Borne Viral Infections Research Articles

Use of intravenous N-acetylcysteine in acute severe hepatitis due to severe dengue infection: a case series

BackgroundDengue fever is a common mosquito borne viral infection. Severe dengue fever associated severe hepatitis carries high mortality. Based on the beneficial effect of N-acetylcysteine (NAC) in paracetamol poisoning and non-acetaminophen induced liver failure, it is used in dengue fever associated hepatitis in clinical practice. We aim to study the reversal of liver enzymes with NAC in the setting of severe hepatitis due to severe dengue infection.MethodsA retrospective analysis was conducted on hospitalized 30 adults with severe dengue fever with severe hepatitis. These 30 patients had aspartate transaminase (AST) and alanine transaminases (ALT) more than 500 U/L and/or PT INR (prothrombin time and international normalized ratio) more than 1.5. They were treated with NAC infusion of 100 mg/h for 3 to 5 days.ResultsThe mean age of the group was 49.9 ± 11.46 years and 18 (60%) patients were males. Nineteen patients (63%) developed dengue shock. Of them 12 patients (40%) developed hepatic encephalopathy. Median AST on the day of administration of NAC was 1125 U/L interquartile range (IQR) 1653.25 while median ALT was 752 (IQR 459.25). There was a statistically significant reduction of both ALT (p = 0.034) and AST (p = 0.049) from day 1 to 4 after NAC infusion. Rise of platelet count between day 1 and day 4 also showed statistically significant difference (p = 0.011) but the reduction of prothrombin time and international normalized ratio (PT/INR) from 1 to day 4 did not show statistical significance difference. Mean duration of treatment with NAC was 3.61 ± 0.75 days while mean length of hospital stay was 6.2 ± 1.27 days. Only one patient died (3.3%). None of the patients reported adverse drug reaction due to NAC.ConclusionMajority of patients demonstrated marked clinical and biochemical improvements and they recovered fully. We observed faster and significant recovery of liver enzymes following administration of NAC. Based on the above findings, this study provides preliminary evidence for the beneficial effect of NAC in severe hepatitis in dengue infection with greater survival benefits.

A REVIEW ON FIRST MEMBERS OF COVID-19 VACCINES IN PHASE 3 AROUND THE GLOBE

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), a member of the coronaviridae family is the cause of the pandemic which started in 2019 and the world is still fighting against it. In spite of the usage of drugs like remedesivir, flavinavir and hydroxycholoquine along with different approaches to increase the immunity or to treat the respiratory infection in humans, even now this viral infection is uncontrollable. According to the stats, till November 10, 2020 over 10 million people have lost their lives around the world, touching the mark of 37 mill ion plus patients around the world with epidemiology showing the most cases in USA followed by India, Russia, Brazil and Spain. After seeing the rapid spread and post disease effects of this air borne viral infection, an urgent need of the vaccine consider ed. This led to encourage researchers around the world to develop different types of vaccines, namely inactivated, live attenuated, nanoparticle based, viral vectored, recombinant type, DNA and RNA vaccines, among which few have already passed Phase 1 clinical trials and are under Phase 2 or 3 human trials. The vaccines which have the highest potential to be successful with minimal side effects proposed by different countries around the world with their type, mechanism of action and their effects along with the challenges and considerations regarded with these vaccines has been discussed in this paper.

Seroprevalence of dengue infection: A hospital based study from Udaipur, Rajasthan

Dengue is one of the most important arthropod- borne viral infections, widely distributed throughout the tropics and subtropics. It is endemic to the Indian subcontinent and associated with explosive urban epidemics and has become a major public health problem in India. The present study was conducted to detect prevalence of Dengue virus infection in Udaipur, Rajasthan. Materials and Methods: Serum samples from 640 patients clinically suspected of having dengue infection visiting a tertiary care hospital during the period of August 2016 to February 2018 were screened for the presence of Dengue NS1 antigen and IgM and IgG antibodies using one-step immune-chromatographic assay (Dengue Rapid IgM/IgG test and NS1 test by SD BIOLINE). Result: Out of 640 samples 62 samples (9.68%) were positive for Dengue virus infection. Out of total positive Sample for dengue virus infection, 61% samples were of male patients and 39% samples were from female patients. Among them 28% positive samples were from paediatric age group (Age 1- 14 years) and rest were from Adult age group. Seasonal trend showed a gradual increase in Dengue positives starting from August with a peak in October. Most common presentation was fever (98%). Conclusion: Number of dengue cases is on increase in the region and continued surveillance is essential to determine epidemiological and seasonal trend.

