援外埃博拉医疗队成员疾病发生情况分析与护理

目的对援助利比亚里期间医疗队人员的疾病发生情况及防护措施进行总结,为后续援外医疗工作提供参考依据。方法通过疾病分类法运用统计软件进行描述性统计。结果援非期间队员患病共72例,其中晒伤性皮炎发病率最高,占15.3%;其次为氯气吸入性损伤、湿疹、蚊虫咬伤。经对症处理均治愈。本次行动中医疗队成员未感染埃博拉病毒,未发现其他国家部队中高发或散在发病的疟疾及疟疾带虫者,未出现痢疾、阿米巴病、肝炎和性传播疾病等。结论对当地的传染病进行流行病学分析,制定相应的预防措施;组织队员集中学习、对各项工作环节严格管理;对生活区定期防疫消杀是维护医务人员自身安全的重要保证。     

Assessing the Potential Role of Pigs in the Epidemiology of Ebola Virus in Uganda

Uganda has experienced 4 Ebola outbreaks since the discovery of the virus. Recent epidemiological work has shown pigs are hosts for Ebola viruses. Due to their high reproduction rates, rapid weight gain, potential to provide quick financial returns and rising demand for pork, pig production in Uganda has undergone massive expansion. The combination of pork sector growth supported by development programmes and Ebola virus risk prompted a foresight exercise using desk, interview and spatial methods. The study found that the lack of serological evidence for specific reservoir species, the number of human index cases unable to account for their source of infection, domestic pig habitat overlap with potential Ebola virus zoonotic host environments, reported interactions at the human–pig–wildlife interface that could support transmission, fever in pigs as a commonly reported problem by pig farmers and temporal correlation of outbreaks with peak pork consumption periods warrants further research into potential zoonotic transmission in Uganda from pigs.     

利比里亚埃博拉诊治中心医护人员个人防护督查

目的探讨防护督查小组在利比里亚埃博拉诊治中心抗击埃博拉病毒病,实现医务人员零感染中的作用。方法在利比里亚中国埃博拉诊治中心成立防护督查组,建立传染病监控机制。收集6周内督查小组在诊治中心医务人员穿脱防护装备全过程实施24h监控中出现的问题类别及不同周数时间段发生问题的频次,针对问题进行汇总分析、定时反馈、持续改进、制定对策。结果督查小组记录的问题以医务人员脱防护装备的问题为多,发生问题的频次随周数而呈递减趋势。结论在烈性传染病暴发流行时,高度重视防护工作,尤其是采取督查防护方式进行及时、有效,甚至是过度防护及监控措施,对确保医务人员零感染起到了至关重要的作用。     

The early vascular ageing of long-term RRT patients: endoprosthetic repair of an aortic aneurysm in a young patient on RRT for over 20 years.

The impressive calcifications seen in the computed tomography(CT) reconstruction of an aortic aneurysm of the abdominal aortain Figure 1 belong to a 48-year-old male, on renal replacementtherapy (RRT) from the age of 22. His end-stage renal diseasewas membrano-proliferative glomerulonephritis with     

Seminal Transmission of Lumpy Skin Disease Virus in Heifers

It is known that lumpy skin disease virus (LSDV) can be shed in bull semen following infection and also that artificial insemination (AI) poses a biosecurity risk. However, it is not known whether the use of LSDV infected semen in AI poses a biosecurity risk. The aim of this study was to investigate whether LSDV, transmitted through semen, can infect cows and their embryos. Two controlled trials were performed simultaneously. Eleven young beef heifers, naïve to LSDV, were synchronized using an OvSynch protocol and inseminated on Day 0 with fresh semen spiked with a field strain of LSDV on day 0. Six of the heifers were superovulated on Day 1 using pregnant mare serum gonadotropin, and embryos were flushed from these heifers on Day 6. Blood and serum samples were collected from Day 4 until Day 27 to determine the presence of LSDV by PCR and virus isolation, and the presence of antibodies against LSDV by SNT. The first clinical signs of LSD were noticed on Day 10, followed by severe generalized LSD in three heifers and mild LSD in two more heifers. Two heifers were humanely euthanized due to severe unresponsive stranguria. LSDV was detected by PCR, virus isolation or electron microscopy in blood, embryos and organs of experimentally infected animals; and eight heifers had seroconverted by Day 27. Two control animals were not affected. This is the first report of experimental seminal transmission of LSDV in cattle.     

