Fever Pattern Research Articles

Clinical profiles and outcomes of dengue fever in hospitalized patients: Insights from Purbanchal University Teaching Hospital

Background: Dengue is a mosquito-borne viral infection that poses a significant health threat, particularly in tropical and subtropical regions. This study aims to assess the risk factors and clinical outcomes of dengue fever in hospitalized patients. Methods: This prospective observational study included 110 patients admitted to Purbanchal University Teaching Hospital between May 2023 and July 2024. Patients were classified into three groups based on clinical and laboratory findings: Group I (Dengue without Warning Signs), Group II (Dengue with Warning Signs), and Group III (Severe Dengue). Clinical history and physical examination data were recorded, and various laboratory tests were conducted. Results: Of the 110 patients, 80.9% were classified as Group II, 15.4% as Group I, and 3.7% as Group III. The majority of patients were male, with a male-to-female ratio of 5:1. The mean age of patients in Groups I, II, and III was 29±6.45, 33.3±9.6, and 25±1.8 years, respectively. All patients experienced sudden onset fever, with varying patterns of fever. Common symptoms included headache (100%), myalgia (96%), and gastrointestinal symptoms, such as nausea, vomiting, and diarrhea. Organomegaly was observed predominantly in Group III patients. Conclusion: This study highlights the importance of recognizing clinical profiles and laboratory findings in diagnosing dengue early to reduce morbidity and mortality associated with severe forms of the disease.

Adult-onset Still’s disease masquerading as acute coronary syndrome: a case report and review of the literature

IntroductionAdult-onset Still’s disease is a rare systemic autoinflammatory disease. We present a case of a young man with a constellation of symptoms and myopericarditis as a complication of this disease.CaseA 36-year-old Hispanic man with no significant past medical history developed a quotidian fever pattern following an upper respiratory tract infection. He initially presented with chest pain concerning for myocardial infarction and underwent cardiac catheterization, which revealed non-obstructive coronary artery disease. He was found to have myopericarditis, significant neutrophilic leukocytosis, and hyperferritinemia. He improved on high-dose corticosteroids but developed steroid-induced psychosis, and 4 months from symptom onset, he finally received tocilizumab, which eventually induced remission without adverse reactions.DiscussionAdult-onset Still’s disease should be considered in a patient with fevers of undetermined origin. Due to its multisystemic involvement, adult-onset Still’s disease is often a diagnosis arrived at after an extensive cardiac, hematologic, malignant, and infectious workup. Imaging, laboratory testing, and bone marrow biopsy were necessary to rule out alternative etiologies of this patient’s presentation. Steroids are the mainstay of treatment because they are easily affordable, although the high risk of adverse effects makes them less desirable. Interleukin-1 inhibitors (anakinra or canakinumab) and interleukin-6 inhibitor tocilizumab are the steroid-sparing biologic agents of choice but are cost-prohibitive.ConclusionAdult-onset Still’s disease should be considered in the differential diagnoses of fever of undetermined origin. Early identification and initiation of treatment are critical to faster recovery and prevention of progression to severe complications. Steroids remain the standard first-line therapy and should be followed by disease-modifying steroid sparing drugs. The social determinants of health may preclude their timely initiation and should alert providers of proactive ways to avoid further delays.

Global patterns of syphilis, gonococcal infection, typhoid fever, paratyphoid fever, diphtheria, pertussis, tetanus, and leprosy from 1990 to 2021: findings from the Global Burden of Disease Study 2021