P1456PREVALENCE OF HEPATITIS B CORE ANTIBODY AND OCCULT INFECTION AMONG HAEMODIALYSIS PATIENTS

Abstract Background and Aims Haemodialysis (HD) patients are highly susceptible to blood borne virus infections and prevention strategies include surveillance, segregation, vaccination and strict implementation of standard precautions. As per new guidelines it is mandatory for all HD patients to be tested for hepatitis B core antibody at the beginning of renal replacement therapy. In the present study we sought to determine the prevalence of core antibody positivity and occult HBV infection as evidenced by viraemia in hepatitis B surface antigen (HBsAg) negative patients on maintenance haemodialysis. Method All HD patients (aged≥ 18 years) who were dialyzing in 2019 were included in this cross-sectional study. Retrospective data based on one-off screening for hepatitis B core antibody total (anti-HBc) for all HBsAg negative patients (study population) carried out between May and Oct 2019 was used for analysis. Information was gathered on HBsAg, anti-HBc antibody, surface antibody (anti-HBs) and Hepatitis B virus (HBV) DNA. All anti-HBc antibody positive patients were tested for HBV DNA using quantitative PCR assay. Patients were classified as immune (anti-HBs >10 IU/L) and non-immune (anti-HBs ≤10 IU/L) based on surface antibody levels. Demographic data were compared using Chi square test for categorical variables and Independent T test/Mann Whitney U test for continuous variables between the patients with and without HBV core antibody. Baseline characteristics were compared between the immune and non-immune groups using Chi square test and Independent T test/Mann Whitney U test as appropriate. Results A total of 3704 HBsAg negative HD patients (mean age 63.5±11.3 years, 56.1% male, 57.7% Chinese, 65.4% diabetic and mean vintage of 5.8±5.4 years) were included in the study after exclusion of 147 patients (3.8%) who had chronic HBV infection from the entire HD cohort of 3851 patients. 895 (24.2%) showed evidence of past HBV infection (anti-HBc positive but HBsAg negative) with only 3 (0.1%) patients having detectable HBV DNA. The HBV core antibody positive patients were predominantly elderly, Chinese, males and with high medical dependency compared to the patients without HBV core antibodies (p<0.001). There were no statistically significant differences in diabetic status and dialysis vintage between the patients with and without HBV core antibody. 3202 (86.4%) patients were immune following vaccination (anti-HBs >10 IU/L). The non-immune patients (13.5%) were more likely to be diabetic, with high medical dependency and lower vintage compared to immune patients (p<0.001). Age, race and gender did not differ significantly between the immune and non-immune patients. Conclusion The prevalence of hepatitis B core antibody positivity was 24.2% in our large racially diverse haemodialysis cohort but the presence of occult HBV was low (0.1%). Elderly Chinese males with high comorbidity and poor functional status were more likely to have evidence of past HBV infection. Occult HBV infection has implications in policy development for the prevention of HBV infection in dialysis centres.

A STUDY TO DETERMINE THE INCREASING DENGUE INCIDENCE IN BIHAR REGION: AN OBSERVATIONAL STUDY.

