weight loss, malaise. Clinical examination and imaging tests showed no sign of lymphadenopathy. A biopsy specimen of a nodule showed a dense dermal polymorphic infiltrate with numerous histiocytes exhibiting emperipolesis phenomenon. Immunohistochemical staining of the histiocytes showed S-100 protein (+), CD68(+), but CD1a (-). Aforementioned findings were consistent with CRDD characteristics. Additionally, a routine serological screening and confirmatory serological tests for syphilis were positive. Syphilis of unknown duration was diagnosed. The IgG antibodies titre against Chlamydia trachomatis was elevated. An isolated sensory impairment over the right trigeminal nerve was found on neurological consultation. Comprehensive gynaecological assessment was carried out because of patient’s complaints of bleeding after sexual intercourse and led to diagnosis of cervical cancer. The initial therapy with methotrexate was discontinued after three months due to neutropenia. Further therapy with dapson was ineffective, therefore complete surgical excision was recommended. Conclusions CRDD is a rare, benign condition especially difficult to diagnose due to lack of general symptoms and lymphadenopathy. Histopathologic examination with immunohistochemical staining, exhibiting characteristic and reproducible findings play a key role in establishing an accurate diagnosis. In the presented case activated histiocytes demonstrated in a lesional skin might be a response to immune dysregulation related to chronic, untreated sexually transmitted infections and cancer.
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Upadhyaya, Gargi, Malini R. Capoor, Hemlata Verma, Supriya Gambhir, S. Saxena, and Niti Khungar. "P302 Disseminated histoplasmosis: Rare entity in immunocompromised individuals in India." Medical Mycology 60, Supplement_1 (September 2022). http://dx.doi.org/10.1093/mmy/myac072.p302.
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Abstract Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Invasive mycoses kill more than one million people every year. The disease burden of mycoses has increased over the last 20 years and the importance of fungal disease is expected to keep increasing in the years to come. One of these mycoses, histoplasmosis, a disease caused by species of dimorphic genera, Histoplasma and is endemic in the USA, Asia, and Africa with sporadic cases reported from India. In the United States alone, 3.4 cases/100 000 people occur yearly. In India, prevalence of histoplasmosis is seen in the eastern part of the country and few cases are reported from north India. Here, we present four cases of classic progressive disseminated histoplasmosis from non-endemic central and northern parts of India. Cases I and II: Two cases, firstly a 51-year-old male resident of Delhi, came with complaints of fever, generalized weakness and weight loss for the past 6 months, and another a 55-year-old in an apparently immunocompetent female from a non-endemic state in central India. The disease was diagnosed by bone marrow aspirate incidentally. Cases III and IV: A 25-year-old female and a 29-year-old HIV-infected female, with chief complaints of multiple skins colored swellings on her face, neck, chest, and back and also on both limbs. Physical examination revealed multiple skin-colored papules and nodules coalescing to form large plaques on the face, neck, upper back, and chest which had overlying yellowish-brown crusting (Fig.1). Her entire face was involved with depression of the nasal bridge and madarosis. Multiple discrete 0.1-0.5 mm papules and nodules on bilateral upper and lower limbs. Patient was started on the treatment of cutaneous histoplasmosis with injection of liposomal amphotericin-B 100 mg intravenous (around 3 mg/kg/day) after pre-medication for 10 days. For both cases, capsule itraconazole 200 mg BD started for 4 days. Patient responded well to the treatment and follow-up showed improvement in the condition of the patient. Results In all the cases, fine needle aspirate cytology of the lesions showed plenty of inflammatory cells and macrophages in pathological microscopic examination. Microscopic examination of skin tissue revealed that macrophages comprising of yeast forms of Histoplasma have pericellular halo around them. Moreover, on long incubation of biopsy sample on SDA media plate at 27˚C, white/buff colonies with yellow-tan on the back were observed. Furthermore, microscopic examination of grown fungal culture showed mycelial septate hyphae bearing round to pear-shaped, smooth-walled broadly elliptical microconidia, or tuberculate macroconidia. In all the cases, clinical suspicion, histopathological and mycological findings (microscopy, culture and post-culture sequencing) led to a confirmatory diagnosis of progressive disseminated Histoplasmosis by H. capsulatum var. capsulatum was made. Conclusion In all, 3 of these cases are of progressive disseminated histoplasmosis in apparently immunocompetent patients from the non-endemic states of north India. On the contrary, one of the cases was HIV positive with mucocutaneous lesions. Disseminated histoplasmosis in immunocompetent individuals is not a rare entity, in India. High clinical suspicion and awareness regarding the pathogen are required. From the point of good patient care, an accurate diagnosis, and timely management in cases of histoplasmosis are warranted.