BackgroundCertain infectious diseases are caused by specific bacterial pathogens, including syphilis, gonorrhea, typhoid and paratyphoid fever, diphtheria, pertussis, tetanus, leprosy, and tuberculosis. These diseases significantly impact global health, contributing heavily to the disease burden. The study aims to thoroughly evaluate the global burden of syphilis, gonorrhea, typhoid and paratyphoid fever, diphtheria, pertussis, tetanus, and leprosy.MethodsLeveraging the Global Burden of Disease (GBD) study 2021, age-specific and Socio-demographic Index (SDI)-specific incidence, disability-adjusted life-years (DALYs), and death for eight specific bacterial infections across 204 countries and territories from 1990 to 2021 were analyzed. Percentage changes in age-standardized incidence rate (ASIR), DALY rate, and mortality rate (ASMR) were also examined, with a focus on disease distribution across different regions, age groups, genders, and SDI.ResultsBy 2021, among the eight diseases, gonococcal infection had the highest global ASIR [1096.58 per 100,000 population, 95% uncertainty interval (UI): 838.70, 1385.47 per 100,000 population], and syphilis had the highest global age-standardized DALY rate (107.13 per 100,000 population, 95% UI: 41.77, 212.12 per 100,000 population). Except for syphilis and gonococcal infection, the age-standardized DALY rate of the remaining diseases decreased by at least 55% compared to 1990, with tetanus showing the largest decrease by at least 90%. Globally, significant declines in the ASIR, age-standardized DALY rate, and ASMR for these eight bacterial infections have been observed in association with increases in the SDI. Regions with lower SDI, such as sub-Saharan Africa, experienced a relatively higher burden of these eight bacterial infections.ConclusionsAlthough there has been an overall decline in these eight diseases, they continue to pose significant public health challenges, particularly in low SDI regions. To further reduce this burden in these areas, targeted intervention strategies are essential, including multi-sectoral collaboration, policy support, improved WASH management, and enhanced research efforts.Graphical

Transmission patterns of malignant catarrhal fever in sheep and cattle in Karnataka, India.

Malignant catarrhal fever (MCF) presents a sporadic yet significant threat to livestock and wildlife. A comprehensive investigation in Karnataka, India into the prevalence and transmission patterns of sheep-associated MCF (SA-MCF) was conducted. A total of 507 sheep peripheral blood leukocyte samples from 13 districts along with 27 cows and 10 buffalo samples from various regions in Karnataka were tested for SA-MCF infection i.e. Ovine gammaherpesvirus 2 (OvHV-2) using heminested PCR. Furthermore, serum samples collected from 73 cows and 15 buffalo suspected of MCF were tested using a commercially available ELISA kit. Additionally, histopathological examinations of affected tissues and phylogenetic analysis of viral tegument protein sequences were conducted. Our findings indicated a 20.11%, 33.33% and 20% positivity for OvHV-2 in sheep, cows and buffalo respectively by PCR. Statistical analysis revealed a significant association between the age of sheep and the detection of OvHV-2. Seven cows and one buffalo serum samples tested positive for ELISA. Clinical findings in bovids were consistent with typical MCF signs, and histopathological results revealed multi-organ involvement characterised by necrotising vasculitis and lymphoid hyperplasia. The nucleotide pairwise identity matrix revealed 99.5% identity between the sequences obtained in the study with sequences from other states. The phylogenetic analysis of partial tegument protein sequences from bovid and sheep samples suggested a close genetic relationship between the local OvHV-2 strains and those from various global regions. Crucially, this study underscores the widespread presence of SA-MCF in Karnataka, with significant implications for both livestock management and wildlife conservation.

Evaluation of the sentinel yellow fever surveillance system in Uganda, 2017–2022: strengths and weaknesses

BackgroundUganda has a sentinel surveillance system in seven high-risk sites to monitor yellow fever (YF) patterns and detect outbreaks. We evaluated the performance of this system from 2017 to 2022.MethodsWe evaluated selected attributes, including timeliness (lags between different critical time points), external completeness (proportion of expected sentinel sites reporting ≥ 1 suspect case in the system annually), and internal completeness (proportion of reports with the minimum required data elements filled), using secondary data in the YF surveillance database from January 2017–July 2022. We conducted key informant interviews with stakeholders at health facility and national level to assess usefulness, flexibility, simplicity, and acceptability of the surveillance system.ResultsIn total, 3,073 suspected and 15 confirmed YF cases were reported. The median time lag from sample collection to laboratory shipment was 37 days (IQR:21–54). External completeness was 76%; internal completeness was 65%. Stakeholders felt that the surveillance system was simple and acceptable, but were uncertain about flexibility. Most (71%) YF cases in previous outbreaks were detected through the sentinel surveillance system; data were used to inform interventions such as intensified YF vaccination.ConclusionThe YF sentinel surveillance system was useful in detecting outbreaks and informing public health action. Delays in case confirmation and incomplete data compromised its overall effectiveness and efficiency.

