2019年1月全球传染病疫情概要

2019年1月全球共监测到传染病53种,涉及68个国家和地区,其中传染病数量位于前5位的为登革热（32个）、麻疹（24个）、霍乱（8个）、军团菌病（7个）和基孔肯雅热（6个）。 病死率位于前5位的传染病为埃博拉出血热（61.7%）、中东呼吸综合征（35.3%）、黄热病（28.5%）、拉沙热（19.7%）和汉坦病毒肺综合征（18.6%）。 死亡病例数位于前5位的传染病为埃博拉出血热、拉沙热、霍乱、登革热和汉坦病毒肺综合征。 非洲流行的传染病主要为霍乱、埃博拉出血热、黄热病、拉沙热和麻疹;亚洲流行的传染病主要为登革热、霍乱、中东呼吸综合征、流行性腮腺炎和肺结核;美洲流行的传染病主要为登革热、麻疹和基孔肯雅热;欧洲流行的传染病主要为麻疹和风疹。     

Dengue fever leading to acute dengue hemorrhagic leukoencephalitis: A case report

Rationale: Dengue fever is a prevalent tropical infectious disease that has a broad panorama of presentations from mild febrile illness to life-threatening manifestations in the form of dengue hemorrhagic fever and dengue shock syndrome. Patient's concerns: A 20-year-old male presented with a 2-day history of fever, multiple episodes of vomiting, and altered sensorium. Diagnosis: Dengue fever leading to acute hemorrhagic leukoencephalitis. Interventions: Multiple transfusions of single donor platelets, intravenous methylprednisolone, intravenous immunoglobulin, anti-seizure prophylaxis, and broad-spectrum antibiotics. Outcomes: Repeat brain magnetic resonance imaging showed resolution of lesions. The patient was subsequently discharged from the hospital in a healthy state. Lessons: This report helps us to gain a better understanding of the patient's presentation, which will help to improve the timely recognition and prevention of this rare devastating presentation.     

登革病毒和蠕虫感染与免疫

登革热主要流行于热带、亚热带地区,这些地区也常见蠕虫（华支睾吸虫/肝吸虫、蛲虫、钩虫、蛔虫）感染流行。有观点认为蠕虫和登革病毒的双重感染可增加重症登革热的发生率。本研究拟综述登革病毒和常见蠕虫感染与免疫机制的相关研究进展,探讨登革病毒和蠕虫感染与免疫之间可能存在的关联性,供相关领域工作者参考。     

Dengue fever: a resurgent risk for the international traveler.

The incidence of dengue fever, an acute febrile illness transmitted by the Aedes aegypti mosquito, is on the rise. High fever, severe headache, skin rash and a variety of constitutional symptoms are hallmarks of classic dengue fever. Dengue hemorrhagic fever, a severe manifestation associated with secondary infection, most often occurs in children. Treatment of classic dengue fever is supportive, whereas urgent rehydration therapy is often required in more severe forms. Community-based and personal strategies for avoiding the mosquito vector represent the best methods of prevention, although vaccine development programs are under way.     

Dengue fever: diagnosis and treatment

Dengue fever is a common tropical infection. This acute febrile illness can be a deadly infection in cases of severe manifestation, causing dengue hemorrhagic shock. In this brief article, I will summarize and discuss the diagnosis and treatment of this disease. For diagnosis of dengue, most tropical doctors make use of presumptive diagnosis; however, the definite diagnosis should be based on immunodiagnosis or viral study. Focusing on treatment, symptomatic and supportive treatment is the main therapeutic approach. The role of antiviral drugs in the treatment of dengue fever has been limited, but is currently widely studied.     

Febrile Illness in a Young Traveler: Dengue Fever and its Complications

Background

Dengue fever, a tropical disease once confined mostly to endemic areas in developing countries, is becoming more prevalent. Globalization has led to an increased incidence of the virus both in foreign travelers returning home and local outbreaks in traditionally nonendemic areas, such as the southern United States and southern Europe. Advances in diagnostic tests, therapies, and vaccines for dengue virus have been limited, but research is ongoing.

Objectives

To review the current literature regarding the diagnosis and management of dengue fever.

