Vesicular Lesions Research Articles

Ayurveda management of Visarpa (Herpes zoster) - A Case Study

Skin is the largest organ of the body which acts as a first line of defence in providing resistance to the body. The aggravation of various Dhatus and Doshas result in skin diseases. Visarpa is an acute condition with a quick spreading involving mainly skin, blood, lymph and muscle tissue due to vitiation of all three Doshas. As the basic nature of the disease is Rakta and Pitta predominant, management is focused on Shodhana, Rakthamokshana, Langhana, Shamana, Lepa Chikitsa. This case study is an attempt to evaluate the role of Ayurvedic management in Visarpa. A 50 year-male presented with vesicular lesions on his chest, below the left axillary region and back associated with mild itching, burning sensation and pain. He was approached with Shodhana and Shamana therapies which showed significant improvement in the condition.

A rapid and visual detection assay for Senecavirus A based on recombinase-aided amplification and lateral flow dipstick.

Senecavirus A (SVA) is a newly pathogenic virus correlated with the acute death of piglets and vesicular lesions in pigs. The further prevalence of SVA will cause considerable economic damage to the global pig farming industry. Therefore, rapid and accurate diagnostic tools for SVA are crucial for preventing and controlling the disease. We designed multiple primer pairs targeting the most conserved region of the SVA 3D gene and selected those with the highest specificity. Nfo-probes were subsequently developed based on the highest specificity primer pairs. Subsequently, the recombinase-assisted amplification (RAA) reaction was completed, and the reaction temperature and duration were optimized. The RAA amplicons were detected using a lateral flow device (LFD). Finally, a rapid and intuitive RAA-LFD assay was established against SVA. The SVA RAA-LFD assay can be performed under reaction conditions of 35°C within 17 minutes, with results observable to the naked eye. We then evaluated the performance of this method. It exhibited high specificity and no cross-reaction with the other common swine pathogens. The lowest detectable limits of this method for the plasmid of pMD18-SVA-3D, DNA amplification product, and viral were 3.86×101 copies/µL, 8.76×10-7 ng/µL, and 1×100.25 TCID50/mL, respectively. A total of 44 clinical samples were then tested using the RAA-LFD, PCR, and RT-qPCR methods. The results demonstrated a consistent detection rate between the RAA-LFD and RT-qPCR assays. The SVA RAA-LFD assay developed in our study exhibits excellent specificity, sensitivity, and time-saving attributes, making it ideally suited for utilization in lack-instrumented laboratory and field settings.

Development and optimization of a double antigen sandwich ELISA detecting for Senecavirus A antibodies based on VP2 protein.

Senecavirus A (SVA) is an emerging viral pathogen that threatens the global swine industry significantly. The major clinical symptoms of SVA-infected animals are vesicular lesions, but various diseases can cause the same symptoms, which makes it difficult to distinguish SVA from other vesicular diseases clinically. The absence of an effective and safe vaccine necessitates the development of a simple, specific, and sensitive serological detection method for SVA antibodies. The VP2 protein of SVA, characterized by high immunogenicity and sequence conservatism, is an essential target for serological diagnosis. In this study, a double-antigen sandwich enzyme-linked immunosorbent assay [ELISA (DAgS-ELISA)] based on VP2 protein expressed by Escherichia coli was established for SVA antibody detection. With a cutoff value of 0.237, this assay demonstrated outstanding performance, showing high sensitivity and sharp specificity, which is manifested in the absence of cross-reaction with classical swine fever virus (CSFV), African swine fever virus (ASFV), pseudorabies virus (PRV), and porcine reproductive and respiratory syndrome virus (PRRSV), and foot-and-mouth disease virus (FMDV) serotype A and O. Additionally, the repeatability of the method is remarkable, as shown by the coefficients variation (CV) of both the intra- and inter-assay below 10%. By detecting 166 clinical sera, it was found that the kappa value of the DAgS-ELISA was 0.78 compared with that of the virus neutralization test (VNT), indicating a high level of consistency. In general, this method has high sensitivity, sharp specificity, remarkable repeatability, sound consistency, and low cost, making it a reliable and effective tool for detecting SVA antibodies.IMPORTANCESVA has rapidly become prevalent in many countries, and its outbreaks have threatened the global swine industry significantly. The major clinical symptoms of SVA-infected animals are vesicular lesions that are similar to other vesicular diseases, making it difficult to distinguish SVA. Currently, no commercial vaccines are available for SVA; therefore, effective diagnosis of SVA infection is vital for its prevention and control. In this study, VP2 protein of SVA was expressed by E. coli, and a double-antigen sandwich enzyme-linked immunosorbent assay [ELISA (DAgS-ELISA)] for SVA antibodies detection was successfully established based on the VP2 protein. The DAgS-ELISA has a high sensitivity, sharp specificity, remarkable repeatability, sound consistency, and low cost for detecting SVA antibodies. Therefore, the DAgS-ELISA established in this study may be a reliable and effective tool for detecting SVA antibodies and may be used to strengthen the monitoring and prevention of SVA epidemic in the long run.