Viral shedding pattern of severe fever with thrombocytopenia syndrome virus in severely ill patients: A prospective, Multicenter cohort study

BackgroundSevere fever with thrombocytopenia syndrome (SFTS) is spreading rapidly in Asia. The pathway of SFTS virus shedding from patient and specific use of personal protective equipments (PPEs) against viral transmission have rarely been reported. The study was to determine SFTS virus (SFTSV) shedding pattern from the respiratory, digestive and urinary tract to outside in patients. Methods: Patients were divided into mild and severe groups in three sentinel hospitals for SFTS in Anhui province from April 2020 to October 2022. SFTSV level from blood, throat swabs, fecal/anal swabs, urine and bedside environment swabs of SFTS patients were detected by qRT-PCR. Specific PPEs were applied in healthcare workers contacting with the patients who had oropharyngeal virus shedding and hemorrhagic signs. ResultsA total of 189 SFTSV-confirmed patients were included in the study, 54 patients died (case fatality rate, 28.57 %). Positive SFTSV in throat swabs (T-SFTSV), fecal/anal swabs (F-SFTSV) and urine (U-SFTSV) were detected in 121 (64.02 %), 91 (48.15 %) and 65 (34.4 %) severely ill patients, respectively. The levels of T-SFTSV, F-SFTSV and U-SFTSV were positively correlated with the load of SFTSV in blood. We firstly revealed that SFTSV positive rate of throat swabs were correlated with occurrence of pneumonia and case fatality rate of patients (P < 0.0001). Specific precaution measures were applied by healthcare workers in participating cardiopulmonary resuscitation and orotracheal intubation for severely ill patients with positive T-SFTSV, no event of SFTSV human-to-human transmission occurred after application of effective PPEs. ConclusionsOur research demonstrated SFTSV could shed out from blood, oropharynx, feces and urine in severely ill patients. The excretion of SFTSV from these parts was positively correlated with viral load in the blood. Effective prevention measures against SFTSV human-to-human transmission are needed.

Case Report: A rare case of Intracranial tuberculous granuloma (tuberculoma) in a 19-year -old male

A tuberculoma is a clinical sign of tuberculosis that combines tubercles into a solid mass and can resemble several forms of malignant tumors on imaging. They frequently develop in people whose original tuberculosis infection is not well controlled. When they develop intracranially, tuberculomas are symptoms of CNS tuberculosis Meningitis, radiculomyelitis, bony spinal disease, and tuberculoma/tuberculous abscess are some of the symptoms of neurological tuberculosis (TB) that can also arise intracranially or in the spinal canal. comparable to other neurological TB symptoms. The majority of the time, the diagnosis of cerebral tuberculoma is presumptive and is based on radiological findings, additional supportive TB evidence from other areas, and treatment response. However, despite adequate TB treatment and concomitant corticosteroid therapy, lesions may persist for many years, as the therapeutic response of tuberculomas is unpredictable. A 19-year-old male patient admitted to the hospital for medical treatment complained of abdominal pain, constipation, nausea and vomiting, generalized weakness, fever, and chills. According to the patient’s complaints, my patient has a history of tonic-clonic seizures dating back a month, as well as a history of typhoid fever and sickle cell disease AS pattern, both of which he had been receiving treatment at a civil hospital. At the time of admission, he had undergone a number of invasive and non-invasive investigations, including a CT brain plane and an MRI brain with contrast. Brain computed tomography (CT) revealed a persistent lacunar infarct in the left corona radiata. Acute infarct in the right corona radiata, abnormal meningeal enhancement on post-contrast with meningitis, multiple ring-enhancing lesions in the bilateral cerebral hemisphere, cerebellum, corpus callosum, and intracranial tuberculous granuloma are all revealed by MRI with contrast. left corona radiata chronic infarction.

