Endemic Viral Infections Research Articles

First detection and impact of bovine herpesvirus type 4 on dairy cattle reproduction in Thailand

Background and Aim: Postpartum reproductive tract infections pose significant challenges to dairy farms, leading to economic losses due to reduced fertility associated with uterine inflammation. In veterinary practice, numerous research groups have explored the underlying causes of subfertility in cows, including surveying endemic viral infections related to endometritis in local areas. This study investigated bovine herpesvirus 4 (BoHV-4) infection in Thai dairy herds and assessed its impact on endometritis and subsequent reproductive outcomes. Materials and Methods: The present study analyzed BoHV-4 DNA in various samples, including milk, blood, and endometrial tissue, from 44 Holstein-Friesian cows 21–47 days postpartum across five dairy herds in Central Thailand. BoHV-4 glycoprotein B and thymidine kinase DNA sequences were detected using the polymerase chain reaction (PCR) and nested PCR, with sequence comparisons made to GenBank data for phylogenetic analysis. The endometritis status was diagnosed through vaginal mucus examination and endometrial cytology, with reproductive performance monitored up to the subsequent calving. Results: BoHV-4 DNA was identified in blood and endometrial tissues (15.91%) but not in milk samples. Phylogenetic analysis revealed that the local BoHV-4 strains are similar to those identified in Brazil and Japan. Notably, the presence of BoHV-4 was correlated with reduced postpartum reproductive performance, particularly extending the interval from calving to the first service. Conclusion: Our findings underscore the importance of integrating BoHV-4 genomic surveys and uterine health assessments to refine reproductive management strategies within the dairy industry. Keywords: bovine herpesvirus-4, dairy cattle, endometritis, phylogenetic analysis, reproductive performance, Thailand.

Endemic viral infections in immunocompromised hosts: Dengue, Chikungunya, Zika.

Arbovirus infections are a challenge for immunocompromised hosts who travel to or live in endemic regions or who receive organs or tissues from donors who travel or live in such areas. This review addresses Dengue (DENV), Chikungunya (CHIKV), and Zika (ZIKV) infections in hematological patients, hematopoietic cell or solid organ transplant recipients, and people with HIV (PWH). Transmission is mainly due through Aedes mosquito bite. DENV and ZIKV may also be transmitted through blood, tissues or donor grafts. Clinical manifestations are quite similar and diagnosis requires laboratory confirmation to provide appropriate management. The best diagnostic method is PCR since serology may present false negative results in immunocompromised patients, or cross-reactivity as in the case of DENV and ZIKV. There is no specific treatment for any of these infections. Educational and preventive measures are the best strategy: vector control, knowledge of the vector's habits, protection against mosquito bites, avoiding travel to endemic areas or with a current epidemic, and avoiding nonvector transmission according to local recommendations for donor deferral. Vaccination, currently only available for DENV, has not yet been studied in immunocompromised patients and is not currently recommended.

186 Outbreak of Bacterial Subdural Empyema in Pediatric Patients After Relaxation of COVID-19 Non-pharmaceutical Interventions (NPIs)

INTRODUCTION: Non-pharmaceutical interventions (NPIs), in response to the COVID-19 viral pandemic altered viral transmission. In addition, endemic viral strains (influenza, RSV, etc) also experienced unprecedentedly low infection rates. Endemic viral infections typically followed seasonal outbreak spikes, but these spikes were noticeably absent in the COVID-19 control period. After many COVID-19 restrictions were ceased, there was an unusually high spike in endemic viral infections. Many COVID-19 measures were relaxed in the early/middle part of 2021, and we noted a sharp increase in post-viral, complicated sinusitis/subdural empyema cases. METHODS: Data collection was via retrospective chart review of subdural empyema cases at our institution. “Post-viral” was defined as positive viral test or VURI symptoms within 30 days. RESULTS: Our group previously published our case series on the management of subdural empyema. That served as an historical cohort of 16 patients and 23 procedures over an 8 year period (July 2013-June 2021). During the previous academic year, July 2021 to June 2022, there were a total of 14 patients and 19 surgeries, which nearly doubles the previous 8 years combined. The current academic year (to date) has had 9 empyema patients and 12 surgical cases. 100% of patients in the previous 2 years has had historical symptoms of viral URI symptoms or positive viral URI testing within 30 days. None were documented positive for COVID-19. In less than 2 years since many NPIs were lifted, post-viral, bacterial empyema cases have increased dramatically by a fold of 2.56. CONCLUSIONS: NPIs may have created an endemic viral “immunity gap” and an immunologically susceptible population, and thereby could have contributed to a sharp increase in bacterial subdural empyema.