Quantification of Lumpy Skin Disease Virus Following Experimental Infection in Cattle

Lumpy skin disease along with sheep pox and goatpox are the most serious poxvirus diseases of livestock, and are caused by viruses that belong to the genus Capripoxvirus within the subfamily Chordopoxvirinae, family Poxviridae. To facilitate the study of lumpy skin disease pathogenesis, we inoculated eight 4‐ to 6‐month‐old Holstein calves intravenously with lumpy skin disease virus (LSDV) and collected samples over a period of 42 days for analysis by virus isolation, real‐time PCR and light microscopy. Following inoculation, cattle developed fever and skin nodules, with the extent of infection varying between animals. Skin nodules remained visible until the end of the experiment on day post‐inoculation (DPI) 42. Viremia measured by real‐time PCR and virus isolation was not observed in all animals but was detectable between 6 and 15 DPI. Low levels of viral shedding were observed in oral and nasal secretions between 12 and 18 DPI. Several tissues were assessed for the presence of virus at DPI 3, 6, 9, 12, 15, 18 and 42 by virus isolation and real‐time PCR. Virus was consistently detected by real‐time PCR and virus isolation at high levels in skin nodules indicating LSDV has a tropism for skin. In contrast, relatively few lesions were observed systemically. Viral DNA was detected by real‐time PCR in skin lesions collected on DPI 42. Cattle developing anti‐capripoxvirus antibodies starting at DPI 21 was detected by serum neutralization. The disease in this study varied from mild with few secondary skin nodules to generalized infection of varying severity, and was characterized by morbidity with no mortality.     

Carp Edema Virus/Koi Sleepy Disease: An Emerging Disease in Central‐East Europe

Koi sleepy disease (KSD), also known as carp edema virus (CEV), was first reported from juvenile colour carp in Japan in the 1970s. Recently, this pox virus was detected in several European countries, including Germany, France and the Netherlands. In England, in addition to colour carp, outbreaks in common carp are reported. KSD/CEV is an emerging infectious disease characterized by a typical sleepy behaviour, enophthalmia, generalized oedematous condition and gill necrosis, leading to hypoxia. High mortality, of up to 80–100%, is seen in juvenile koi collected from infected ponds. In Austria, this disease had not been detected until now. In spring 2014, diagnostic work revealed the disease in two unrelated cases. In one instance, a pond with adult koi was affected; in the other, the disease was diagnosed in adult common carp recently imported from the Czech Republic. A survey was carried out on recent cases (2013/2014), chosen from those with similar anamnestic and physical examination findings, revealing a total of 5/22 cases positive for KSD/CEV. In this study, two paradigmatic cases are presented in detail. Results together with molecular evidence shaped the pattern of the first diagnosis of KSD/CEV in fish from Austrian ponds. In the light of the positive cases detected from archived material, and the spread of the disease through live stock, imported from a neighbouring country, the need for epidemiological investigations in Austria and surrounding countries is emphasized.     

Foot‐and‐Mouth Disease Virus Concentrations in Products of Animal Origin

Foot‐and‐mouth disease (FMD) is a highly contagious disease of cloven‐hoofed animals which can have devastating economic consequences. Maintaining an FMD‐free status is a priority for non‐endemic countries, which restrict importation of animals and animal products from countries in which the disease is present or sporadic, thus presenting a considerable barrier to international trade. This review examines the concentration of FMD virus in animal tissues during the viraemic stage of disease and in animal products derived from infected animals.     

Detection and Molecular Characterization of Foot and Mouth Disease Viruses from Outbreaks in Some States of Northern Nigeria 2013–2015