Drug Resistant XDR Typhoid in Children Admitted in a Tertiary Care Hospital

Objective: To evaluate the prevalence and patterns of drug-resistant typhoid fever, including extensively drug-resistant (XDR) and multidrug-resistant (MDR) strains, among children admitted to a tertiary care Hospital. Methodology: This descriptive observational study was done at Paediatric department of LUMHS from May 2022-november 2022. Children aged 1-12 years, both gender and with confirmed diagnosis of typhoid fever based on positive blood cultures were included. Blood culture samples were collected from pediatric patients presenting with suspected typhoid fever are processed according to standard microbiological techniques. Isolation and identification of Salmonella Typhi are performed using appropriate culture media and biochemical tests. Antimicrobial susceptibility testing was conducted using standardized methods. Drug resistance patterns, including multidrug resistance (MDR) and extensively drug-resistant (XDR) phenotypes, are determined based on susceptibility testing results. MDR was defined as resistance to at least three classes of antibiotics commonly used for typhoid fever treatment, while XDR indicates additional resistance to fluoroquinolones and third-generation cephalosporins, which are frontline treatment options for typhoid fever. Data was entered and analyzed using SPSS version 26. Results: A total of 43 patients were studied, their mean age was 5.91 years. Boys were 72.15 and girls were 27.9%. Most of the cases 65.1% were consuming tap water. MDR resistance was observed in 9.4% of the cases, while XDR resistance was highly frequent among 83.7% of the patients. Very few cases 16.3% had history of typhoid vaccination. However, MDR and XDR resistance were statistically insignificant according to type of water consumption (p-&gt;0.05). Conclusion: In conclusion, the study revealed alarmingly high prevalence rates of extensively drug-resistant (XDR) typhoid with multidrug-resistant (MDR) strains observed in 9.4% of cases. These findings emphasize the urgent need for comprehensive strategies that address both antimicrobial resistance and vaccination efforts to combat the increasing burden of XDR typhoid in children.

Distinct patterns of postoperative fever in paediatric neurosurgery patients.

Postoperative fever is a common problem following neurosurgery but data on the causes among paediatric patients is sparse. In this report, we determined the incidence, causes, and outcomes of postoperative fever in paediatric neurosurgical patients (< 18years), and contrasted the findings with an adult cohort published recently from our unit. We recruited 61 patients who underwent 73 surgeries for non-traumatic neurosurgical indications over 12months. A standard protocol was followed for the evaluation and management of postoperative fever. We prospectively collected data pertaining to operative details, daily maximal temperature, clinical features, and use of surgical drains, urinary catheters, and other adjuncts. Elevated body temperature of > 99.9 °F or 37.7°C for > 48h or associated with clinical deterioration or localising features was considered as "fever"; elevated temperature not meeting these criteria was classified as transient elevation in temperature (TET). Twenty-six patients (35.6%) had postoperative fever, more frequent than in adult patients. TET occurred in 12 patients (16.4%). The most common causes of fever were aseptic meningitis (34.6%), followed by urinary tract infections (15.4%), pyogenic meningitis, COVID-19, and wound infections. Postoperative fever was associated with significantly longer duration of hospital admission and was the commonest cause of readmission. In contrast to adults, early temperature elevations in paediatric patients may portend infectious and serious non-infectious causes of fever, including delayed presentation with aseptic meningitis, a novel association among paediatric patients. Investigation guided by clinical assessment and conservative antibiotic policy in keeping with the institutional microbiological profile provides the most appropriate strategy in managing paediatric postoperative fever.