Opportunities and challenges for the application of artificial intelligence paradigms into the management of endemic viral infections: The example of Chronic Hepatitis C Virus

AbstractDespite the advent of direct‐acting antiviral agents (DAAs) as a definitive therapy for chronic hepatitis C virus (HCV) infection, the burden of the disease remains globally elevated. The emerging big data on different HCV paradigms fostered the introduction of artificial intelligence/machine learning (AI/ML) applications to help decrease that burden by providing more optimised strategies for early diagnosis and treatment prioritisation. The current review provides descriptive and analytical insight into the recently published AI/ML applications in five medical aspects of HCV infection. In addition, it highlights the opportunities these powerful tools offer in designing national health policies that prioritise HCV patients for the costly DAAs and developing broadly neutralising HCV antibodies. Finally, this paper highlights the challenges encountered in developing and applying these AI/ML models to clinical practice and suggests schemes to overcome some of them. The presented models were primarily evaluated using the Matthews correlation coefficient and the F1‐score to make a more reliable inference about their predictive power under imbalanced datasets. Many published AI/ML applications offered great utilities for predicting novel HCV treatments and prioritising patients for DAAs receipt, especially in settings of limited resources and high HCV burden. Some outperformed the classical diagnostic tools, such as third‐generation serological tests, alpha‐fetoprotein, and ultrasound, in detecting HCV infections and early HCV‐associated hepatocellular carcinoma, respectively. However, further statistical and clinical validation of AI/ML models is highly advocated before incorporating these applications into clinical practice.

Feline Morbillivirus: Clinical Relevance of a Widespread Endemic Viral Infection of Cats.

Feline morbillivirus (FeMV) was first isolated in 2012 from stray cats in Hong Kong. It has been found in association with tubulointerstitial nephritis (TIN), the most common cause of feline chronic kidney disease (CKD). However, viral host spectrum and virus tropism go beyond the domestic cat and kidney tissues. The viral genetic diversity of FeMV is extensive, but it is not known if this is clinically relevant. Urine and kidney tissues have been widely tested in attempts to confirm associations between FeMV infection and renal disease, but samples from both healthy and sick cats can test positive and some cross-sectional studies have not found associations between FeMV infection and CKD. There is also evidence for acute kidney injury following infection with FeMV. The results of prevalence studies differ greatly depending on the population tested and methodologies used for detection, but worldwide distribution of FeMV has been shown. Experimental studies have confirmed previous field observations that higher viral loads are present in the urine compared to other tissues, and renal TIN lesions associated with FeMV antigen have been demonstrated, alongside virus lymphotropism and viraemia-associated lymphopenia. Longitudinal field studies have revealed persistent viral shedding in urine, although infection can be cleared spontaneously.

Learn the Past and Present to Teach the Future—Role of Active Surveillance of Exposure to Endemic and Emerging Viruses in the Approach of European Bison Health Protection

As the population size of free-living European bison in Poland has increased significantly over the last few years, conservation and management should be reconsidered to face new challenges, which aim to protect the whole population, not just individuals. The aim of our study was to analyse prevalence and identify risk factors for infections with viruses affecting reproduction (BVDV, BoHV-1, and BoHV-4), causing respiratory diseases (BRV3, BAdV-3, and BRSV), and emerging vector-borne viruses (BTV and SBV). Over 600 serum samples used in serology and 270 lung tissue samples, and 284 nasal swabs used in virological tests were collected from 24 free-living and captive European bison herds between 2016 and 2023. The seroprevalences varied between low (0.3–6.1% for BVDV, BoHV-1, and BoHV-4), medium (15.9% for BRSV and 22.1% for BTV) and high (43.3% for BRV3, 59.5% for BAdV-3, and 69.5% for SBV). Interspecies’ and intraspecies’ risk of endemic viral infections was observed to be density-dependent, while the effect of anthropogenic factors on the spread of infections in free-living European bison has not been demonstrated. BTV is no longer circulating, while SBV has become endemic. The higher exposure to viruses in the European bison eliminated on the basis of a veterinary decision indicates the importance of an expert supervision for disease control and prevention.