Monkeypox Clade Ib virus introduction into Burundi: first findings, July to mid-August 2024.

We describe cases with monkeypox virus (MPXV) Clade Ib in Burundi from their first detection in July until 20 August 2024. Testing 442 people with vesicular lesions confirmed 170 cases (98 male; 72 female), 82 (48%) being < 15 years old. Differential diagnosis of the first 30 individuals testing MPXV negative revealed chickenpox in 20. Cases occurred in 26 of 49 Burundi health districts, but mostly in Bujumbura Nord (88/170; 67%). Case-derived MPXV genetic sequences from Burundi and South-Kivu (Democratic Republic of the Congo), clustered together in phylogenetic analysis.

A-297 Feasibility of a novel Seegene Multiplex PCR panel for the simultaneous detection of HSV-1, HSV-2, VZV and Mpox: a focus on inclusion, confirmation and LOD assessment

Abstract Background Characterized by atypical presentations of short prodromal symptoms, variations in clinical staging, non-uniform presentation of rash, and varied syndromes of proctitis and pharyngitis, the WHO declared the 2022 Mpox outbreak a global public health emergency in July 2022. The overlap of clinical presentation with other causes of vesicular lesions identified gaps in the diagnostic tests available for MPXV and highlighted the need for a multiplex PCR approach to the diagnosis of HSV, VZV, and MPXV among patients presenting with vesicular lesions. Currently, no FDA cleared multiplex approach offering a single unified approach to the diagnosis of HSV, VZV, and MPXV from a single sample exists. Multiplex assays offer a role in diagnostic support where clinicians are challenged to determine the causative agent because of overlap. Furthermore, no assay capable of providing MPXV clade II reporting, needed for compliance to select agent reporting rules, exist for routine clinical labs. This study outlines the initial feasibility of Seegene’s multiplex HSV, VZV, MPXV PCR assay, highlighting the LOD assessment from the 1st WHO International Standards, ZeptoMetrix® NATtrolTM Controls, and custom plasmids. Methods Gene targets representing conserved, differentiated regions of HSV-1, HSV-2, VZV, MPXV, and MPXV clade II were identified through phylogenetic analysis. A total of 28 oligonucleotide combinations, were applied to Seegene’s proprietary amplification and detection process creating a multiplex assay capable of 8 unique detection signals in 5 channels using the BioRad Opus® 96. 1st WHO International Standards (IS) for HSV-1/2, VZV, ZeptoMetrix® NATtrolTM and custom designed plasmids controls were titrated and spiked into Copan UTM supplemented with 5% HeLa cells and used to define target LOD panels ranging in concentrations tested with multiple replicates. Sample processing, DNA extraction, and PCR amplification were performed on the Seegene Starlet® automated liquid handler and BioRad® OPUS 96 using Seegene software. Results Detection rates for HSV-1 at target concentrations of 1x102 IU/ml (WHO) and 6.17x100 copies/ml (NATtrolTM) were 100%. Detection of HSV-1 with plasmid DNA at target concentrations of 1.25x101 was 95%. Detection rates for HSV-2 were 100% at 5x102 IU/ml (WHO) and 5.56x101 copies/ml (NATtrolTM). Detection of HSV-2 with plasmid DNA at target concentrations 2.5E1 was 100%. For VZV, detection rates of 100% were observed at LOD challenge pools comprising 1x102 IU/ml (WHO) and 1.85x101 copies/ml (NATtrolTM). Detection of VZV with plasmid DNA at target concentrations 2.5x101 was 95%. For MPXV, detection rates of 100% were observed when challenged with LOD pools at 1.67x101 copies/ml respectively. Detection of MPXV with plasmid DNA at target concentrations 6.25x100 was 95%. Confirmation of clade II reporting for MPXV was determined using phylogenetic analysis. Conclusions Standardize of Seegene’s multiplex HSV-1, HSV-2, VZV, MPXV assay using traceable quantitated standard resulted in &amp;gt;95% detection rates of 6.17x100 copies/ml for HSV-1, 5.56x101 copies/ml for HSV-2, 1.85x101 copies/ml for VZV, and 1.67x101 copies/ml for MPXV respectively. A single multiplex PCR assay offers advantages for the simultaneous detection of HSV, VZV, and MPXV DNA in lesions specimens where clinical features present overlap and in patients whose clinical history is difficult to obtain.