Spatial and temporal patterns of haemorrhagic fever with renal syndrome (HFRS) and the impact of environmental drivers in a border area of the Russian Far East.

Haemorrhagic fever with renal syndrome (HFRS) is a significant zoonotic disease transmitted by rodents. The distribution of HFRS in the European part of Russia has been studied quite well; however, much less is known about the endemic area in the Russian Far East. The mutual influence of the epidemic situation in the border regions and the possibility of cross-border transmission of infection remain poorly understood. This study aims to identify the spatiotemporal hot spots of the incidence and the impact of environmental drivers on the HFRS distribution in the Russian Far East. A two-scale study design was performed. Kulldorf's spatial scan statistic was used to conduct spatiotemporal analysis at a regional scale from 2000 to 2020. In addition, an ecological niche model based on maximum entropy was applied to analyse the contribution of various factors and identify spatial favourability at the local scale. One spatiotemporal cluster that existed from 2002 to 2011 and located in the border area and one pure temporal cluster from 2004 to 2007 were revealed. The best suitability for orthohantavirus persistence was found along rivers, including those at the Chinese-Russian border, and was mainly explained by land cover, NDVI (as an indicator of vegetation density and greenness) and elevation. Despite the stable incidence in recent years in, targeted prevention strategies are still needed due to the high potential for HRFS distribution in the southeast of the Russian Far East.

Study on the mortality pattern of African Swine Fever in pigs during an outbreak in Ranchi, Jharkhand

Study on the mortality pattern of African Swine Fever in pigs during an outbreak in Ranchi, Jharkhand

Typhoid Fever: A comparison among various age group people. A detailed case report and Review

In this article, we took three cases from our locality in which we get to know about their common symptoms like fever, vomiting, diarrhea, irrespective of their age group but we also found that convulsion was a unique symptom of infant. We have also noted about the spiking pattern of fever on the evenings, for our reference we took data from National public health profile (2021) in which west Bengal has high case incidence in overall India.We have mentioned some drugs that are used in these cases, which could become resistant in upcoming years, so we have concluded that India should bring more programs and develop a newer drug to eradicate or to prevent an endemic.

Spatial Analysis on the Spread of Dengue Hemorrhagic Fever in Baubau, Southeast Sulawesi, Indonesia

We studied the spatial patterns of Dengue Hemorrhagic Fever (DHF) transmission in Baubau, a city in Southeast Sulawesi, Indonesia. DHF is a serious disease caused by the dengue virus and spread by Aedes mosquitoes. We used Moran’s Index, a spatial analysis tool, to create a DHF spread map for Baubau’s sub-districts. We found different patterns of DHF risk, such as: cold spots, Betoambari and Batupoaro had lower DHF cases, but they were vulnerable to infection from nearby areas; hot spot, Murhum had higher DHF cases and could transmit the disease to neighboring areas; and low risk, Bungi had the lowest DHF risk and was resilient to infection. Our findings suggest that preventive measures should be tailored to the specific risk level of each sub-district. Our study also provides useful guidance for controlling DHF transmission in Baubau and beyond. Our research is a beacon of hope for a safer and healthier future.

Analysis of the Distribution Pattern Environmental Risk Factors with the Incidence Dengue Hemorrhagic Fever in South Binjai District, Binjai City