Vector-borne Endemic Viral Infection in Antalya Region: Sandfly Fever

Objective: Sandfly fever (SF) is a self-limited vector-related viral infection caused by the SF virus and is spread by phlebotomine sandflies (PSF). Fever, headache, myalgia, arthralgia, loss of appetite, weakness, nausea, and vomiting are the most common symptoms. Laboratory findings include leukopenia, thrombocytopenia, and elevated liver transaminase enzymes. We aimed to examine the demographic, clinical, and laboratory data of patients who were followed with SF diagnosis. Methods: Patients who were followed with SF diagnosis in our hospital between January 2011 and December 2018 were included. The data were obtained retrospectively. Results: A total of 64 patients were included in the study. The mean age was 33.1 ± 9.7(min:19-max:58) years and 35(54.7%) of them were male. Although 53.1% had a history of contact with PSF, 92.2% had a bite mark. 91.6% of the patients were living on the ground and first floor. Fever was the most common symptom in 95.3% of the patients; 89% had myalgia-weakness, 79.6% had a headache, and 50% had a conjunctival rash. Increased transaminase enzyme levels were observed in approximately 93% of the patients. The average of ALT and AST were 284.7 U/L and 243.5 U/L, respectively. Leukopenia was observed in 79.6% (51/64) of them, and thrombocytopenia in 78% (50/64). CK elevation was 54% ratio (35/64). Samples were tested from 19 patients for the serological diagnosis of SF. IgM was positive in 15 (78.9%) of 19 patients and negative in 4(21%) patients. IgG was positive in 10 (52.6%) of 19 patients. Both IgG and IgM were positive in 9 patients. Only IgG positivity was detected in one patient. Conclusion: SF should be considered in patients presenting with complaints such as fever, headache, muscle joint pain, nausea-vomiting, redness in the eyes, leukopenia, thrombocytopenia, elevated transaminase enzyme, CK level, and living in or having a history of travel to subtropical regions, especially during the summer season and a history of PSF contact.

Understanding the Biology and Immune Pathogenesis of Chikungunya Virus Infection for Diagnostic and Vaccine Development.

Chikungunya virus, the causative agent of chikungunya fever, is generally characterized by the sudden onset of symptoms, including fever, rash, myalgia, and headache. In some patients, acute chikungunya virus infection progresses to severe and chronic arthralgia that persists for years. Chikungunya infection is more commonly identified in tropical and subtropical regions. However, recent expansions and epidemics in the temperate regions have raised concerns about the future public health impact of chikungunya diseases. Several underlying factors have likely contributed to the recent re-emergence of chikungunya infection, including urbanization, human travel, viral adaptation to mosquito vectors, lack of effective control measures, and the spread of mosquito vectors to new regions. However, the true burden of chikungunya disease is most likely to be underestimated, particularly in developing countries, due to the lack of standard diagnostic assays and clinical manifestations overlapping with those of other endemic viral infections in the regions. Additionally, there have been no chikungunya vaccines available to prevent the infection. Thus, it is important to update our understanding of the immunopathogenesis of chikungunya infection, its clinical manifestations, the diagnosis, and the development of chikungunya vaccines.

Identification of Novel Reassortant Shuni Virus Strain in Clinical Cases of Israeli Ruminants, 2020-2021.

The Shuni virus (SHUV) causes an endemic viral infection in Israel and South Africa. It belongs to the Simbu serogroup within the order Bunyavirales, family Peribunyaviridae, genus Orthobunyavirus. Recently, it has been identified in aborted cases of domestic ruminants, young cattle and horses manifesting neural signs and acute death, symptomatic cows, and in carcasses of wild animals. Moreover, SHUV was isolated and identified in humans. In this study, we describe clinical cases of SHUV infection in Israeli domestic ruminants in 2020–2021, which represented clinical manifestations of simbuviral infection including abortions, a neural lethal case in a fattening calf, and an acute symptomatic case in a beef cow. In all cases, SHUV was confirmed by complete or partial viral genome sequencing. There is a significant difference of M and L segments of the novel strains compared with those of all known SHUV strains, while the S segments have more than 99% nucleotide (nt) identity with Israeli and African “Israeli-like” strains previously circulated in 2014–2019. This indicates a reassortment origin of the strain. At the same time, M and S segment nt sequences showed about 98–99% nt identity with some South African strains collected in 2016–2018. Nevertheless, the viral origin and the geographical place of the reassortment stayed unknown.