Clinical and morphological specifics, pathogenetic ways of skin manifestations in SARS-CoV-2 infection

To date, the most studied clinical and morphological changes characteristic of SARS-CoV-2 virus are its pulmonary manifestations and cardiovascular involvement. However, the evaluation of COVID-associated skin changes and the analysis of their mechanisms are also important for us, because the skin manifestations of the infection can change the patient's appearance for the worse, i.e. affect the aesthetic sphere and significantly reduce the quality of life. The study of not only skin manifestations of COVID-19, but also their morphological substrate and pathogenetic basis allows us to apply the most effective methods of treatment and provide adequate management of patients even in the post-coital status. According to the information collected to date, the most frequently reported skin manifestations of SARS-CoV-2 are pseudo-frostbite, maculopapular and vesicular lesions, urticaria, lividoid and necrotic lesions, hemorrhagic purpura (vasculitis), and conditions from the group of other unclassified skin lesions. Despite the variety of clinical variants of SARS-CoV-2-associated skin changes, morphological stigmas are often stencil-like: these are areas of lymphohistiocytic infiltration of perivascular localization, the presence of fibrinoid necrosis foci in the vessel walls, the formation of occlusive thrombi, erythrocyte extravasation. Mechanisms of damage to epidermis and dermis within COVID-19 infection may be due to the influence of complement components, activation of cytotoxic lymphocytes and NK-cells, excessive synthesis of proinflammatory cytokines, in particular, interleukin 6, as well as interferons, hyperergic reactions. In addition to routine morphological, immunohistochemical examination of skin biopsy specimens from patients with different forms of skin manifestations of SARS-CoV-2 infection is an important tool in the diagnostic confirmation of COVID-associated dermatologic pathology, especially in patients with a suspected history of this disease or with problematic laboratory results.