Case Report

This case report describes a young woman returning from Central America with many of the common signs and symptoms who was misdiagnosed both abroad and at home. We explore the epidemiology, disease course, complications, and treatment of dengue fever.

Conclusion

Emergency physicians should consider dengue fever in patients with acute febrile illnesses, especially among those with recent travel.     

Dengue fever in the Western Hemisphere.

Dengue virus, an arthropod-borne viral agent, causes two distinct diseases: classic dengue fever (DF) and dengue hemorrhagic fever (DHF). There are four dengue virus serotypes: DEN-1, DEN-2, DEN-3, and DEN-4. Although infection with dengue stimulates immunologic response to a serotype, there is no cross-immunity conferred. Hence, a person can potentially be infected with each serotype during his or her lifetime. An infected female Aedes mosquito transmits the virus from person to person while feeding. The disease, now endemic in more than 100 countries in Africa, the Americas, the Eastern Mediterranean, Southeast Asia, and Western Pacific, is spreading to new areas and causing explosive outbreaks. Because of the major impact on lives and local economies epidemics produce, rapid detection of dengue infection has become an important public health research issue. Recently developed serological procedures to detect dengue infections have shown great potential for field use.     

Evaluation of three commercially available kits for serological diagnosis of dengue haemorrhagic fever

Seventy one acute phase serum samples collected during an epidemic of dengue hemorrhagic fever were tested by immunoblot, a rapid immunochromatographic assay and Dengue Duo ELISA for presence of anti dengue IgM and IgG antibodies. A concordance of 81.7% and 76.1% was seen between the three tests for the detection of anti-dengue IgM antibodies and IgG antibodies respectively. The rapid test takes only five minutes, can be easily carried out in most laboratories and compares well with the ELISA and the immunoblot.     

浙江省义乌市一例输入性登革热的病毒分离及全基因组序列分析

目的调查浙江省义乌市2013年1例输入性登革热病例的分子流行病学特点。方法采集患者血清标本,采用酯酶联免疫吸附试验和实时荧光定量聚合酶链反应分别检测登革病毒IgM抗体和核酸。用C6/36细胞分离病毒和全基因组测序及分析。结果从来自安哥拉的1例登革热患者血清中检测到登革病毒IgM抗体和1型登革病毒核酸,并分离到1株病毒(Zj/yw01)。经序列测定,该病毒基因组全长10 141 bp(GenBank no.KF864667),进化树显示该病毒为登革1型病毒Ⅴ亚型,与安哥拉分离株(KF184957)同源性最高。结论分子生物学证实该病例为来自安哥拉的输入性病例。     

2019年7月全球传染病疫情概要

2019年7月全球共监测到传染病57种,涉及108个国家和地区。 除流感外,涉及国家和地区数量位于前5位的传染病为麻疹（56个）、登革热（32个）、基孔肯雅热（16个）、霍乱（11个）和疟疾（7个）。 病死率位于前3位的传染病为埃博拉出血热（67.2%）、中东呼吸综合征（34.5%）和拉沙热（22.5%）。 死亡病例数位于前5位的传染病为埃博拉出血热、登革热、霍乱、麻疹和拉沙热。 非洲流行的传染病主要为埃博拉出血热、霍乱、黄热病和拉沙热;亚洲流行的传染病主要为中东呼吸综合征和登革热;美洲和欧洲流行的传染病主要为登革热和麻疹。     

Heterosandwich immunoswab assay for dengue virus Ns1 antigen detection

Dengue and the more severe dengue hemorrhagic fever have been a very critical public health problem globally. Millions of people especially in the tropical areas get infected with dengue. An efficient diagnostic is very important for early screening of dengue infection. In dengue-infected patients, the nonstructural protein NS1 is present on the surface of infected cells and secreted in plasma. The NS1 antigen is an important target for developing a quick diagnostic largely due to its long presence in the blood. We have developed a simple-to-use immunoswab-based diagnostic procedure employing monoclonal antibodies and the second-generation quadromas. The detection limit for NS1 has been established to be in the subnanogram range. The assay is very sensitive, has a visual end point, and also being extremely inexpensive. With this assay, screening time for a dengue-infected person would be very rapid.     

