Insect Bites Research Articles

Borrelial lymphocytoma of the areola in a 9-year-old boy: a case report

Purpose: This study presents a rare skin manifestation of Lyme borreliosis, specifically affecting the areola in a child in the absence of a history of a tick bite or erythema migrans. 
 Case report: A 9-year-old boy presented with symptomless erythematous swelling of the breast areola for one month. Initial treatment for gynecomastia and then mastitis proved ineffective. A biopsy was performed, with histological findings revealing lymphocytoma, likely stemming from an insect bite. Serology for Borrelia burgdorferi was positive. Following a two-week course of oral amoxicillin, the lesion completely resolved. 
 Conclusion: The consideration of Lyme disease should be a component of the differential diagnosis of skin lesions localised in typical areas, particularly in patients living in endemic regions.

Phytochemically analysed extract of Ageratina adenophora (Sprengel) R.M.King & H. Rob. initiates caspase 3-dependant apoptosis in colorectal cancer cell: A synergistic approach with chemotherapeutic drugs

Ethnopharmacological relevanceAgeratina adenophora (Sprengel) R.M.King & H.Rob. has been used as traditional indigenous medicine all across the globe for its diverse therapeutic applications such as anticancer, analgesic, antipyretic, thermogenic, antiseptic, antimicrobial as well as astringent. The various ethnic groups of India use plant parts to treat cuts and wounds, venomous insect bites, skin lesions, blisters, scabies and other skin irritations, gastritis and indigestion problems, cough, stomach ache and dysentery. The Portuguese traditionally extract the juice from the plant and use it for cancer, diabetes, liver disorder, gallbladder and stomach ailments. Nigerian healers use different parts of the plant to treat diabetes, fever and inflammation. Aim of the studyThe aim of this study is to investigate the cytotoxic potential of A. adenophora hydroalcoholic leaves extract (AHL) on Colorectal cancer (CRC) cell lines (HCT-116, HCT-15 and HT-29), synergistic potential with chemotherapeutic drugs 5FU and Cisplatin as well as reactive oxygen species (ROS) generation, based on the sample collected from Mao district of Manipur, India. Identification of bioactive phytocompounds in AHL was also performed by HRLCMS. MethodsThe AHL was evaluated for its cytotoxic as well as antiproliferative activities by 3-(4, 5-dimethylthiazol-2-yl)-2, 5 diphenyltetrazolium bromide (MTT) assay, clonogenic and cell migration assays. The total phenolic content (TPC) and total flavonoid content (TFC) were quantified by Folin-ciocalteu and Aluminium chloride assays respectively. Caspase 3 activation was evaluated using Caspase-3 Assay Kit. Apoptosis detection by flow cytometry was carried out using annexin V-FITC/PI apoptosis detection kit. The apoptotic cells were also visualized by Giemsa and 4′,6-Diamidino-2-phenylindole (DAPI) staining. The intracellular Reactive oxygen species (ROS) generation was also evaluated using fluorescent probe 2′,7′-dichlorodihydrofluorescein di-acetate (H2DCFDA) in flow cytometry. The combination effects of AHL with chemotherapeutic drugs 5FU and Cisplatin were also evaluated. The identification of phytochemical constituents of AHL were analysed by HR-LCMS. ResultsThe AHL induced cytotoxic activity significantly in HCT-116 with IC50 of 65.65 ± 2.10 μg/mL, but non-cancerous cell HeK-293 was least cytotoxic. Colony formation and cell migration were inhibited in a dose and time dependent manner. The cell morphology upon AHL treatment was significantly altered with apoptotic features. The extract was rich in total phenolic (82.09 ± 0.35mgGAE/g) and total flavonoid (58.31 ± 0.55 mgQAE/g) contents. AHL induced apoptosis as detected by AnnexinV/PI, via activation of caspase 3 and elevated production of Reactive oxygen species (ROS). AHL in combination with 5FU and Cisplatin acts synergistically and potentiates the therapeutic properties of the extract. Sesquiterpenes, phenolic as well as flavonoid derivatives with anticancer properties were detected in AHL by HRLCMS, and these phytoconstituents may be attributed for anticancer property of AHL. ConclusionThe present study evaluates the effectiveness of AHL against Colorectal cancer cell lines. AHL is cytotoxic and induces apoptosis in HCT-116 cells by caspase 3 activation and increased ROS production that can be attributed to sesquiterpenoids. Thus, the plant A. adenophora has therapeutic potential for Colorectal cancer and can be further exploited for developing anticancer drug.