Evidence of vertical transmission of Senecavirus A in naturally infected sows

Senecavirus A (SVA) is a Picornaviridae RNA virus that causes vesicular disease (VD) and transitory neonatal losses in pigs. The major ways SVA is spread are by oral, nasal, and feces. Vertical transmission of SVA was investigated during a VD epidemic in a farrow-to-finish herd in Brazil. Vesicular lesions were observed on sows before farrowing and on piglets within 24 h of birth. Analyses included RT-qPCR, viral isolation, sequencing, and virus-neutralization assays on serum, vesicular fluid, colostrum, and milk. Five out of ten sows were viremic before farrowing, and 46.7% of tested piglets had high viral loads in the first 24 h after birth. Infectious virus was detected in colostrum and milk from one postnatal sow. Despite high levels of neutralizing antibodies (nAbs) in piglet serum, colostrum, and milk, piglets were not protected from viremia and clinical illness. These findings support the vertical and congenital transmission of SVA.

Mucocutaneous manifestation of COVID-19 infection in pediatrics age groups

Background and objectives: It is known that the COVID-19 virus can induce a wide range of mucocutaneous symptoms. This study's main goal is to describe the variety of cutaneous symptoms caused by COVID-19 in the pediatric age category. Methods: This is a retrospective case series study of pediatric patients with COVID-19 infection who were admitted to Jamal Ahmad Rashid Pediatrics Teaching Hospital in Sulaimaniyah city from September 2021 to March 2022. Moderate to severe Covid-19 infection was a factor in the patients' admissions. The patient’s complete medical history was reviewed, which should include their age, gender, and any mucocutaneous manifestations, as well as their past medical history, family history. Results: Three hundred twenty three cases of COVID-19 infection were enrolled in this study, 36 of them had skin manifestations. There were 56% female and 44% males. Their ages ranged from zero to 13 years. Skin manifestations were 13 patients (36%) had erythematomaculopapular rash, 8 patients (22%) had vesicular lesions, 7 patients (19%) had chilblain, 6 patients (17%) had urticaria and 2 patients (6%) had erythema multiforme. Overall 41 patients had Multisystem inflammatory syndrome in children (MIS-C), 11 patients had cutaneous manifestations (6 patients had erythematomaculopapular rash, 5 patients had vesicular rash), and 6 patients had mucosal lesions (4 patients had conjunctivitis, 2 patients had oral lesions). Conclusions: We found that despite pulmonary and other systemic manifestation also corona virus infection can cause many mucocutaneoues manifestation in pediatrics age groups.However, further studies with larger samples size and longer duration is recommended.

A nonhuman primate model for genital herpes simplex virus 2 infection that results in vaginal vesicular lesions, virus shedding, and seroconversion.

The most commonly used animal models for evaluating the efficacy of HSV-2 candidate vaccines are mice and guinea pigs. While numerous HSV-2 vaccine candidates have been tested in these animals and were effective in reducing disease and mortality, these results did not predict the effectiveness of the vaccines in human trials. Infection of rhesus macaques rarely results in lesions or HSV-2 specific antibody responses. In seeking an animal model that better recapitulates human disease and that might be more predictive of the efficacy of prophylactic vaccines than mice and guinea pigs, we evaluated Cebus apella (C. apella), a New World primate, in an HSV-2 genital infection model. Infectious HSV-2 was cultured from vaginal swabs from all 4 animals for 9-14 days after intravaginal inoculation of HSV-2 seronegative monkeys. Two of 4 monkeys had vesicular lesions in the vagina or vulva. No neurological symptoms were noted. Recurrent lesions and HSV-2 DNA shedding after acute disease resolved was infrequent. UV irradiation of the genital area did not induce recurrent genital lesions or virus shedding. All 4 monkeys developed HSV-2 neutralizing antibodies as well as virus-specific CD4 and CD8 T cell responses. Reinfection of animals 15 to 19 months after primary infection did not result in lesions; animals had reduced virus shedding and a shorter duration of shedding compared with that during primary infection, suggesting that primary infection induced protective immunity. Primary fibroblasts from C. apella monkeys supported the growth of HSV-2 in vitro; in contrast, HSV-2 did not replicate above the titer of the input inoculum in fibroblasts from rhesus macaques. These observations suggest that the C. apella monkey has potential to serve as a model for evaluating the efficacy of prophylactic vaccines, antivirals, or monoclonal antibodies to HSV-2.