&lt;div&gt;&lt;table cellspacing="0" cellpadding="0" align="left"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" valign="top"&gt;&lt;p class="Default"&gt;&lt;em&gt;Environmental conditions have a big influence on the incidence of dengue hemorrhagic fever, because a bad environment can increase the breeding and reproduction of the Aedes aegypti mosquito. Research Objectives: To determine environmental risk factors and distribution patterns of dengue hemorrhagic fever in South Binjai District, Binjai City. The type of research used was analytical observational research with a cross sectional design and an ecological approach. The population in this study was 54.422 people and a sample of 100 people. Analysis of research data with bivariate using Chi square test. And mapping analysis of the distribution of cases of Dengue Hemorrhagic Fever using the Geographic Information System application to describe the distribution pattern of Dengue Hemorrhagic Fever in Binjai City. The results of the study showed that there was a relationship between the presence of larvae and cases of dengue hemorrhagic fever (p-value=0.000), there was a significant relationship between the presence of larvae and cases of dengue hemorrhagic fever (p-value=0.000), there was a significant relationship between the habit of hanging clothes with cases of dengue hemorrhagic fever (p-value=0.000), there is a significant relationship between the frequency of draining the bathtub and cases of dengue hemorrhagic fever (p-value=0.004), there is no significant relationship between the frequency of support from health workers and cases of dengue hemorrhagic fever (p-value = 0.359), and there is no significant relationship between the frequency of experience of receiving health education and cases of dengue hemorrhagic fever (p-value = 0.359). The distribution of dengue fever cases is not spread throughout the sub-district, but only in several adjacent areas. Based on research results, the highest number of cases occurred in mixed plantation areas. It is recommended that health workers compile a more specific distribution pattern map regarding the factors causing Dengue Hemorrhagic Fever.&lt;/em&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;&lt;/div&gt;&lt;strong&gt;&lt;em&gt;Keywords: Dengue hemorrhagic fever, Distribution pattern, Environmental, Risk factors&lt;/em&gt;&lt;/strong&gt;

First Fever between Lymphodepletion and Day 30 after CAR-T Cell Therapy: Patterns, Origins, and Implications in Lymphoma Patients

Introduction: Fever is a common adverse event associated with chimeric antigen receptor-T cell (CAR-T cell) therapy and serves as the hallmark of cytokine release syndrome (CRS). However, limited data are available on competing and contributing etiologies of fever. Thus, we aimed to investigate the causes, risk factors, and implications of fever in CAR-T cell recipients in the period with the most profound immunosuppression: between lymphodepletion (LD) and day 30 after infusion. Methods: In this single-center retrospective analysis, we studied 304 non-Hodgkin lymphoma patients (80% large B-cell lymphoma, 11% mantle cell lymphoma, 4% follicular lymphoma) treated with CD19-CAR-T cells (48% axi-cel, 23% tisa-cel, 23% liso-cel, 6% brexu-cel) between 2016 and 2023. First fever was defined as a temperature of 38°C or higher between LD and day 30 after CD19-CAR-T cells. Patients experiencing fever were routinely cultured, following institutional guidelines. Additional workup, including respiratory virus PCR panel, stool gastrointestinal PCR panel, Clostridioides difficile PCR, urine culture, chest x-ray, and fungal infection assessment, was done at the medical team's discretion. A contributing infectious source for the fever was considered if there was a positive test in the workup within 72 hours of the initial fever. Results: Fever occurred in 232/304 (76%) of patients between LD and day 30 after CAR-T cell infusion. The median time from LD to first fever was 5 days (range 2-13) and from CAR-T infusion to first fever was 2 days (range: LD initiation to 16). Of patients who had not developed a fever up to the day of infusion (n=271), 199 (73%) experienced a fever between infusion (day 0) and day 30. The primary etiology of fever between LD and day 30 was CRS (n=159/232, 68.5%), with 54% experiencing grade 2 or higher. An infectious source was identified in 52/232 (22%) of all patients and 35/194 (18%) of the subgroup developing CRS. Leading infectious etiologies were gastrointestinal (GI), bloodstream, and respiratory infections in 20 (38%), 14 (27%), and 11 (21%) of patients, respectively (Figure A). The most frequent pathogens identified were Clostridioides difficile for GI tract infections (10/20), Enterobacteriaceae for bloodstream infections (8/14), and common upper respiratory viruses, such as Rhinovirus and Parainfluenzavirus (10/16). Importantly, in patients developing fever after infusion, an infectious source was identified in 42/199 (21%). Among them, 12/42 (29%) were bloodstream infections, and 10/42 (24%) were Clostridioides difficile infections requiring rapid antibiotic management. Of an array of potential risk factors, only pre-apheresis metabolic tumor volume was associated with an increased risk for an infectious cause of fever in a univariable logistic-regression model (p=0.029). Furthermore, an infectious source of fever, compared to a non-infectious cause, was associated with an increased risk of mortality (HR 1.60, 95%CI 1.02-2.51, p=0.039) in a multivariable Cox regression model adjusted for LDH range before lymphodepletion, age and CAR-T construct type (Figure B). Conclusions: This study represents one of the first and largest investigations into fever patterns and origins in CAR-T cell therapy recipients. Although fever is common, treatable infectious sources are infrequent. Our findings may have implications for antibiotic stewardship and fever management in CAR-T patients. Finally, the association between infectious fever and inferior survival warrants further investigation on the biological processes driving mortality.