A woman with Clostridium tetani infection and metastatic breast cancer: A case report

Tetanus could be a genuine and possibly dangerous neurological infection caused by the tetanus poison delivered by the bacterium Clostridium tetani. Infection occurs through contaminated wounds, burns, surgical wounds, and insect bites. Related symptoms include muscle spasms, autonomic instability, and respiratory failure. Complications occur in the form of fractures, sprains, muscle tears, and death. Early diagnosis and prompt treatment are crucial to prevent complications and improve outcomes. Risk factors for tetanus infection include the lack of routine vaccinations, wound contamination with C. tetani-contaminated soil, and improper hygiene practices during childbirth. We presented a case report of a 32-year-old woman with a history of breast cancer, who developed a rapidly growing and foul-smelling mass. Despite early diagnosis and treatment measures, the patient did not respond to treatment and died due to the severity of mixed infections. The case highlights the importance of early diagnosis, prompt treatment, and routine vaccinations to prevent complications and improve outcomes in tetanus infection.

A Review on Pharmacological and Therapeutic Aspect of Shirishadi Agada w.s.r. Vishachikitsa

In Agadtantra many Jangam (animal poison) and Sthawar visha (plant poisoning) are described and in treatment of Visha many Agada are described. Agad means drug or formulation of drug which act against poisons or neutralize the poisoning effects. Keet visha (insect bite) is one of the common poisoning in Jangam visha. In Ayurvedic Samhitas many Agada formulations are described in treatment of Keet visha. Shirishadi Agada is mentioned in treatment of Keet visha (insect bite), Sarp (snake bite), Luta (spider), Mushak (rat poison) and Vruschik visha (scorpion bite) in Ashtang hridayam in Uttarsthana. Shirishadi Agad is herbal formulation contains Shirish, Pippali and Arka. This review is for collective information about therapeutic and pharmacological action of Shirishadi Agada.

International health regulations and pre-travel health practices of international travelers at Nigerian airport: a cross-sectional study

BackgroundInternational Health Regulations (IHR) were developed by the World Health Organization (WHO) to curb the trans-border spread of epidemics. To our knowledge, no airport-based studies have assessed travelers’ health practices against a combination of diseases subject to IHR 2005. Therefore, we aimed to generate and describe the baseline travelers’ pre-travel health practices towards Cholera, Yellow Fever (YF), and Plague at Murtala Muhammed International Airport (MMIA) in Nigeria.MethodsA cross-sectional study was employed to collect data from 486 international travelers using a multistage sampling technique. Pre-travel health practices (a combination of pre-travel consultation, pre-travel vaccination, and preventive measures against insect bites) were assessed using an interviewer-administered questionnaire. Logistic regression models were used to estimates the association between selected variables and pre-travel health practices. Statistical significance level was set at 5%.ResultsA total of 479 complete questionnaires were analyzed. The median age of respondents was 34.0 years Interquartile range (IQR) = 28.0, 44.0). Of the total respondents, 311 (64.3%) were aware of pre-travel health consultation and sources of information, amongst others, including friends/relatives in 180 (37.6%) travelers, social media/internet in 155 (32.4%) travelers, and health professionals in 102 (21.3%) travelers. Two hundred and seventy-one (56.6%) had pre-travel consultation, 156 (32.6%) had YF vaccination, and 226 (47.2%) were prepared to use preventive measures against insect bites. Only 10.6% had good pre-travel practices against the diseases subject to 2 International Health Regulations (IHR). Travelers with bachelor/college degrees, when compared to those with secondary/high education, had 2.91 times higher odds of having good practices when adjusting for other factors (95% C.I: 1.10, 7.70; p < 0.03). Also, those traveling to destinations endemic for YF infection, when compared to those who are not traveling to endemic countries/areas, had 48% lower odds of having good practices after adjusting for other factors (95% C.I: 1.41, 7.77; p < 0.01).ConclusionsOur study revealed a low prevalence of good pre-travel health practices among participants. Educational level and endemicity of YF at the destination were predictors of pre-travel health practices. Introducing topics on travelers’ health into schools’ curriculums may have a ripple positive effect on health practices among international travelers. Also, there is a need for public enlightenment programs on pre-travel health practices using social media platforms.