Introduction: Dengue is one of the most serious mosquitos borne viral infection mainly affecting tropical and subtropical countries of the world. In absence of specific treatment and vaccine for dengue fever (DF); vector control is the only method by which spread of dengue can be prevented. The present study was conducted to determine the increasing dengue incidence in Bihar region.
 Material and Method: This study was done to report the sero prevalence of Dengue virus infection at Bihar, North India. The laboratory records of clinically suspected Dengue patients from jan 2018 to Nov 2018 were analyzed retrospectively for demographic features, seasonal variations, and results of IgM and IgG anti dengue antibodies tested by Dengue IGM capture enzyme linked immune sorbent assay (MAC ELISA).
 Results: A total of 1035 serum samples were analyzed. Out of which 209 samples (20.19%) were found positive for dengue virus infection. Maximum positive cases were seen in 2019 (53.11%). Seasonal trend showed that infection started appearing in august, peaked in October and slowly tapered by December.
 Conclusion: The most affected age group was 11 to 15 years of age, (57.3%) followed by 6 to10 year’s group (27.3 %)and least effective age group was 0 to 5 year (15.4%), majority of cases were found to be of secondary dengue virus infection (93.8%). Male to female ratio was 2:1.The present outbreak thus emphasizes the need for continuous sero epidemiological surveillance for the timely formulation and implementation of effective dengue control programme.
 Keywords: Dengue, dengue haemorrhagic fever, IgM antibody capture enzyme linked immune sorbent assay (MAC ELISA), India, vector.

Research progress in RNA interference against the infection of mosquito-borne viruses.

Mosquito-borne diseases have become an important public health issue of global concern because of their high incidence and transmission rate. As a vector for mosquito-borne diseases, studying the interaction mechanism between mosquitoes and mosquito-borne viruses will help control mosquito-borne diseases. The impaired innate immunity and immune barriers evasion caused by mosquito-borne viruses in mosquitoes pose a potential risk for the persistent infection of the virus in mosquitoes and the outbreak of mosquito-borne diseases. The RNA interference (RNAi) pathway, as a powerful antiviral defense barrier in mosquitoes, can inhibit viral replication and transmission by producing a variety of small RNAs to degrade viral RNA. In this review, we summarize the related studies on the innate immune mechanism against mosquito- borne virus infection in mosquitoes about small interfering RNA (siRNA), microRNA (miRNA), and Piwi-interacting RNA (piRNA), aiming to provide a theoretical reference for the prevention and control of mosquito-borne diseases.

Towards a Web GIS-based approach for mapping a dengue outbreak

Dengue, a most common vector (mosquito)-borne viral infection causing serious illness and death mostly among children, is commonly widespread throughout the tropical and sub-tropical areas with local/regional variations. There are some important environment factors which are affecting the dengue spread. This study was conducted to evaluate the spatial outbreak patterns of dengue in Lahore District which was among the majorly affected areas. The environmental factors affecting the spread of the disease have been mapped in a GIS using all the spatial and tabular data obtained from different sources. Land surface temperature (LST), rainfall, land use/land cover, Normalized Difference Vegetation Index (NDVI), and population density are considered the major factors which are affecting the dengue spread. The results depicted some particular trends. Areas with high population density were found to be more infected for the simple reason of lack of hygiene measures and water accumulation on the unpaved roads (as these areas were mostly low-income pockets of the city). Some posh areas although with comparatively low population density were also found to be infected from dengue due to the reason that they mostly had lawns and swimming pools in their houses which are the most active breeding sites of the mosquitoes.

A cross-sectional study of acute dengue infection in paediatric clinics in Cameroon