Distribution Pattern and Density Figure on The Incident Of DHF

Dengue hemorrhagic fever (DHF) is a disease that causes death, known for &gt; 200 years, and has become a health problem in the world, especially in developing countries, including Indonesia. Deli Serdang Regency had the highest number of cases in North Sumatra Province in 2019 with 1,326 cases, in 2020 there were 974 cases, IR: 50.4. In 2021, the Regency/City ranked 14th out of 514 Regency/City in Indonesia for the highest number of dengue fever cases in 2021 with 803 cases, IR/morbidity rate: 34.63/100,000 population, CFR/death rate: 0.12%. It is possible to identify the location of the patient down to the address of the individual's location, so as to obtain information regarding the distribution pattern of cases in each region using the Geographic Information System (GIS). The aim of this research was to obtain a vector entomological survey (CI, BI, HI, ABJ), and the distribution pattern of Dengue Hemorrhagic Fever (DHF). Research used a case control design, determining the location of houses referring to FUNASA and WHO regulations (taking into account the number of buildings and House Index (HI) with household members as subjects of 100 case houses and 100 control houses consisting of 22 sub-districts in Deli Serdang Regency. Based on the distribution results using Stascan, there are 4 clusters and the case points for dengue fever sufferers are located at a distance of 500 - 1500 m from the Community Health Center. Data on dengue fever sufferers in each community health center buffer in Deli Serdang Regency contained 81 cases.&#x0D;

Spatiotemporal Patterns of African Swine Fever in Wild Boar in the Russian Federation (2007-2022): Using Clustering Tools for Revealing High-Risk Areas.

African swine fever (ASF) is an infectious disease that affects both domestic pigs (DPs) and wild boar (WB). The WB population plays an important role in the spread of ASF as the WB acts as a natural reservoir of the virus and transmits it to other susceptible wild and domestic pigs. Our study was aimed at revealing the areas with a high concentration of the WB population, and their potential relationships with the grouping of ASF cases in WB during the course of the ASF spread in the Russian Federation (2007-2022). We collected the annual data on WB numbers by municipalities within the regions of the most intensive ASF spread. We then conducted spatiotemporal analysis to identify clustering areas of ASF cases and compare them with the territories with a high density of WB population. We found that some of the territories with elevated ASF incidence in WB demonstrated spatial and temporal coincidence with the areas with a high WB population density. We also visualized the zones ("emerging hot spots") with a statistically significant rise in the WB population density in recent years, which may be treated as areas of paramount importance for the application of surveillance measures and WB population control.

Genomic diversity and evolution analysis of severe fever with thrombocytopenia syndrome in East Asia from 2010 to 2022.