Pandemic, Epidemic, Endemic: B Cell Repertoire Analysis Reveals Unique Anti-Viral Responses to SARS-CoV-2, Ebola and Respiratory Syncytial Virus.

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.

A Silver Lining in a Dark Cloud? Pandemic Hospitalizations in Children With Medical Complexity.

A Silver Lining in a Dark Cloud? Pandemic Hospitalizations in Children With Medical Complexity.

Awareness and Practice of Lassa Fever Prevention among Health Workers in a Tertiary Health Facility in a Southern Nigerian City

Background: The Lassa fever outbreak has claimed the lives of numerous healthcare personnel in recent years and this reflects the poor infection prevention control practices and ill-preparedness for such contagious epidemic. Objective: The aim of the study was to assess the knowledge and quality of practice with regard to prevention of Lassa fever transmission among health workers. Methods: In this cross sectional study 230 health workers including intern nurses & doctors were assessed using pretested self- administered questionnaire adopting the WHO & Nigerian Centre for Disease and Control (NCDC) recommended prevention protocols against the deadly virus. Data were analyzed using Statistical Package for Social Science version 25. Results: Two hundred and twenty-four completed questionnaire (97.4% response rate) were analyzed. A vast majority 172 (76.8%) possessed satisfactory knowledge about Lassa fever transmission and infection prevention whereas only 77(44%) actively practiced the recommended protocols for infection prevention against Lassa fever virus satisfactorily. In the regression analysis, duration of service was the only significant factor positively associated with satisfactory knowledge on Lassa fever infection prevention (X 2 9 (0.05) = 19.559, P value= 0.001) . Almost all the participants practiced hand washing before and after attending to patients. However, only 1.34% of the respondents utilized full personal protective equipment (PPE) kits consistently while attending to high risk patients. Overall, their infection preventive practices were not significantly influenced by their occupation designation (P=0.586), duration of service or training in years and demographic profile such as: gender (P=0.118), age (P=0.840), marital status (P=0.819) and residing in urban area (P = 0.561). There was a weak positive correlation between knowledge scores and practice scores (r=0.137). Conclusion: It is recommended that the standard infection prevention practice protocols be adopted consistently in caring for patients with suspected or confirmed endemic viral infection like Lassa fever. Hospital management and policy makers should provide adequate PPE to minimize nosocomial infection in healthcare workers. Regular hospital-based seminars on infection prevention is recommended. Keywords: Nosocomial infection, hand washing, personal protective equipment, healthcare workers, endemic viral infection. DOI: 10.7176/JEP/13-7-08 Publication date: March 31 st 2022

Viral Ecology and Natural Infection Dynamics of Kaeng Khoi Virus in Cave-Dwelling Wrinkle-Lipped Free-Tailed Bats (Chaerephon plicatus) in Thailand.

Kaeng Khoi virus (KKV; Order: Bunyavirales), is an endemic viral infection of the wrinkle-lipped free-tailed bat (Chaerephon plicatus aka Tadarida plicata plicata). Little is known about the ecology and maintenance of KKV within the bat population, nor the infection dynamics and transmission among bats or between bats and other vertebrates. Therefore, KKV was studied in Kaeng Khoi cave, Saraburi province, Thailand, during 1973–1974 with the objectives to (1) characterize the seasonal infection rates of KKV in the context of the bat population ecology, and (2) describe the infection dynamics and viral shedding by naturally- and experimentally-infected bats. To this end, the free-tailed bat population was estimated by a series of timed photographs taken during the evening exodus. The case population of 900,000 adult bats doubled at the time of weaning of the young and returned to its previous level soon thereafter. The newborn bats had neutralizing antibodies to KKV that were likely to be maternal in origin. The KKV antibody prevalence in adult bats was high (69–91%) in March–May and low (29–40%) in August and September. Kaeng Khoi virus was isolated from 75% of dead and 50% of moribund bats, but was not found in nearly 400 apparently healthy bats. Virus was present in saliva, urine and blood of most of the naturally-moribund bats tested. Consistent with observations from naturally-infected bats, experimental infection of bats with KKV revealed significant liver pathology, also suggestive that this is not a benign infection. Kaeng Khoi virus is an endemic, year-round infection maintained by the annual recruitment of a large number of immunologically-naïve juvenile bats. Moreover, it produces an acute infection in the bat, either leading to death by hepatitis, or immunity.