Miliaria crystallina complicating infectious spondylodiscitis

We report the case of miliaria crystallina complicating infectious spondylodiscitis in the lumbar region in a 66-year old woman. The eruption was concomitant with a persistent malignant fever and consisted of diffuse vesicular lesions spread all over the body with regress after resolution of fever.

Beyond dermatomes disseminated Herpes zoster in the immunocompetent: two rare cases

Herpes zoster is typically a localized reactivation of the varicella-zoster virus (VZV) that occurs in individuals following a primary varicella infection (chickenpox). Disseminated herpes zoster, characterized by widespread vesicular lesions beyond the primary dermatome, is uncommon and usually associated with immunocompromised states. Till date only 25 immunocompetent patients with disseminated HZ have been reported in literature. We report two such cases of disseminated HZ in immunocompetent individuals. The 1st patient is a 53-year-old woman with painful, itchy multiple grouped erythematous papules, vesicles, and bullae over right T8-T9 dermatome and multiple papules, crusted papules, and vesicles over face associated with fever and fatigue. The 2nd patient is an 8-year-old boy with multiple grouped clear vesicles and bullae with erythematous base involving the left S1-S5 dermatome. Multiple discrete erythematous papules and vesicles (active and crusted) were noted over trunk, right forearm, left arm, bilateral thigh and left mandibular area. Routine laboratory investigations were within normal limits. Tzanck smears were done, and multinucleated giant cells were seen in both cases. They were treated with antivirals and showed improvement. We have reported these two cases of disseminated HZ due to their occurrence in immunocompetent patients, which is a very rare phenomenon.

Foot and Mouth Disease Virus Strain-specific Antibody Titres in Naturally Infected or Vaccinated Bulls in Kenya

Foot-and-mouth disease (FMD) is a global viral infection that causes vesicular lesions in and around the mouth and feet, causing reluctance of animals to eat or move. In Kenya, bulls raised for AI receive vaccinations against FMD, but it is unclear if these animals experience vaccine-induced immunity. No research has been conducted to determine if animals in endemic areas develop natural immunity or whether animals in disease-free regions might be seropositive. This study aimed to determine the prevalence and levels of foot and mouth disease virus infection-triggered and vaccine-induced antibodies. A cross-sectional study was conducted on bulls farmed for AI production and vaccinated against FMD. Antibodies were quantified using a virus-neutralization test. One-way analysis of variance (ANOVA) and the Kruskal-Wallis test with Tukey and Dunn post-tests, respectively, were used to examine the data using the GraphPad InStat program. Additionally, the Spearman test was employed for correlation analysis and the t-test for intergroup differences analysis. A statistically significant P value was defined as less than 0.05. Findings showed protective antibody levels were present in 23%, 10.3%, 2.6%, and 7.7% of the animals in the FMD non-endemic region against the FMD virus strains O, A, SAT 1, and SAT 2, respectively. The protection provided by the O strain virus was significantly greater than that of SAT 1 (P = 0.01). In the FMD endemic area, all sampled animals showed protection levels at 100%, 100%, 100% and 29% for virus strains O, A, SAT 1, and SAT 2 respectively with the antibody titres showing significant differences (P &lt; 0.05) for all the intergroup analysis except between strains O vs SAT 1 and A vs SAT 1 (P &gt; 0.05). To conclude, the current research suggests that FMD may be making a comeback in the areas where the illness is not established. Furthermore, it seems that sperm recovery upon freezing is somewhat mitigated by FMDV-specific antibodies. The study advises monitoring FMD in areas where the illness is not endemic and confirms the current findings with larger sample sizes to enable more informed decision-making.