2019年2月全球传染病疫情概要

2019年2月全球共监测到传染病46种，涉及63个国家和地区。 涉及国家和地区数量位于前5位的传染病为登革热（33个）、麻疹（18个）、基孔肯雅热（9个）、霍乱（6个）和军团菌病（6个）。 病死率位于前3位的传染病为埃博拉出血热（62.7%）、中东呼吸综合征（34.7%）和拉沙热（21.8%）。 死亡病例数位于前5位的传染病为麻疹、霍乱、埃博拉出血热、拉沙热和登革热。 非洲流行的传染病主要为霍乱、埃博拉出血热、黄热病、拉沙热和麻疹；亚洲流行的传染病主要为登革热、中东呼吸综合征和麻疹；美洲流行的传染病主要为登革热和麻疹；欧洲流行的传染病主要为麻疹。     

广州市某大院一起登革热暴发的流行病学调查

１９９４年９月下旬至１０月中旬，广州市某大院发生一起登革热疫情。流行病学、病原学及血清学调查证实:这是一起由登革血清Ⅰ型病毒引起的登革热小规模暴发，罹患率为１２．３％（１３／１０６）。经疫情紧急处理，未引起大院外流行。此次暴发时间之集中，罹患率之高，流行范围之局限，在广州是少见的。流行病学调查提示，传染来源可能来自境外。     

2019年4月全球传染病疫情概要

2019年4月全球共监测到传染病48种，涉及82个国家和地区。 除流感外，涉及国家和地区数量位于前5位的传染病为麻疹（33个）、登革热（32个）、基孔肯雅热（15个）、霍乱（10个）和疟疾（6个）。 病死率位于前3位的传染病为埃博拉出血热（65.8%）、中东呼吸综合征（34.4%）和拉沙热（22.5%）。 死亡病例数位于前5位的传染病为麻疹、埃博拉出血热、霍乱、登革热和中东呼吸综合征。 非洲流行的传染病主要为埃博拉出血热、霍乱、黄热病、拉沙热和麻疹；亚洲流行的传染病主要为中东呼吸综合征、登革热和霍乱；美洲流行的传染病主要为登革热、麻疹和基孔肯雅热；欧洲流行的传染病主要为麻疹。     

Evaluation of the SD BIOLINE dengue duo rapid test in the course of acute and convalescent dengue infections in a Mexican endemic region

In this study, we evaluated the performance of a rapid test, the SD BIOLINE Dengue Duo (SD BDD) kit, with a panel of serum samples from 310 Mexican patients with diagnosis of dengue infection previously confirmed by reference enzyme-linked immunosorbent assay tests. Eighty-seven negative samples from other febrile illnesses were included as controls. The SD BDD showed an overall sensitivity of 90.65% and specificity of 89.66%. No statistically significant differences were found in the sensitivity of the SD BDD kit compared between primary or secondary infections (87.05% versus 93.57%, respectively, P = 0.0761) and dengue fever or dengue hemorrhagic fever cases (90.77% versus 89.74%, respectively, P = 0.7716). However, a higher sensitivity in the acute phase of dengue infection was found compared with the convalescent phase (93.03% versus 81.82%, respectively, P = 0.0089). These results indicate that the SD BDD kit is a useful tool to diagnose dengue infections, both in primary or secondary infections and mainly during the acute phase.     

2019年8月全球传染病疫情概要

2019年8月全球共监测到传染病58种,涉及79个国家和地区。 除流感外,涉及国家和地区数量位于前5位的传染病为登革热（32个）、麻疹（30个）、霍乱（10个）、西尼罗热（8个）和脊髓灰质炎（8个）。 病死率位于前4位的传染病为埃博拉出血热（66.8%）、中东呼吸综合征（34.5%）、拉沙热（22.1%）和西尼罗热（9.2%）。 死亡病例数位于前5位的传染病为登革热、埃博拉出血热、麻疹、霍乱和西尼罗热。 非洲流行的传染病主要为埃博拉出血热、鼠疫、霍乱、黄热病和拉沙热;亚洲流行的传染病主要为中东呼吸综合征和登革热;美洲流行的传染病主要为登革热和麻疹;欧洲流行的传染病主要为西尼罗热和麻疹。     