Investigations on Vector-Borne and Aerosol Transmission Potential of Kaeng Khoi Virus in Cave-Dwelling Wrinkle-Lipped Free-Tailed Bats (Chaerephon plicatus) in Thailand.

Kaeng Khoi virus (KKV; Order: Bunyavirales, Family: Peribunyaviridae, Genus: Orthobunyavirus), is an endemic viral infection of the wrinkle-lipped free-tailed bat (Chaerephon plicatus; also known as Tadarida plicata plicata). Viral isolates from bat bugs (Family: Cimicidae) suggest vector-borne transmission, but in general little is known about the ecology of KKV and seroprevalence in the local human and animal populations. Transmission studies and a serosurvey were carried out in Kaeng Khoi cave, Saraburi province, Thailand, during 1973–1974. Experimental transmission studies were performed with bat bugs captured within the cave to determine the potential for vector-borne transmission, and sentinel laboratory mice placed inside arthropod-proof cages within the cave to assess the potential for aerosolized transmission. Antibodies to KKV were detected in roof rats (Rattus rattus) inhabiting the cave, in dogs living in the valley, and in humans. Freshly collected cimicids were positive for KKV, but the virus did not replicate in laboratory-inoculated bugs. Sentinel mice placed in Kaeng Khoi cave in open cages consistently became infected with KKV, as determined by the development of neutralizing antibodies. Mice placed in arthropod-proof cages also developed antibodies, indicating the possibility of airborne transmission of KKV.

Genetically Determined Strength of Natural Killer Cells is Enhanced by Adaptive Admixture of HLA class I Allotypes in East <a>Asians</a>

Abstract Human natural killer (NK) cells are essential for controlling infection, cancer and fetal development. NK cell functions are modulated by interactions between polymorphic inhibitory killer cell immunoglobulin-like receptors (KIR) and polymorphic HLA-A, -B and -C ligands expressed on tissue cells. All HLA-C alleles encode a KIR ligand and contribute to reproduction and immunity. In contrast, only some HLA-A and -B alleles encode KIR ligands and they focus on immunity. By high-resolution analysis of KIR and HLA-A, -B and -C genes, we show that the Chinese Southern Han are significantly enriched for interactions between inhibitory KIR and HLA-A and -B. This enrichment has had substantial input through population admixture with neighboring populations, who contributed HLA class I haplotypes expressing the KIR ligands B*46:01 and B*58:01, which subsequently rose to high frequency by natural selection. Consequently, over 80% of Southern Han HLA haplotypes encode more than one KIR ligand. Complementing the high number of KIR ligands, the Chinese Southern Han KIR locus combines a high frequency of genes expressing potent inhibitory KIR, with a low frequency of those expressing activating KIR. The Southern Han centromeric KIR region encodes strong, conserved, inhibitory HLA-C specific receptors, and the telomeric region provides a high number and diversity of inhibitory HLA-A and -B specific receptors. In all these characteristics, the Southern Han represent other East Asians, whose NK cell repertoires are thus enhanced in quantity, diversity and effector strength, likely through natural selection for resistance to endemic viral infections.

Adaptive Admixture of HLA Class I Allotypes Enhanced Genetically Determined Strength of Natural Killer Cells in East Asians.