Conducting an up-to-date analysis on the genomic diversity and evolution patterns of severe fever with thrombocytopenia syndrome virus (SFTSV) is crucial for elucidating the underlying mechanisms of its emergency and pathogenicity, as well as assessing the extent of its threat to public health. Complete genome sequences of SFTSV were obtained from GenBank until December 19, 2022. A thorough phylogenetic analysis was conducted using comprehensive bioinformatics methods to estimate the genomic diversity and evolution. The phylogenetic classification of SFTSV strains yielded seven lineages (A-G) for each genome segment. SFTSV displayed notable variations in evolutionary patterns among different regions and segments, without a linear accumulation of nucleotide substitutions within segments and regions. The comprehensive analysis revealed 54 recombination events and 17 reassortment strains, including the first discovery of recombination events involving sea-crossing and species-crossing. Selection analysis identified three positive sites (2, 671, 1353) in RNA-dependent RNA polymerase, three positive sites (22, 298, 404) in glycoprotein, and two positive sites (9, 289) in nonstructural protein. No positive selection sites were found in nucleoprotein. Our study unveiled the existence of multiple evolutionary forces influencing SFTSV, contributing to its increasing genetic diversity, which had the potential to modify its antigenicity and pathogenicity. Furthermore, our study highlights the importance of tracking the spread of SFTSV across regions and species.

Clinical Presentation of Dengue Fever among Bangladeshi Children: A Study of 100 Cases

Background: Dengue is a common tropical disease in Bangladesh. It is prevalent in our country during and just after the rainy season. The symptoms and signs are similar to many other diseases. Objective: The objective of the study is to observe the pattern of dengue fever in this institution for better care of the patients and also comparing with follow-up studies. Methodology: This cross-sectional study was conducted in the Department of Pediatrics at Holy Family Red Crescent Medical College Hospital, Dhaka, Bangladesh from May 2019 to August 2019. A total number of 100 patients were enrolled for this study. They were selected form the inpatient admission. Results: Most commonly children from the 5 to 10 years’ age group were affected with slight preponderance of girls. 90% patients presented with fever with chills and rigor. About 38.18 % children had uncomplicated dengue fever. Most common bleeding manifestation was melena (12.0%). About 21 patients had associated rickettsia infections. About 11 patients developed shock after admission only 22 patients had respiratory distress and 15 patients had pleural effusion. Six patients had neurological symptoms. Conclusions: Classical DF is most common form of the disease. This is followed by other two manifestations. Bangladesh Journal of Infectious Diseases, June 2022;9(1):25-30

Culture positivity and antibiotic sensitivity pattern of typhoid fever in children aged 1 to 10 years: A 10-year retrospective study from a tertiary care centre of Eastern India

Background: Over the last few decades there has been a change in the trend of antibiotic sensitivity of Salmonella typhi from being sensitive to first line drugs like chloramphenicol, ampicillin and cotrimoxazole to developing multi-drug resistance. Most strains are presently sensitive to third generation cephalosporins and azithromycin but are developing resistance against fluoroquinolones. Objectives: To determine the culture positivity and antibiotic sensitivity pattern of Salmonella typhi. Method: This retrospective study was conducted at the Institute of Child Health, Kolkata from July 2014 to December 2020. Nine hundred and twenty children aged 1-10 years were included in the study, all with fever for more than 5 days. These children were suspected to have typhoid fever clinically i.e., with history, suggestive physical examination and after excluding other common febrile illnesses with routine blood test as per hospital protocol. Blood culture was done to confirm the diagnosis of typhoid fever, determine the proportion of blood culture positive cases and to find out the antibiotic susceptibility of Salmonella typhi in our hospital set up. Children were included in the study irrespective of prior antibiotic treatment. Results: Of the 920 children, 55% were male and 45% were female; 15% cases were between 1-2 years of age and 85% were between 2-10 years of age; 53% cases were culture positive. In our study S. typhi was fully sensitive to ampicillin, chloramphenicol, cefixime, ceftriaxone and azithromycin. It was highly sensitive to cotrimoxazole. It was highly resistant to ciprofloxacin and nalidixic acid Conclusions: There was complete sensitivity of Salmonella typhi to third generation cephalosporins and azithromycin. It was also sensitive to older, less commonly used antibiotics like chloramphenicol, cotrimoxazole and ampicillin. There was increased resistance to fluroquinolones. Sri Lanka Journal of Child Health, 2023: 52(2): 169-174