Assessment of Brazil's vesicular syndrome surveillance system: Profile of notifications and performance of the official veterinary service

Foot-and-mouth disease (FMD) is an ailment that causes serious damage to the productive chain, and its control through vaccination is of utmost importance for its eradication. Brazil initiated the National Foot-and-Mouth Disease Surveillance Program (PNEFA) with the aim of making the country FMD-free by 2026. As part of the program, notifications of vesicular lesions became mandatory for the Official Veterinary Service (OVS), which is responsible for verifying them. Due to its size, border areas with countries that do not have FMD-free status pose a risk to Brazil and require greater attention. This study described the profile of notifications of suspected outbreaks of vesicular syndrome in Brazil and analyzed the performance of the surveillance system. The results showed 7134 registered notifications of suspected vesicular syndrome outbreaks from 2018 to 2022, with 2022 having the highest number (n = 2343 or 32.85 %). The species that generated the most notifications were swine (90.99 %), cattle and buffaloes (7.54 %), goats and sheep (1.44 %), and others (0.03 %). The sources of notification were "Veterinary medicine professionals" (61.82 %), "Owners or employees" (13.66 %), "Third parties" (8.90 %), "OVS" (7.20 %), and "others" (2.66 %). 41.69 % of notifications originated from non-border municipalities, and 58.32 % from border areas. Only the state of Paraná account for 51.73 % of the total notifications. This state also accounted for 66.70 % of the 32.47 % of notifications with a final diagnosis of "absence of clinically compatible signs or susceptible animals", indicating a certain lack of knowledge in the area, leading to unnecessary notifications and system overload. The performance of the OVS was evaluated based on the service response time from notification registration trough Logistic and Negative binomial regressions. A total of 27.83 % of notifications did not meet the Brazilian legally specified time, and the zone related to the state of Parana needs improvements in performance. The presence and peaks of Senecavirus A cases may have influenced an increased number of swine notifications and led to a decrease in OVS response time. The results demonstrate better performance of surveillance in border areas. Given the vast territory of Brazil, it is not expected that 100 % of responses occur within the legal timeframe, however, the performance of the surveillance system proved to be adequate, with 86 % complied to the legislation. The performance indicators could be used as a monitoring tool, along with indicators to demonstrate system overload. Continued education actions are crucial for strengthening PNEFA.

Epidemiological investigation of Senecavirus A infection in pig herds in China from 2018 to 2021.

Senecaviurs A (SVA) infection, an emerging infectious disease in pig populations, is characterized by vesicular lesions predominantly affecting the mouth, snout, and hooves of infected pigs, similar to the symptoms of Foot and Mouth Disease Virus (FMDV). This disease first spread into China in 2015, causing great panic in the pig breeding industry. To determine the prevalence of SVA in pig herds in China from 2018 to 2021, a total of 4,901 pig tissue samples were collected from 18 provinces, autonomous regions and municipalities (P.A.M.s) for epidemiological investigation, virus isolation and genetic analysis. In 2021, the individual positive rates (IPRs) from the perspective of spatial distribution in East China, South China, Central China, North China, Southwest China, Northwest China, and Northeast China were 0, 0, 1.69, 0.94, 11.70, 3.31 and 2.21%, respectively. The herd positive rates (HPRs) were 0, 0, 9.52, 9.09, 50.00, 7.69 and 23.08%. From the perspective of temporal distribution, the IPR showed an overall downwards trend from 2018 to 2021, with only a slight increase in 2020. Moreover, the HPR decreased from 36.63 to 10.07%. From the perspective of population distribution in 2021, the IPR (2.62%) and HPR (12.00%) in apparently healthy pig herds (slaughterhouses) were greater than those in non-healthy pig herds (2.10 and 5.13%, respectively), consistent with the results in 2019. To characterize the prevalent strains, 10 SVA strains isolated from positive samples in 2019 were clustered in Clades I and VII; SVA-FJ039-2019, SVA-HuN032-2019, SVA-GX011-2019, SVA-FJ036-2019, SVA-GXF011-2019 and SVA-GXF053-2019 were clustered in Clade I; and SVA-FJ018-2019, SVA-SD069-2019, SVA-SD072-2019, and SVA-SD074-2019 were clustered in Clade VII. In conclusion, until 2021, the prevalence of SVA in pig herds in China was still relatively high, the contaminated area was still large, and there were a number of hidden infections. In the future, the epidemic status of SVA in pig herds in China must be closely monitored and the prevention and control measures must be adjusted in a timely manner.