Wound healing potential of extract from Sambucus nigra L. leaves and its fractions

Ethnopharmacological relevanceSambucus nigra L. (Viburnaceae), commonly known as black elderberry, is a native species throughout Europe and Western Asia. Elderberry leaves have been used in traditional European medicine, mainly externally, to treat skin and mucosal diseases. They are usually used as decoctions for washing hemorrhoids, ulcers, insect bites, wounds, scrapes, and gingivitis. Aim of the studyOur work aimed to scientifically verify the traditional use of the plant material in treating wounds and skin inflammations accompanied by its phytochemical characterization. Materials and methodsThe effect of 70% (v/v) ethanolic extract and its fractions of different polarities on the inflammatory response of cells involved in wound healing (fibroblasts, keratinocytes, and neutrophils) was investigated. In addition, their effect on the migration of keratinocytes to the scratch site in an in vitro wound healing assay and their impact on the activity of the enzymes involved in skin inflammation, were assessed. The chemical composition was analyzed by UHPLC-DAD-MSn, and the structure of the isolated compounds was determined by NMR. ResultsThe supportive effect of the elderberry leaves extract towards wound healing and modulation of the inflammatory response was demonstrated by induction of the keratinocytes. Additionally, the extract was shown to affect the cellular secretion of TNF-α and interleukins -1β, −6, and −8. Examinations of fractionated extract have shown that active principles were mainly contained in dichloromethane fraction. Eleven chemical constituents belonging to flavonoids, cyanogenic glycosides, and lignans were isolated and characterized. ConclusionThe beneficial effect of S. nigra leaves in treating skin diseases has been partially verified and supports its traditional use in skin ailments of different etiologies.

Benign subcutaneous emphysema after insect bite

A 16-year-old girl presented to the emergency department with a several days history of insect bite to the dorsal aspect of the left hand. Initially the swelling was localized to the dorsal hand, over the following four days the swelling became more diffuse involving the whole left forearm, arm, axilla and left hemithorax. She reported no fever.

Coexistence of Granuloma Annulare and Castleman’s Disease: A Case Report

Granuloma annulare (GA) is a self-limited disorder that may present as localized or general. Localized GA, the most common form, presents as an erythematous annular plaque without scale. The generalized form of GA presents as widespread erythematous papules and plaques over the trunk and extremities. A cross-sectional study in the United States found a female to male prevalence ratio of 3:1 with a higher prevalence in the fifth decade of life.1 The etiology of GA is largely unknown; however, a number of potential inciting factors have been reported including viral infections, drug exposure, trauma, and insect bites.&#x0D; Castleman’s Disease is a rare heterogenous lymphoproliferative disorder that encompasses a spectrum of clinicopathologic manifestations. Unicentric disease affects one lymph node or chain of lymph nodes with primarily hyaline vascular changes. The multicentric form affects multiple chains of lymph nodes with primarily plasmacytic changes. The pathogenesis is related to hypercytokinemia due to dysregulated interleukin-6 (IL-6) activity in unicentric disease and dysregulated IL-6 and human herpes virus-8 in multicentric disease.&#x0D; We report a case of concomitant granuloma annulare and Castleman’s Disease.