Human natural killer (NK) cells are essential for controlling infection, cancer, and fetal development. NK cell functions are modulated by interactions between polymorphic inhibitory killer cell immunoglobulin-like receptors (KIR) and polymorphic HLA-A, -B, and -C ligands expressed on tissue cells. All HLA-C alleles encode a KIR ligand and contribute to reproduction and immunity. In contrast, only some HLA-A and -B alleles encode KIR ligands and they focus on immunity. By high-resolution analysis of KIR and HLA-A, -B, and -C genes, we show that the Chinese Southern Han (CHS) are significantly enriched for interactions between inhibitory KIR and HLA-A and -B. This enrichment has had substantial input through population admixture with neighboring populations, who contributed HLA class I haplotypes expressing the KIR ligands B*46:01 and B*58:01, which subsequently rose to high frequency by natural selection. Consequently, over 80% of Southern Han HLA haplotypes encode more than one KIR ligand. Complementing the high number of KIR ligands, the CHS KIR locus combines a high frequency of genes expressing potent inhibitory KIR, with a low frequency of those expressing activating KIR. The Southern Han centromeric KIR region encodes strong, conserved, inhibitory HLA-C-specific receptors, and the telomeric region provides a high number and diversity of inhibitory HLA-A and -B-specific receptors. In all these characteristics, the CHS represent other East Asians, whose NK cell repertoires are thus enhanced in quantity, diversity, and effector strength, likely augmenting resistance to endemic viral infections.

Retrospective Demographic Analysis of Neurovascular Syndrome—Secondary to: A) Endemic Subacute (Fruits Borne) Viral Infection, Consequent to Global Aborted Blood, Contraceptives Menstrual Blood Pollution; B) Consumption of Waterliving Toxinous Mammals

15 patients after the middle of 2018, during the initial onset of the epidemic of identified Nipah viral infection (fruits borne virus) in adjacent state, presented with fever, acute coma, delirium, movement disorders, required referral to district headquarters hospital, for virology confirmation, and management. 135 mostly afebrile patients, who refused referral to government hospital, for virology confirmation, presented with symptoms of mainly subacute pan encephalitis, over the past 14 months; 90% presented with conglomeration of vertigo, staring, personality changes, imbalance in gait, difficulty to walk, bilateral drooling of saliva, tremors, confusion, altered sensorium, nausea, vomiting; 83% presented with dysarthria, 28% presented with symptoms of raised intracranial pressure-mimicking accelerated, malignant hypertensive emergencies, bradycardia, vomiting; decreased vision in 4.6%, myoclonic jerks in 58%, choreoathetosis in 8%. All of them could not afford INR 10000 for virology confirmation. Fruits borne viral subacute pan encephalitis, can present as subacute neurovascular syndrome, simulating ischemic stroke, mediated by Hapten triggered autoimmune angiopathy (blood borne) with resultant bilateral, asymmetrical multifocal, infarcts, cerebritis with consequent edema, requiring recognition, successful treatment with acyclovir, antiedema, antiepileptic measures and not antiplatelets, since the etiology is inflammatory and not degenerative. Promoting awareness to steam cook, pressure cook, cook with coconut oil (pie) fruits, steaming fresh fruit juices, before consumption will prevent incidence of fruits borne, tobacco leaves borne, and endemic viral infection. Economical screening card tests for Nipah fruits borne virus, will enable early detection, authenticate notification, early recognition treatment of subacute pan encephalitis presenting as neurovascular syndrome, mimicking ischemic stroke Global aborted blood pollution, contraceptive menstrual blood pollution, documented by rising environmental estrogen, beta human chorionic gonadotropins, alpha fetoprotein, favours emergence, virulence, drug resistance of microbes, including the recent fruits borne virus; global eradication of contraception, abortion (—non-evidence-based medical practice, without therapeutic indication, therapeutic protocols, therapeutic policies), to be replaced by global baby boom (promoting childbirth >10 - 20 children per family) will prevent further emergence, virulence of microbial infections, including Nipah, oncoming Ebola corona. Over the past 5 years, consumption of water living without scales, gills, fins,-toxin containing mammals, presented as cortical venous, sigmoid sinus thrombosis, in 3.5%, choreoathetosis in 12.5%, unresponsive but restless in 12.5%, quadriparesis, hemiparesis in 37.5% mimicking neurovascular syndrome, ischemic stroke; treatment with methylprednisolone, immunoglobulin reverted.