Clinical profile and symptoms of young women aged 10–24 years diagnosed with pelvic endometriosis: a 5-year experience of a tertiary hospital in the Philippines

ObjectiveData on pelvic endometriosis among young women in the Philippines remains scarce. This study aims to describe the clinical profile and symptoms of Filipino young women aged 10–24 years old diagnosed with pelvic endometriosis in the Philippine General Hospital from 2015 to 2019. Materials and methodsA chart review was conducted among young women aged 10–24 years with a clinical and sonologic diagnosis and/or a histologic diagnosis of pelvic endometriosis. Clinical presentation, severity of disease, and management received were described. ResultsA total of 50 young women were included in the study, aged between 11 and 24 years. Majority had menarche while 3 patients were premenarchal. Eighty-six percent were nulligravid. The most common co-morbidities were polycystic ovary syndrome and bronchial asthma. Cyclic pelvic pain was the most common symptom (42%) followed by acyclic pelvic pain (24%) and heavy menstrual bleeding (24%). Half of the patients were treated using non-steroidal anti-inflammatory drugs (NSAIDS) (61%) and combined oral contraceptives (COCs) (39%). Younger women who underwent laparoscopy showed clear vesicular or white fibrotic lesions. ConclusionYoung Filipino women can have pelvic endometriosis that range from mild to moderate disease and should therefore be considered in those who complain of severe pelvic pain that occurs prior or within the first 6 years of menarche. The mean time from experience of first symptom to diagnosis is 1 year. Seeing an obstetrician gynecologist for the first consult shortens diagnostic delay.

Late-Onset Concurrent Infection of Vaccine Strain VZV and HSV-1 after Varicella Vaccination in a Child with Natural killer T Cell Deficiency

AbstractWe describe a case with natural killer cell deficiency of late-onset Oka vaccine varicella zoster virus (VZV) strain and Herpes simplex virus-1 (HSV-1) dual infection resulting in fatal clinical course. An 18-month-old boy presented with a papulovesicular rash, mucocutaneous candidiasis, encephalopathy, and severe respiratory distress 6 months after receiving varicella vaccine. VZV and HSV-1 were analysed by real-time reverse-transcriptase polymerase chain reaction (RT-qPCR) and Oka vaccine strain of VZV by gene sequencing. HSV-1 and VZV dual infection was detected in the blood and skin samples by RT-qPCR. Gene sequencing of VZV isolated from vesicular lesions was compatible with the Oka vaccine strain. Flow cytometry revealed a natural killer deficiency, but whole exome analysis failed to identify an associated genetic defect. Vesicular rashes in immunocompromised patients who were inadvertently vaccinated should be taken seriously, and antiviral therapy should be prompt and aggressive.

Leaderless foot-and-mouth disease virus serotype O did not cause clinical disease and failed to establish a persistent infection in cattle

ABSTRACT The foot-and-mouth disease virus (FMDV) Leader proteinase Lpro inhibits host mRNA translation and blocks the interferon response which promotes viral survival. Lpro is not required for viral replication in vitro but serotype A FMDV lacking Lpro has been shown to be attenuated in cattle and pigs. However, it is not known, whether leaderless viruses can cause persistent infection in vivo after simulated natural infection and whether the attenuated phenotype is the same in other serotypes. We have generated an FMDV O/FRA/1/2001 variant lacking most of the Lpro coding region (ΔLb). Cattle were inoculated intranasopharyngeally and observed for 35 days to determine if O FRA/1/2001 ΔLb is attenuated during the acute phase of infection and whether it can maintain a persistent infection in the upper respiratory tract. We found that although this leaderless virus can replicate in vitro in different cell lines, it is unable to establish an acute infection with vesicular lesions and viral shedding nor is it able to persistently infect bovine pharyngeal tissues.