An Ill-bred Culture of Experimentation: Malaria Therapy and Race in the United States Public Health Service Laboratory at the South Carolina State Hospital, 1932-1952

Abstract While most are aware of the Tuskegee syphilis experiments in which African American syphilis patients went untreated, less is known about experiments with malaria fever therapy conducted upon syphilis patients during the same period by the Unites States Public Health Service at the Williams Laboratory on the grounds of the South Carolina State Hospital (SCSH) in Columbia, SC. Over a twenty-year period, physicians maintained patients as malaria reservoirs for patient-to-patient inoculation and subjected patients to extreme fevers and thousands upon thousands of insect bites as part of a program in which one disease was tested as therapy for another. Using extant administrative files, medical journals from the period, and a database created from SCSH annual reports, this paper considers the ethics of malaria fever therapy experiments while exposing the conditions under which patients suffered the intersecting oppressions of race, class, and mental illness. It illuminates the prevalent scientific racism of the period that enabled pseudo-medical assumptions about African Americans’ perceived penchant for poverty, deviant sex, and pain tolerance, which combined to enable a culture of experimentation that influenced events at Stateville Penitentiary and continued long after penicillin became widely available.

Efficacy and Safety of Makabuhay (Tinospora rumphii) 25% Cream Versus Hydrocortisone 1% Cream in the Management of Mosquito Bite Reactions: Randomized Double-Blind Controlled Trial.

Most insect bite reactions resolve spontaneously, but the inflammation and pruritus induced have been shown to decrease the quality of life. Previous studies have shown the potential anti-inflammatory properties of Tinospora rumphii. The aim of the study is to assess the efficacy and safety of T rumphii 25% cream versus hydrocortisone 1% cream in the management of local cutaneous reactions caused by mosquito bites. This study was a parallel-group, double-blind, randomized, placebo-controlled trial with a 1-week duration in a span of 3 months (June 2019 to August 2019). Participants were exposed to sterile noninfectious mosquitoes (Aedes aegypti) for 5-10 minutes to elicit cutaneous lesions. Tinospora 25% cream or hydrocortisone 1% cream was applied twice daily throughout the 7-day study period. Of the 70 participants screened for this study, which was approved by an institutional review board (IRB 2019-07) at the Dermatology Outpatient Department of the Research Institute for Tropical Medicine, Alabang, Muntinlupa, Philippines, 58 participants in total met the inclusion criteria and were randomized to treatment (Tinospora: n=29) and active control (hydrocortisone: n=29) groups. In total, 58 participants were randomized to receive Tinospora cream (n=29) or hydrocortisone cream (n=29). All participants completed the follow-up. There was a significant decrease in lesion size in both groups from the first 15 minutes to day 7 (P<.001). Comparing the lesion size in both groups, there was a statistically significant decrease in lesion size in the first hour (P=.003) and after 24 hours (P=.03). On day 1, 10% (n=29) of participants in the hydrocortisone group and 7% (n=29) in the Tinospora group experienced complete resolution. On day 3, all participants experienced complete resolution. No adverse effects were documented. Tinospora 25% cream is safe, effective, and comparable to hydrocortisone 1% cream as an anti-inflammatory agent for mosquito bite reactions based on the decrease in lesion size, the proportion of participants with complete resolution of wheals, and improvement in pruritus intensity score using a visual analog scale. Long-term safety studies are recommended. Philippine Health Research Registry PHRR230716-005932; https://www.herdin.ph/index.php/registry?view=research&layout=details&cid=5932.

Abstract 16036: Concomitant Culture-Negative Left-Sided Native Valve Endocarditis With Splenic Emboli and Babesiosis: A Case Report