Control measures for foot and mouth disease (FMD) in Nigeria have not been implemented due to the absence of locally produced vaccines and risk‐based analysis resulting from insufficient data on the circulating FMD virus (FMDV) serotypes/strains. In 2013‐2015, blood and epithelial samples were collected from reported FMD outbreaks in four states (Kaduna, Kwara, Plateau and Bauchi) in northern Nigeria. FMDV non‐structural protein (NSP) seroprevalence for the outbreaks was estimated at 80% (72 of 90) and 70% (131 of 188) post‐outbreak. Antibodies against FMDV serotypes O, A, SAT1, SAT2 and SAT3 were detected across the states using solid‐phase competitive ELISA. FMDV genome was detected in 99% (73 of 74) of the samples from FMD‐affected animals using rRT‐PCR, and cytopathic effect was found in cell culture by 59% (44 of 74) of these samples. Three FMDV serotypes O, A and SAT2 were isolated and characterized. The phylogenetic assessments of the virus isolates showed that two topotypes of FMDV serotype O, East Africa‐3 (EA‐3) and West Africa (WA) topotypes were circulating, as well as FMDV strains belonging to the Africa genotype (G‐IV) of serotype A and FMDV SAT2 topotype VII strains. While the serotype O (EA‐3) strains from Nigeria were most closely related to a 1999 virus strain from Sudan, the WA strain in Nigeria shares genetic relationship with three 1988 viruses in Niger. The FMDV serotype A strains were closely related to a known virus from Cameroon, and the SAT2 strains were most closely related to virus subtypes in Libya. This study provides evidence of co‐occurrence of FMDV serotypes and topotypes in West, Central, East and North Africa, and this has implication for control. The findings help filling the knowledge gap of FMDV dynamics in Nigeria and West Africa subregion to support local and regional development of vaccination‐based control plans and international risk assessment.     

Experimental Infection of Giraffe (Giraffa camelopardalis) With SAT‐1 and SAT‐2 Foot‐and‐Mouth Disease Virus

The potential role of giraffe (Giraffa camelopardalis) in the epidemiology and spread of foot‐and‐mouth disease (FMD) SAT types was investigated by experimental infection and detection of virus in excretions using virus isolation on primary pig kidney cell cultures. In two experiments separated by a period of 24 months, groups of four animals were needle infected with a SAT‐1 or SAT‐2 virus, respectively and two in‐contact controls were kept with each group. Viraemia was detected 3–9 days post‐infection and virus isolated from mouth washes and faeces only occasionally up to day 13. The SAT‐1 virus was transmitted to only one in‐contact control animal, probably via saliva that contained virus from vesicles in the mouth of a needle‐infected animal. None of the animals infected with the SAT‐2 virus had any vesicles in the mouth, and there was no evidence of transmission to the in‐contact controls. No virus was detected in probang samples for the duration of the experiments (60 days post‐infection), indicating that persistent infection probably did not establish with either of these isolates. Giraffe most likely do not play an important role in FMD dissemination. Transmission of infection would possibly occur only during close contact with other animals when mouth vesicles are evident.     

Successful Renal Transplantation in Patients with Chronic Granulomatous Disease

Chronic granulomatous disease (CGD) is a genetic disease caused by structural mutations in the enzyme NADPH oxidase that results in severe immunodeficiency. End-stage renal disease occurs in this patient population, and is often attributed to the necessary use of nephrotoxic anti-infectives. In this report, we present the experiences of two centers in transplantation of three patients with CGD: one transplanted with CGD, one cured of his CGD with bone marrow transplantation who subsequently underwent kidney transplantation and one that received a kidney transplant prior to being cured of CGD via a sequential peripheral blood stem cell transplant (SCT). All three recipients have enjoyed excellent outcomes. Their courses demonstrate the absolute requirements for a multidisciplinary and compulsive approach before, during and after transplantation. These case reports also highlight the unexpectedly benign effects of immunosuppressive therapy in this patient population.     

Isolation and Characterization of a Novel Tembusu Virus Circulating in Muscovy Ducks in South China

Duck Tembusu virus (DTMUV) is an infectious pathogen that can cause epidemics in egg‐laying ducks. Here, we isolated and characterized a DTMUV, designated GDLH01, thought to be responsible for the noticeable egg drop in Muscovy duck flocks in South China since 2011. The genome sequence of GDLH01 shared 97–99% homology with other avian‐origin Tembusu viruses, and 99.5% homology with the mosquito‐borne strain SDMS recently reported in China. Phylogenetic analysis based on the nucleotide sequence of the entire open reading frame confirmed that the isolate was of avian origin and closely related to a mosquito‐borne strain. Our findings characterize a novel Tembusu virus circulating in Muscovy ducks in South China and emphasize the importance of reinforcing biosecurity measures and developing vaccines to prevent the spread of this viral pathogen.     