Dermatological Manifestations of COVID-19 Patients

Background: COVID-19 is a highly contagious respiratory tract infection caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), was first identified in China, in December 2019. Almost 10% of the patients develop dermatological manifestations before the onset of respiratory illness, with cutaneous signs that can appear from before to several days after the diagnosis of COVID-19. We believe that the dermatologist can play an important role through early recognition of skin lesions suggestive of COVID-19, particularly in asymptomatic infections where this recognition could direct toward an early diagnosis of infection that certainly leads to a better prognosis. Objective: To explore the pattern of dermatological manifestations among COVID-19 Bangladeshi patients. Materials and Methods: A cross sectional study was carried out May 2020 to October 2021 with COVID 19 positive hospital admitted patients. Data were collected through a group of Dermatologists who were serving at COVID dedicated Hospitals. Dermatologists, who were working in different medical college hospital and health complexes, were attached with the study as research associate. Results: Among the muco-cutaneous findings, maculo-papular eruption 52(53.6%) was the most common, followed by chilblain like eruption 40(41.2%), petechiae or purpura 16 (16.5%), urticarial lesions 13(13.4%), vesicular lesion 10(10.3%), Bilateral conjunctivitis with clear/mucoid discharge 10 (10.3%), aphthous stomatitis 13 (13.4%), Alopecia 16(16.5%), Darkening of the face 13 (13.4%), Eczematoid reaction 13 (13.4%), livedo reticularis like eruption 5(5.2%) etc. Conclusion: The major dermatological patterns of COVID-19 can be classified as inflammatory reactions (maculopapular, urticarial and vesicular rashes), or lesions of vascular origin (chilblain like rashes, petechiae/purpura, and livedo reticularis like pattern).

Identification of a linear B-cell epitope on the "puff" loop of the Senecavirus A VP2 protein involved in receptor binding.

Senecavirus A (SVA) is an important emerging swine pathogen that causes vesicular lesions in swine and acute death in newborn piglets. VP2 plays a significant role in the production of antibodies, which can be used in development of diagnostic tools and vaccines. Herein, the aim of the current study was to identify B-cell epitopes (BCEs) of SVA for generation of epitope-based SVA marker vaccine. Three monoclonal antibodies (mAbs), named 2E4, 1B8, and 2C7, against the SVA VP2 protein were obtained, and two novel linear BCEs, 177SLGTYYR183 and 266SPYFNGL272, were identified by peptide scanning. The epitope 177SLGTYYR183 was recognized by the mAb 1B8 and was fully exposed on the VP2 surface, and alanine scanning analysis revealed that it contained a high continuity of key amino acids. Importantly, we confirmed that 177SLGTYYR183 locates on "the puff" region within the VP2 EF loop, and contains three key amino acid residues involved in receptor binding. Moreover, a single mutation, Y182A, blocked the interaction of the mutant virus with the mAb 1B8, indicating that this mutation is the pivotal point for antibody recognition. In summary, the BCEs that identified in this study could be used to develop diagnostic tools and an epitope-based SVA marker vaccine.

An Unusual Presentation of Herpes Zoster: A Case Report

Herpes zoster, known as shingles, typically presents with a well‑defined dermatomal rash, but atypical manifestations can post diagnostic challenges. We present the case of a 55‑year‑old African American woman with a history of childhood varicella‑zoster virus (VZV) vaccination who presented with a painful perianal rash initially mistaken for an allergic reaction. Despite previous vaccination, she developed a series of asymmetric ulcerative lesions with associated itching and burning, extending into the perianal region. Visual inspection revealed vesicular lesions on the right medial buttock, suggestive of shingles.