Description of Case: A 76-year-old man with type 2 diabetes and a previously drained hepatic abscess presented with 3 days of fevers and chills associated with dizziness, weakness, and fatigue after hiking at a New York State Park. He denied any shortness of breath, chest pain, abdominal pain, diarrhea, skin rashes, insect bites, IV drug use, recent travel or sick contacts but reported having dental work one month prior to admission. Initial vital signs were notable for a fever of 38.4°C with a blood pressure of 145/76, heart rate of 90, and physical examination was unremarkable. Extensive laboratory studies were drawn, which initially were notable for normocytic anemia, thrombocytopenia, low haptoglobin and elevated lactate dehydrogenase. Empiric antibiotics were initiated as the patient met criteria for systemic inflammatory response syndrome (SIRS). CT abdomen and pelvis was remarkable for right-sided spleen with polysplenia and multiple peripheral wedge-shaped splenic infarcts. A transthoracic echocardiogram (TTE) was inconclusive for infective endocarditis (IE). A subsequent transesophageal echocardiogram (TEE) showed vegetations on the aortic and mitral valves with mild regurgitation respectively. After cardiothoracic surgery evaluation, he was deemed not a surgical candidate. Blood and urine cultures remained negative, but the Babesia antibodies IgM and IgG antibodies, and Babesia microti PCR was detected. He was started on atovaquone 750 mg twice daily and azithromycin 250 mg once daily for 10 days for babesiosis. He was discharged on vancomycin 1g every 12 hours and ceftriaxone 2g every 24 hours for a total of 6 weeks for empiric IE treatment given splenic emboli. Discussion : We describe a rare case of fever caused by culture-negative mitral and aortic valvular endocarditis with splenic emboli and babesiosis. Recent dental work and hiking outdoors in the Northeast United States of America were the key predisposing factors. Given splenic infarcts, pursuing a TEE was pivotal in ascertaining the diagnosis. The patient received empiric IE treatment for gram-positive cocci, HACEK organisms and babesiosis with improvement of symptoms. Identifying and treating unusual causes of fever and SIRS are crucial in reducing mortality and morbidity.

Atropine and Kounis syndrome, a rare association mimicking ST segment elevation myocardial infarction in a young patient: A Case Report

Kounis syndrome is a hypersensitivity acute coronary disorder which occurs with allergic reaction with drugs, food and insect bite. Atropine is rarely found to be reported with such allergic reactions in the literatures. In this report, we describe a case of a 25 years old male, with a background history of psychotic disorder and cannabis dependent syndrome with persistent bradycardia. When challenged with atropine he developed chest pain, shortness of breath and urticarial rash. ECG showed ST segment changes which settled after symptomatic management. Coronary angiogram revealed normal coronary arteries. Though uncommonly reported, it is one of the confusing and underdiagnosed serious conditions for treating physicians which can potentially mimic ST segment elevation myocardial infarction.

Perceptions of Problems with Household Insects: Qualitative and Quantitative Findings from Peri-Urban Communities in Arequipa, Peru.

Vector-borne diseases continue to impose a major health burden on Peru and neighboring countries. The challenge of addressing vector-borne disease is compounded by changing social, economic, and climatic conditions. Peri-urban Arequipa is an important region to study insect infestations because of ongoing challenges with disease vectors such as triatomines and a variety of other insects. We conducted surveys (N = 1,182) and seven focus groups (average seven participants) in peri-urban Arequipa to explore knowledge of and perception toward various insects that infest the region. Focus group participants reported the presence of a wide variety of insects in and around the home, including disease vectors such as triatomines (also identified by 27.2% of survey households), mosquitoes, spiders, and bed bugs, as well as nuisance insects. Health concerns related to insects included vector-borne diseases, spider bites, allergies, and sequelae from bed bug bites, and hygiene concerns. A majority of participants in the quantitative surveys identified triatomines as the insect they were most worried about (69.9%) and could identify Chagas disease as a health risk associated with triatomines (54.9%). Insect infestations in peri-urban Arequipa present multiple burdens to residents, including injury and illness from triatomines and other insects, as well as potential mental and economic concerns related to insects such as bed bugs. Future initiatives should continue to address triatomine infestations through educational outreach and implement a more holistic approach to address the burden of both disease and nuisance insects.

A Review on Topical GEL Formulation for Psoriasis Treatment

According to the research Psoriasis disease is widely show in human at recent now, this is a long term disease it is triggered by the genetic issue, bed habit such as smoking, drinking, drug addiction etc. and some long term medication, insect bite etc. it can be affecting adult, child or old age people also. Now days latest research we have lot of option in drug or dosage form. In the topical dosage form GEL dosage form is the best option because of their application or improves patient compliance. It is big option for those drugs who had a problem with solubility with the dosage form. In the gel any drug can be easily incorporated. GEL can be easily applied or removed form skin by the single wash, their no extra afford need to rubbed on skin as compare other dosage form only just make single thin layer of skin. It also the problem with children dosing. Drug can be shows better effect on penetration on skin, and also increase bioavailability of drug. There is no adverse effect or using humectant cool the skin and relief form pain and itchy dry skin.