BackgroundDengue fever is the world’s fastest spreading mosquito borne viral infection. It is prevalent throughout both subtropical and tropical region, and affects over 128 countries. Dengue virus (DENV) infection poses a serious global public health challenge to three billion people, resulting in approximately 200 million cases of morbidity and 50,000 cases of mortality annually. In Cameroon like in most sub-Saharan African countries, DENV infection occur concurrently with other infectious diseases whose symptoms often overlap, rendering differential diagnosis challenging. This study aims at determining the frequency of acute dengue among febrile children under 15 years attending hospitals in some areas of Cameroon.MethodsA total of 961 children under the age of 15 were recruited in a cross-sectional study using systematic sampling technique and by selecting each subject out of the three. The study was conducted in 10 public health centers in Cameroon. Demographic data and risk factors of the subjects were obtained using well-structured questionnaires. Dengue virus NS1 antigen, IgM and IgG were analysed using a Tell me fast® Combo Dengue NS1-IgG/IgM Rapid Test. An in-house ELISA test for dengue specific IgM antibody was equally performed for confirmation. Descriptive statistical analysis was performed using Graph pad version 6.0.ResultsA prevalence of 6.14% acute dengue virus infection was observed among children with febrile illness with a significant difference (p = 0.0488) between males (4.7%) and females (7.7%). In addition, children who reportedly were unprotected from vectors, showed a comparatively higher prevalence of the disease seropositivity than those practicing protective measures.ConclusionDENV infection therefore is an important cause of fever among children in Cameroon. Thus, there is a need to include differential screening for DENV infections as a tool in the management of fever in children in the country.

Sensitive Serological Testing and Universal Precautions Prevent Blood Borne Viral Infections in Patients Undergoing Haemodialysis

Sensitive Serological Testing and Universal Precautions Prevent Blood Borne Viral Infections in Patients Undergoing Haemodialysis

The ENABLE projects: Consistent high prevalence of undiagnosed active blood borne virus infection [HBV, HCV, HIV] across four urban emergency departments in England – Data for action?

The ENABLE projects: Consistent high prevalence of undiagnosed active blood borne virus infection [HBV, HCV, HIV] across four urban emergency departments in England – Data for action?

Surgeons’ Perception to Needle Stick Injuries and Transmission of Blood Borne Viral Infections

Surgeons’ Perception to Needle Stick Injuries and Transmission of Blood Borne Viral Infections

Postexposure management of occupational injuries amongst health care workers

Occupational exposure comprises of needle stick injury (NSI) and mucosal splashes. A health care worker (HCW) is at a greater risk of developing blood borne virus infection while at work. Due to high prevalence of human immunodeficiency virus, hepatitis B surface antigen and hepatitis C virus in developing countries, there is a higher risk of infection after occupational exposure to HCW. Factors such as sub-optimal infection control practices and lack of equipment, increases the risk of acquiring NSIs. Reporting of each episode of occupational exposure should be mandatory in institutions. Postexposure management policies should be included among the institutional policies.

Viral sepsis in the pediatric intensive care unit

Consensus definitions of pediatric sepsis clearly include viral infections, and yet most studies of sepsis in the intensive care environment specifically exclude viral infections. Viral infections are a common cause of admission to the pediatric or neonatal intensive care. They are probably underestimated, and new techniques of viral identification offer an opportunity to expand our understanding of the true impact of viral infections on critical illness in childhood. Not only are viral infections a cause of admission, but they may also constitute a significant component and risk of nosocomial infections in the pediatric intensive care unit. Specific antiviral therapies are limited, and in many cases immunization and prevention is the most effective approach to severe viral infections. With climate changes, the distribution of insect borne viral infections is changing across the world and these infections are starting to occur in new geographical areas. Attention has to be paid to the issue of protection of pediatric intensive care staff against viral infections.

Dengue & malaria global burden: A cross sectional study of awareness & practice of dengue and malaria & its difference among different age group in Pakistan

Malaria and Dengue both are mosquito borne infections. Malaria is spread by Anopheles mosquitoes. It’s caused by a parasite called Plasmodium. When an infected mosquito bites us this parasite enters in to our body and goes to liver where it affects red blood cells. While dengue is a mosquito borne viral infection it’s also called break bone fever in severe cases it changes in to life threatening dengue hemorrhagic fever, resulting in low level of platelets, low blood pressure and bleeding occurs. This study was conducted based on the awareness of dengue fever and malaria the survey forms were distributed in 100 different age group of people to determine that how much people are aware of these two diseases. In our survey we aimed to determine the awareness between different age groups about dengue fever and malaria. We set three different age ranges first one is between 15-30 years, second one is between 30-45 years and third one is above 45 years. The result of first range for malaria is (72%) and for dengue is (66.42%). The result of second range for malaria is (31.93%) and for dengue is (36.36%) and the result of third range for malaria is (35.56%) and for dengue is (34.60%). By our result we can conclude that the people of first range and third range are more aware of malaria as compare to dengue, while in second range people are more aware of dengue as compare to malaria., Faculty of Pharmacy, Jinnah University for Women, Karachi-74600, Pakistan.