Infecciones víricas endémicas: dengue,fiebre del Nilo y otras viriasis

We highlight the endemic viral infections caused by Arbovirus, whose clinical manifestations can be categorised into three large syndromes: fever-arthralgia-rash; viral haemorrhagic fever and central nervous system infections (CNS). In this chapter and based on overall worldwide incidence, the likelihood of imported cases and of local transmission, we shall focus on the following viruses: chikungunya, dengue and zika (all of them may present with similar symptoms and arthritis, and they share the same geographic distribution). We would also focus on viruses causing haemorrhagic fevers, of which we will focus on Crimea Congo virus (local cases having recently been described in our country); yellow fever and Ebola virus (the latest due to the growing interest after the recent epidemic that posed a threat to world health), and viruses affecting the CNS (Japanese encephalitis, Central European encephalitis and West Nile fever).

Prevalence of Lassa Virus Disease (LVD) in Nigerian children with fever or fever and convulsions in an endemic area.

BackgroundConvulsions with fever in children are a common neurologic emergency in the tropics, and determining the contribution of endemic viral infections can be challenging. In particular, there is a dearth of data on the prevalence and clinical differentiation of Lassa virus disease (LVD) in febrile children in endemic areas of Nigeria, which has multiple lineages of the virus. The aim of this study was to determine the prevalence and presentation of LVD in febrile children with and without convulsions.Methodology/Principal findingsThis was a prospective study of consecutive febrile children aged ≥1 month– 15 years admitted to the Children’s Emergency Room of Irrua Specialist Teaching Hospital over a period of 1 year. Febrile children with convulsions (Cases) were compared with those without convulsions (Controls). LVD was defined by the presence of a positive Lassa virus RT-PCR test. Rates were compared between groups using χ2 or Fisher’s exact tests and p <0.05 taken as significant. 373 (40.9%) of 913 admissions had fever. Of these, 108/373 (29%) presented with convulsions. The overall prevalence of LVD was 13/373 (3.5%; 95% CI = 1.9%, 5.7%) in febrile admissions, 3/108 (2.8%) in Cases and 10/265 (3.8%) in Controls [(Odds Ratio (95% Confidence Interval) (OR (95% CI)) of LVD in Cases versus Controls = 0.73 (0.2, 2.7)]. Only vomiting (OR (95% CI) = 0.09 (0.01, 0.70)) and bleeding (OR (95% CI) = 39.56 (8.52, 183.7)) were significantly associated with an increased prevalence of LVD.Conclusions/SignificanceLVD is an important cause of fever, including undifferentiated fever in children in endemic areas, but it is not significantly associated with convulsions associated with fever. Its prevalence, and lack of clinical differentiation on presentation, underscores the importance of a high index of suspicion in diagnosis. Screening of febrile children with undifferentiated fever in endemic areas for LVD could be an important medical and public health control measure.

Cloning, expression and characterization of potential immunogenic recombinant hemagglutinin-neuraminidase protein of Porcine rubulavirus

Blue eye disease caused by Porcine rubulavirus (PorPV) is an endemic viral infection of swine causing neurological and respiratory disease in piglets, and reproductive failure in sows and boars. The hemagglutinin-neuraminidase (HN) glycoprotein of PorPV is the most abundant component in the viral envelope and the main target of the immune response in infected animals. In this study, we expressed the HN-PorPV-recombinant (rHN-PorPV) protein in an Escherichia coli system and analyzed the immune responses in mice. The HN gene was cloned from the reference strain PorPV-La Piedad Michoacan Virus (GenBank accession number BK005918), into the pDual expression vector. The expressed protein was identified at a molecular weight of 61.7 kDa. Three-dimensional modeling showed that the main conformational and functional domains of the rHN-PorPV protein were preserved. The antigenicity of the expressed protein was confirmed by Western blot with a monoclonal antibody recognizing the HN, and by testing against serum samples from pigs experimentally infected with PorPV. The immunogenicity of the rHN-PorPV protein was tested by inoculation of BALB/c mice with AbISCO-100® as adjuvant. Analysis of the humoral immune responses in mice showed an increased level of specific antibodies 14 days after the first immunization, compared to the control group (P < 0.0005). The results show the ability of the rHN-PorPV protein to induce an antibody response in mice. Due to its immunogenic potential, the rHN-PorPV protein will be further evaluated in pig trials for its suitability for prevention and control of blue eye disease.