Congenital lymphocytic choriomeningitis virus infection: decade of rediscovery. (17/1030)

Lymphocytic choriomeningitis virus (LCMV) is an underdiagnosed fetal teratogen. This diagnosis should be considered for infants and children with unexplained hydrocephalus, micro- or macrocephaly, intracranial calcifications, chorioretinitis, and nonimmune hydrops. The immunofluorescent antibody test is the only reasonable, commercially available, screening diagnostic tool. The differential diagnosis of congenital LCMV infection includes toxoplasmosis, rubella, cytomegalovirus, herpes simplex virus, enteroviruses, human parvovirus B19 [corrected], and syphilis. The infection has also been misdiagnosed as various neurologic, ophthalmologic, and chromosomal syndromes. Further research, to determine the prevalence of this infection in human and rodent populations, and prospective studies, to delineate the clinical spectrum of congenital infection, are needed. The public and members of the medical profession should be made aware of the hazard that wild, pet, and laboratory rodents pose to pregnant women.  (+info)

Emerging viral diseases of Southeast Asia and the Western Pacific. (18/1030)

Over the past 6 years, a number of zoonotic and vectorborne viral diseases have emerged in Southeast Asia and the Western Pacific. Vectorborne disease agents discussed in this article include Japanese encephalitis, Barmah Forest, Ross River, and Chikungunya viruses. However, most emerging viruses have been zoonotic, with fruit bats, including flying fox species as the probable wildlife hosts, and these will be discussed as well. The first of these disease agents to emerge was Hendra virus, formerly called equine morbillivirus. This was followed by outbreaks caused by a rabies-related virus, Australian bat lyssavirus, and a virus associated with porcine stillbirths and malformations, Menangle virus. Nipah virus caused an outbreak of fatal pneumonia in pigs and encephalitis in humans in the Malay Peninsula. Most recently, Tioman virus has been isolated from flying foxes, but it has not yet been associated with animal or human disease. Of nonzoonotic viruses, the most important regionally have been enterovirus 71 and HIV.  (+info)

Public/private sector partnership for emerging infections. (19/1030)

This paper gives examples of public/private partnerships that support research, support drug development and that advance policy development, suggesting that such partnerships can advance our understanding and control of emerging infections. The investment in emerging infectious diseases from government and from industry is currently much larger than that from philanthropy. Nevertheless philanthropy, even with limited dollars, is able to play a catalytic function and provide risk capitol for innovative partnerships and could in the future play an even larger role if the value of such investment is better defined and argued to recruit additional dollars to this area.  (+info)

Adaptation of Bordetella pertussis to vaccination: a cause for its reemergence? (20/1030)

In the Netherlands, as in many other western countries, pertussis vaccines have been used extensively for more than 40 years. Therefore, it is conceivable that vaccine-induced immunity has affected the evolution of Bordetella pertussis. Consistent with this notion, pertussis has reemerged in the Netherlands, despite high vaccination coverage. Further, a notable change in the population structure of B. pertussis was observed in the Netherlands subsequent to the introduction of vaccination in the 1950s. Finally, we observed antigenic divergence between clinical isolates and vaccine strains, in particular with respect to the surface-associated proteins pertactin and pertussis toxin. Adaptation may have allowed B. pertussis to remain endemic despite widespread vaccination and may have contributed to the reemergence of pertussis in the Netherlands.  (+info)

Emerging infectious disease issues in blood safety. (21/1030)

Improvements in donor screening and testing and viral inactivation of plasma derivatives together have resulted in substantial declines in transfusion-transmitted infections over the last two decades. Most recently, nucleic acid testing techniques have been developed to screen blood and plasma donations for evidence of very recent viral infections that could be missed by conventional serologic tests. Nonetheless, the blood supply remains vulnerable to new and reemerging infections. In recent years, numerous infectious agents found worldwide have been identified as potential threats to the blood supply. Several newly discovered hepatitis viruses and agents of transmissible spongiform encephalopathies present unique challenges in assessing possible risks they may pose to the safety of blood and plasma products.  (+info)

Neighborhood poverty and the resurgence of tuberculosis in New York City, 1984-1992. (22/1030)

OBJECTIVES: The resurgence of tuberculosis (TB) in NewYork City has been attributed to AIDS and immigration; however, the role of poverty in the epidemic is unclear. We assessed the relation between neighborhood poverty and TB at the height of the epidemic and longitudinally from 1984 through 1992. METHODS: Census block groups were used as proxies for neighborhoods. For each neighborhood, we calculated TB and AIDS incidence in 1984 and 1992 with data from the Bureaus of Tuberculosis Control and AIDS Surveillance and obtained poverty rates from the census. RESULTS: For 1992, 3,343 TB cases were mapped to 5,482 neighborhoods, yielding a mean incidence of 46.5 per 100,000. Neighborhood poverty was associated with TB (relative risk = 1.33; 95% confidence interval = 1.30, 1.36 per 10% increase in poverty). This association persisted after adjustment for AIDS, proportion foreign born, and race/ethnicity. Neighborhoods with declining income from 1980 to 1990 had larger increases in TB incidence than did neighborhoods with increasing income. CONCLUSIONS: Leading up to and at the height of the TB epidemic in New York City, neighborhood poverty was strongly associated with TB incidence. Public health interventions should target impoverished areas.  (+info)

Sporotrichosis: an emergent zoonosis in Rio de Janeiro. (23/1030)

During the period from 1987 to 1998, 13 cases of human sporotrichosis were recorded at the Research Center Evandro Chagas Hospital (CPqHEC) in Rio de Janeiro. Two of these patients related scratch by a sick cat. During the subsequent period from July 1998 to July 2000, 66 human, 117 cats and 7 dogs with sporotrichosis were diagnosed at the CPqHEC. Fifty-two humans (78.8%) reported contact with cats with sporotrichosis, and 31 (47%) of them reporting a history of a scratch or bite. This epidemic, unprecedented in the literature, involving cats, dogs and human beings may have started insidiously before 1998.  (+info)

West Nile outbreak in horses in southern France, 2000: the return after 35 years. (24/1030)

On September 6, 2000, two cases of equine encephalitis caused by West Nile (WN) virus were reported in southern France (Herault Province), near Camargue National Park, where a WN outbreak occurred in 1962. Through November 30, 76 cases were laboratory confirmed among 131 equines with neurologic disorders. The last confirmed case was on November 3, 2000. All but three cases were located in a region nicknamed "la petite Camargue," which has several large marshes, numerous colonies of migratory and resident birds, and large mosquito populations. No human case has been confirmed among clinically suspected patients, nor have abnormal deaths of birds been reported. A serosurvey has been undertaken in horses in the infected area, and other studies are in progress.  (+info)