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Parraguirre-Lezama, Conrado, Omar Romero Arenas, Maria de los Angeles Valencia de Ita, Antonio Rivera, Nemesio Villa-Ruano, and Amparo Mauricio Gutiérrez. "First report of Xanthomonas campestris pv. campestris as the causal agent of necrotic leaf spot in Phaseolus vulgaris at Puebla, Mexico." Plant Disease, June 18, 2021. http://dx.doi.org/10.1094/pdis-05-21-1010-pdn.
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Beans are the most cultivated legume in the world. In Mexico, it is the second most important crop after corn (FAO 2020; SIAP 2020). Bean plants “Flor de Mayo M38” variety were affected by a foliar disease during the agricultural cycle 2019 in Puebla-Mexico (19°02'46.6" LN and 98°05'15.6" LO). Necrotic V- shaped lesions were observed on the margins of the leaves surrounded by yellow halos followed by foliar necrosis, affecting 40% of the crop. In Mexico this variety of cultivars is in great demand for local consumption and generates income in foreign currency (Castellanos et al. 1997). Sampling was carried out on 50 plants “Flor de Mayo M38” variety, with necrotic leaf symptoms from ten plots of one hectare. Samples were cut into pieces (5 mm), disinfested with 1% hypochlorite 3 min, and washed with sterile distilled water. Subsequently, samples were dried on sterile paper and placed on Petri plates containing yeast extract calcium carbonate dextrose agar (YDC) medium and kept at 36°C for 3 days. Colonies of ten typical bacteria isolated from all symptomatic plants were Gram (-), small and uniform in size with rounded edges, yellow, convex with entire borders and mucoid appearance on YDC. Bacteria did not grow on 0.1% triphenyl tetrazolium chloride amended casamino acid, peptone, and glucose medium (CPG). Biochemical tests showed that isolates did not reduce nitrate to nitrites, had positive catalase and starch hydrolysis, while the Kovac oxidase test was negative (Schaad and White 1974). Genus identity of the representative isolate Xcf1-APJR, was confirmed by 16S rRNA encoding gene partial sequencing, using universal primers 518F (5'-CCAGCAGCCGCGGTAATACG-3') and 800R (5′-TACCAGGGTATCTAATCC-3′) (Halim et al. 2020). BLASTn alignments against the nucleotide collection were 100% identical to Xanthomonas sequences including Xanthomonas campestris pv. campestris strains NZ_AP019684.1, CP025750.1, and MN108237.1. The 1,418 bp sequence was deposited in the GenBank database under accession number MT645246. The identification of species/pathovar was accomplished by serological methods using a polyclonal antiserum specific for X. campestris pv. campestris (Popovic ́ et al. 2013) with the DAS-ELISA commercial kit (catalog number 07122C/096, LOEWE Biochemica GmbH, Germany). The pathogenicity test was carried out on 50 healthy bean plants from the "Flor de Mayo M38" variety. Bacterial culture incubated at 28°C for 48 h in YDC medium was used to prepare the bacterial suspension (108 CFU mL-1). The first two lower leaves of 30-day-old plants were inoculated by sprinkling. Ten plants sprayed with sterile distilled water were used as negative control. All plants were kept for 20 days in greenhouse at 18-26°C and relative humidity of 60%. After seven days, chlorotic lesions developed on all inoculated plants that became necrotic from 14 days after inoculation (dai). Necrotic leaf spots merged at 14 dai to form necrotic areas of more than 20 mm in diameter, reaching total necrosis of the leaf tissue at 20 dai and were similar to the symptoms observed in the field. Koch's postulates were confirmed by the reisolation of Xcf1-APJR strain, which presented the same colony morphology, partial sequence, and polyclonal specific detection. This is the first report of this pathogen causing necrotic leaf spot in beans from the "Flor de Mayo M38" variety in Puebla-Mexico. The author(s) declare no conflict of interest. References: FAO. 2020. FAOSTAT. Food and Agriculture Data. http://www.fao.org/faostat/en/#home/. SIAP. 2020. Atlas Agroalimentario. https://www.gob.mx/siap/. Castellanos, J. Z., et al. 1997. Arch. Latinoam. Nutr. 47:163. Schaad, N. W., and White, W. C. 1974. Phytopathology. 64:876. https://doi.org/10.1094/Phyto-64-876 Halim, R. A., et al. 2020. HAYATI J. Biosciences. 27:215. https://doi.org/10.4308/hjb.27.3.215 Popovic ́, T., et al. 2013. Plant Dis. 97:418. https://doi.org/10.1094/PDIS-05-12-0506-PDN