WNV infection - an emergent vector borne viral infection in Serbia: Current situation

West Nile virus (WNV) is a neurovirulent mosquito-borne Flavivirus with zoonotic potential. Virus is maintained in nature in an enzootic transmission cycle between avian hosts and mosquito vectors, but occasionally infects other vertebrates. The infection in horses and humans can be asymptomatic or it can have different clinical manifestations ranging from light febrile diseases to fatal meningoencephalitis. Recently, the number, frequency and severity of outbreaks with neurological consequences for birds, humans and horses have increased dramatically throughout central and south Europe, including Serbia, posing a serious veterinary and public health problem. The emergency of WNV infections in Serbia is described through the current epidemiology situation based on recent data on the incidence of WNV infection among virus natural hosts and vectors; sentinel (horses) and other animal species, and in human population. The results of the WNV serology studies conducted on horse blood samples collected in different occasions during the last six years, and the results of the serology studies conducted among other animal species like pigs, wild boars, roe deer and dogs in Serbia are presented and discussed. Also, the results of the first studies on WNV presence in mosquito vectors and in wild birds as virus natural hosts in Serbia are presented and analyzed. In addition, the data on the WNV serology studies conducted in human population in Serbia in the last few years, and the existing data of WNV outbreaks in 2012 and 2013 are included. Regarding the existing knowledge on WNV epidemiology situation, the crucial role of veterinary service in early detection of WNV presence and ongoing national program of WNV surveillance in sentinel animals, mosquitoes and wild birds are discussed.

Seroprevalence, Immunostatus and Factors Associated with Blood Borne Viral Infections Among Egyptian Municipal Solid Waste Workers

Abstract Objectives Waste collectors have a potential risk of infectious diseases. The high prevalence of viral hepatitis B and C in Egypt has elevated the concern regarding the potential for disease transmission among municipal solid waste workers (MSWWs) from solid waste stream sources. Such transmission has never been epidemiologically demonstrated. This study aimed to explore the occurrence of HIV, Hepatitis B and C and to describe possible ways of virus transmission among MSWWs in Egypt. Methods A descriptive cross-sectional study was conducted among 346 MSWWs recruited from the main municipality in Alexandria, Egypt. Study procedure entailed interviews using a predesigned questionnaire and blood testing for the blood borne viral markers. Analytical statistics were used to identify independent factors correlated with HCV and HBV infections. Results: Overall seroprevalences were: hepatitis B; 36.1%; hepatitis C; 8.4%; and HIV; 0.0%. About 50% of the participants were at risk of HBV infection. Subjects were characterized by a predominance of males with low educational and economic levels. HBV infection was found to be significantly associated with younger age, folk circumcision, and the presence of genital complains suggestive of STDs while HCV infection was primarily associated with past history of parenteral anti-schistosomal therapy, intravenous infusion and direct exposure to solid waste. Conclusion The present work provides a strong evidence of increased occupational risk of blood borne viral infections among MSWWs. This mandates the need of compulsory HBV immunization proph.