A Clinical Study of Allergy and COPD Correlation With Spirometric and FENO Evaluation

Occurrence of allergies &amp; asthma increased in India and may be the top public health concern. The risk of allergies and other allergic diseases might grow with on-going exposure to allergens. There are various unusual allergies, including natural rubber latex, pollen, dust, medications (including antibiotics), food, fungus spores, insect and mite excrement, insect bites and stings (and their venom). The not unusual allergens which might be chargeable for respiratory troubles have been diagnosed after a sincere attempt. A take-look study was conducted on one hundred fifteen patients to assess hypersensitivity and COPD correlation. Their medical histories have been accrued to examine whether or not they were exposed to unique allergens or no longer in the past. All the individuals underwent a Skin Prick Test (SPT) with selected allergens to assess allergens exposure. Patient's Spirometry and FENO check statistics were collected for COPD prognosis. Most COPD patients showed mild to extreme allergic reactions to various allergens.

Allergen Specific Immunotherapy (AIT)

Allergic/atopic patients do not develop immune tolerance to certain substances in the environment which are harmless to non-allergic individuals. These patients are hypersensitive to these substances-allergens. Specific Allergen Immunotherapy (AIT), also known as Allergy Shots or Desensitization, is a therapeutic approach used to treat allergic conditions, such as allergic rhinitis, allergic asthma, and insect sting allergies. The primary goal of AIT is to reduce the allergic response to specific allergens by gradually exposing the patient to increasing doses of the allergen over time. This exposure helps the immune system build tolerance to the allergen, leading to a decrease in allergic symptoms and a long-term improvement in clinical outcomes. Research has confirmed the long-term clinical efficacy of AIT, and its ability to induce antigen-specific tolerance. In this review, we aim to discuss the immunological mechanisms involved in different types of AITs, their efficacy and safety.

An evaluation of video-prompting procedures via telehealth to teach first aid skills to children with intellectual and developmental disabilities.

Unintentional injuries are one of the leading causes of morbidity and mortality among children with intellectual and developmental disabilities (IDD). First aid training involves teaching critical first aid skills, some of which are designed to treat unintentional injuries. To date, no study has (a) evaluated the effects of a video-prompting procedure to teach first aid skills to children with IDD or (b) attempted to teach these skills to children by using a telehealth delivery format. We used a concurrent multiple-baseline-across-skills design to evaluate the efficacy of a video-prompting procedure via telehealth to teach five children with IDD to perform first aid on themselves for insect stings, minor cuts, and minor burns under simulated conditions. For all participants, our procedure produced large improvements that maintained for a minimum of 4 weeks. Furthermore, the effects of the training generalized to novel confederates for all participants, and these effects maintained for a minimum of 4 weeks.

Repellent effect of two anthranilates against the tropical bed bug Cimex hemipterus (Hemiptera: Cimicidae) demonstrated in laboratory assays.

The bites and blood sucking of bed bugs (Cimex spp.) (Hemiptera: Cimicidae) pose a serious threat to human physical and mental health. Application of an effective repellent can prevent or reduce bed bug bites. Previous studies on repellent screening mainly focused on Cimex lectularius L. In this study, we investigated the repellent effect of two safe food additives, ethyl anthranilate (EA) and butyl anthranilate (BA), against Cimex hemipterus (F.), and also explored the role of antennae and mouthparts on C. hemipterus perception of repellents. Both EA and BA had a strong repellent effect against tropical bed bugs and their repellency was similar or lower than that of N,N-diethyl-3-methyl benzoyl amide, depending on whether or not a CO2 source was present. EA had higher repellency than BA and exhibited repellency to C. hemipterus for 3 days when a CO2 source was present. C. hemipterus avoided resting on 20% EA- and BA-treated harborages. Applying 20% EA and BA on rabbit skin significantly reduced the blood intake of C. hemipterus within 2 h. C. hemipterus could perceive EA and BA after their antennae or mouthparts or both antennae and mouthparts were removed. Both EA and BA had strong repellency against C. hemipterus, with EA being more repellent. Ablation of antennae and mouthparts did not affect the perception of EA and BA by C. hemipterus. © 2023 Society of Chemical Industry.