登革热147例临床特点分析

目的：探讨新时期登革热发病的临床特点，提高临床医师对登革热的全面认识。方法：将2002．8—2002．9收治住院的147例登革热进行临床特点分析。结果：登革热发病有家庭聚集性；临床表现为发热、头痛、畏寒、皮疹较常见；伴随有多脏器损害，其中以肝功能异常、白细胞及血小板减少、肾功能损害多见；所有病例登革热病毒IgM阳性。结论：登革热各年龄组均可发病；临床表现无特异性；多脏器损害以肝功能异常最多见；确诊依据登革热IgM抗体检查。     

Viral hemorrhagic fevers including hantavirus pulmonary syndrome in the Americas

The term viral hemorrhagic fever refers to an acute systemic illness with a propensity for bleeding and shock. The viral hemorrhagic fevers endemic in the Americas include yellow fever, dengue hemorrhagic fever, the South American hemorrhagic fevers, hantavirus pulmonary syndrome, and hemorrhagic fever with renal syndrome. Because these diseases are primarily zoonotic, the distribution of any given virus is generally restricted by the distribution of its natural reservoir or arthropod vector. A high index of suspicion, detailed investigation of the travel and exposure history of the patient, and a basic understanding of the incubation periods and distributions of the various reservoirs of hemorrhagic fever viruses are imperative, as are prompt notification and laboratory confirmation. Clinical management is largely supportive, with a special emphasis on safe nursing practices to prevent nosocomial transmission.     

Human T cell responses to dengue virus antigens. Proliferative responses and interferon gamma production.

The severe complications of dengue virus infections, hemorrhagic manifestations and shock, are more commonly observed during secondary dengue virus infections than during primary infections. It has been speculated that these complications are mediated by cross-reactive host-immune responses. We have begun to analyze human T cell responses to dengue antigens in vitro to explain the possible role of T lymphocytes in the pathogenesis of these complications. Dengue antigens induce proliferative responses of PBMC from dengue antibody-positive donors, but do not induce specific proliferative responses of PBMC from dengue antibody-negative donors. IFN gamma is detected in the culture fluids of dengue-immune PBMC stimulated with dengue antigens. The cells that proliferate in the dengue antigen-stimulated bulk cultures have CD3+, CD4+, CD8-, CD16-, and CD20- phenotypes. Dengue-specific T cell lines were established using limiting dilution techniques. They have CD3+, CD4+, and CD8- phenotypes, and produce IFN gamma in response to dengue antigens. Culture fluids from dengue-immune PBMC stimulated with dengue antigens, which contain IFN gamma, augment dengue virus infection of human monocytes by dengue virus-antibody complexes. These results indicate that PBMC from dengue-immune donors contain CD4+ T cells that proliferate and produce IFN gamma after stimulation with dengue antigens, and suggest that the IFN gamma that is produced by these stimulated dengue-specific T cells may contribute to the pathogenesis of dengue hemorrhagic fever and dengue shock syndrome by increasing the number of dengue virus-infected monocytes in the presence of cross-reactive anti-dengue antibodies.     

An experience nursing a patient with dengue hemorrhagic fever

The case report presented a patient with dengue hemorrhagic fever after being bitten by an insect in a suburban area. The author observed and interviewed the patient and utilized Gorden's functional health scale to collect information, from Nov., 08 to Nov., 15 2002. Thrombocytopenia, febrile, and pain accompanied with dengue hemorrhagic fever were recorded during nursing evaluation. Lack of associated medical information contributed to the patient's anxiety status. The major nursing problems were changing of protection/ thrombocytopenia, hyperthermia, pain, and inadequacy of knowledge. The gum bleeding, fevers, and generalized bone pain were relieved by sincere listening and nursing intervention. In addition, medical information was delivered by way of a health information booklet to improve the understanding of the patient and ease the latter's anxiety status. Amid an increase in cases of dengue hemorrhagic fever in Taiwan, this case report might provide some valuable information to the nursing staff in order to enhance their ability to provide comprehensive care.