Seroprevalence of Dengue in Gujarat, Western India: A study at a tertiary care hospital

Background: Dengue is one of the most serious mosquito borne viral infection mainly affecting tropical and subtropical countries of the world. In absence of specific treatment and vaccine for dengue fever (DF); vector control is the only method by which the spread of dengue can be prevented. Aims & Objective: This study was conducted to report the prevalence of Dengue virus infection in Gujarat, Western India. Material and Methods: Study was performed at a tertiary care hospital in Ahmedabad, Gujarat in year 2012. Patients attending various hospitals across Gujarat for suspected dengue were tested. Blood samples collected in plain tubes were tested for dengue IgM antibodies, NS1 antigen and viral nucleic acid detection by Dengue IgM capture enzyme linked immune sorbent assay, Dengue Early ELISA and real time reverse transcriptase PCR, respectively. The laboratory records were analyzed for demographic features and seasonal variations. Descriptive statistics were used. Data were expressed in proportions. Results: Out of total 4401 serum samples tested, 927 were found positive for dengue virus infection. 65% positive samples were of male patients and 58% positive samples were from 18 to 35 years age group (Adult population) (58%). Seasonal trend showed a gradual increase in dengue positives started from August with a peak in October (34.5%). The most common presentation was fever (97%) while only 1% cases presented haemorrhagic manifestations. Conclusion: Dengue has established its transmission in urban and semi-urban areas of Gujarat with predominantly affecting males and active adult population. Virus activity is high during monsoon and post monsoon period which coincides with increased vector breeding. This study thus emphasizes the need for continuous sero epidemiological surveillance for the timely formulation and implementation of effective dengue control programme.

A Cross-Sectional Study on the Knowledge of Hepatitis B Infection among Dental Professionals

Background : Hepatitis B is an inflammatory disease of liver due to double stranded DNA virus of the hepadnaviridae, transmitted through contact with the blood or other body fluids of an infected person. Hepatitis B poses a major health concern and is the world’s most common blood borne viral infection placing healthcare workers, medical and dental professionals at higher occupational risk and in India it is the second most common cause for acute hepatitis. To increase the awareness and knowledge about viral hepatitis WHO has declared 28 th July as the World Hepatitis Day/Eradication day. So the present survey was conducted to evaluate and compare the status of awareness of hepatitis B infection among dental practitioners and students. Methodology : A questionnaire based study was conducted on a randomized sample of 280 dental professionals including dental practitioners, dental postgraduate students and dental interns. The collected data were analyzed using SPSS software. Results & Conclusion: The results obtained reveal that 58.21% dental professionals were ignorant about the investigation procedures & diagnosis of hepatitis. While 82.15%, 95.36%, 58.22% and 93. 93% had good knowledge about hepatitis infection and its transmission, vaccine, attitude towards HBV patients and post exposure prophylaxis respectively. However, the status of awareness among dental practitioners, postgraduate students and interns was found to be insignificant (p >0.05).

Isolated polio-like syndrome after tick-borne encephalitis presenting with acute hyperckemia

Tick borne encephalitis virus infection usually shows a biphasic course. In the first stage of illness symptoms are similar to a flu-like syndrome, then after a defervescence period, fever may represent with neurological manifestations ranging from mild meningitis to severe encephalomyelitis. We report the clinical case of an adult man presented with an acute proximal hyposthenia, severe hyperckemia, clinical and laboratoristic evidence of acute tick borne virus infection. This virus has a favourite tropism for the anterior horn cells of the cervical spine segment. Polio-like syndrome, usually affecting the upper limbs, is the clinical phenotype of an infection of the cervical motoneurons. Usually myelitis is associated to severe encephalitis and a complete diagnosis may be difficult in comatose patients. Rarely, an isolated polio-like syndrome may be the sole neurological complication of tick-borne encephalitis.

Neuralgic amyotrophy associated with dengue fever

Dengue is an acute mosquito borne viral infection caused by one of the four distinct serotype of dengue viruses (type 1-4), belonging to flavivirus family. Dengue fever, an arboviral infection is known to cause various neurological complications. Commonly reported neurological manifestations associated with dengue infection are encephalopathy, myelopathy, stroke, Guillain-Barre syndrome and hypokalemic paralysis. Brachial amyotrophy associated with dengue infection were not described previously. Here, we describe three patients presenting with brachial neuritis associated with dengue infection. Dengue infection should be considered in the etiological list of brachial neuritis in dengue endemic areas, especially if preceded by history of febrile illness compatible with dengue illness.