Knowledge and sources of information on COVID-19 among children in Ghana

The few works on COVID-19 in Ghana have a strong emphasis on the knowledge, attitudes, and practices of adults regarding the disease. As a supplement to the inadequate knowledge, this study examined children’s knowledge and sources of information regarding COVID-19. It was a cross-sectional study that employed mixed research methods for data collection and analysis. The study utilized remote research methods, including a web survey and phone interviews, for data collection from a sample of 385 children in two COVID-19 hotspot cities, Accra and Tema, in Ghana. The results show that almost all children sampled were aware of COVID-19. The qualitative aspects, however, reveal that some children do not have accurate knowledge about the causes and prevention of the virus and disease. This is evident from some children’s claims that bacteria, mosquitoes, and insect bites are the causes of the transmission of the virus and disease. The study reveals the internet, social media, and television are the most common methods for children to learn about COVID-19. The findings also show differences in the information sources across the major subgroups of sex, age, and educational attainment. The study further concludes that precautions should be taken by parents and carers regarding information consumed by children on social media. Hence, there is a need for the government and its partners to increase educational drives aimed at strengthening children’s knowledge about the transmission and prevention of the virus in educational institutions and in settings where children and young people are the dominant groups.

Hypersensitivity reactions amongst Hungarian Patients with Hereditary Angioedema due to C1-Inhibitor Deficiency

BackgroundIn hereditary angioedema (HAE) due to C1-inhibitor deficiency (C1-INH-HAE), bradykinin-mediated submucosal and/or subcutaneous angioedema dominates the clinical picture. The deficiency of C1-inhibitor can lead to the over-activation of the complement system. Complement plays an important role in all types of hypersensitivity reactions. On the other hand, during the degranulation of mast cells, heparin is also released amongst other substances. Heparin can activate the plasma kinin-kallikrein system, leading to bradykinin generation. These observations suggest a possible connection between C1-INH-HAE and mast cell-mediated hypersensitivity reactions. ObjectiveTo assess the occurrence of hypersensitivity reactions in the Hungarian C1-INH-HAE population. MethodsPatients filled out a questionnaire of 112 questions, either online or on paper. The questions were about hypersensitivity and C1-INH-HAE symptoms, the relation between these 2, general health, and demographic data. The study protocol was approved by the institutional review board of Semmelweis University, Budapest, and informed consent was obtained from the participants. ResultsOne hundred and six patients (64 female, 42 male, median age 46 years) responded, with 63.2% having hypersensitivity. Hypersensitivity was provoked by pollen in 25.5% of patients, by contact sensitivity in 22.6%, by food in 21.7%, by insect sting in 19.8%, by pet in 15.1%, by drug in 14.2%, by dust mite in 5.7%, and by mold in 1.9%. In 11 patients, hypersensitivity symptoms appeared after the diagnosis of C1-INH-HAE. Six hypersensitive patients experienced improvement in their symptoms; 42 remained the same, but none experienced worsening after the diagnosis of C1-INH-HAE. In 7.8% of the hypersensitive patients, a C1-INH-HAE attack worsened the hypersensitivity symptoms, while 15.7% of the hypersensitive patients experienced a C1-INH-HAE attack provoked by contact with the provoking factor. ConclusionWhile 63.2% of our C1-INH-HAE patients have reported hypersensitivity symptoms, Eurostat's latest data puts the prevalence of self-reported allergies in Hungary at 19.3%. Since in our experience most Hungarian patients report hypersensitivity reactions as allergies, this may support a possible connection between the 2 diseases, but further molecular studies are needed.