Emergence and Distribution of Foot‐and‐Mouth Disease Virus Serotype A and O in Bangladesh

Foot‐and‐mouth disease (FMD) is endemic in Bangladesh and is predominantly due to FMDV serotype O. In 2012, FMD outbreaks were identified in five different districts of Bangladesh. Of 56 symptomatic cattle epithelial tissue samples, diagnostic PCR assay based on 5′‐URT detected 38 FMDV infections. Viral genotyping targeting VP1‐encoding region confirmed emergence of two distinct serotypes, A and O with an abundance of serotype A in Chittagong and Gazipur districts and serotype O in Pabna and Faridpur. Only single lineage of both A and O was retrieved from samples of five different regions. Sequencing and phylogenetic analysis of VP1 sequences revealed that serotype O sequences were closely related to the Ind 2001 sublineage of Middle East–South Asia (ME‐SA) topotype that was previously circulating in Bangladesh, and serotype A sequences belonging to the genotype VII that was dominant in India during the last decade. The results suggest that extensive cross‐border animal movement from neighbouring countries is the most likely source of FMDV serotypes in Bangladesh.     

Identification and Complete Genome of Seneca Valley Virus in Vesicular Fluid and Sera of Pigs Affected with Idiopathic Vesicular Disease,Brazil

Numerous, ongoing outbreaks in Brazilian swine herds have been characterized by vesicular lesions in sows and acute losses of neonatal piglets. The complete genome of Seneca Valley virus (SVV) was identified in vesicular fluid and sera of sows, providing evidence of association between SVV and vesicular disease and viraemia in affected animals.     

Pathotypic and Genotypic Characterization of Two Bangladeshi Isolates of Newcastle Disease Virus of Chicken and Pigeon Origin

Two Bangladeshi isolates of Newcastle disease virus (NDV), one from a chicken and one from a pigeon, were characterized in this study. Pathogenicity of the isolates was evaluated on the basis of intracerebral pathogenicity index (ICPI). Both the isolates were found to be of velogenic pathotype having ICPI of 1.83 and 1.51 for the chicken and pigeon isolate, respectively. Genotype of the isolates was determined by phylogenetic analysis based on partial F gene sequences. A 766‐bp genome fragment spanning partial M and F gene was amplified by RT‐PCR and sequenced. The first 354 bp of the coding region of F gene and corresponding deduced amino acid sequences (residues 1–118) of these two NDV isolates were aligned with that of other NDV strains retrieved from GenBank. A phylogenetic tree constructed from the alignment showed that the chicken isolate (BD‐C162) belonged to the newly described genotype XIII and the pigeon isolate (BD‐P01) to genotype VI. Both the chicken and pigeon isolates possessed a virulent‐like fusion protein cleavage site ¹¹²RRQKRF¹¹⁷.     

Evidence of Transstadial and Mechanical Transmission of Lumpy Skin Disease Virus by Amblyomma hebraeum Ticks

Lumpy skin disease (LSD) is an economically important disease caused by LSD virus (LSDV), a Capripoxvirus, characterized by fever and circumscribed skin lesions. It is suspected to be transmitted mechanically by biting flies. To assess the vector potential of Amblyomma hebraeum in transmission of LSDV, mechanical/intrastadial and transstadial modes of transmission of the virus by this tick species were investigated. Two cattle were artificially infected as sources (donors) of infection to ticks. Ticks were infected as either nymphs or adults. Male A. hebraeum ticks were partially fed on donor animals and transferred to recipient animals to test for mechanical/intrastadial transmission. Nymphal A. hebraeum were fed to repletion on donor animals. The emergent adult ticks were placed on recipient animals to test for transstadial transmission of the virus. Successful transmission of LSDV infection was determined in recipient animals by monitoring development of clinical signs, testing of blood for the presence of LSDV by real‐time PCR, virus isolation and the serum neutralization test. This report provides further evidence of mechanical/intrastadial and, for the first time, transstadial transmission of LSDV by A. hebraeum. These findings implicate A. hebraeum as a possible maintenance host in the epidemiology of the disease.     

Review of the Global Distribution of Foot‐and‐Mouth Disease Virus from 2007 to 2014

Foot‐and‐mouth disease (FMD) virus affects livestock worldwide. There are seven different serotypes, each with a diversity of topotypes, genetic lineages and strains. Some lineages have different properties that may contribute to sporadic spread beyond their recognized endemic areas. The objective of this study was to review the most significant FMD epidemiological events that took place worldwide between 2007 and 2014. Severe epidemics were caused by FMD virus (FMDV) lineage O/Asia/Mya‐98 in Japan and South Korea in 2010, both previously free of disease. In India, where FMD is endemic, the most important event was the re‐emergence of lineage O/ME‐SA/Ind‐2001 in 2008. Notably, this lineage, normally restricted to India, Bangladesh, Nepal and Bhutan, was also found in Saudi Arabia and Libya in 2013 and has caused several outbreaks in Tunisia and Algeria in 2014–2015. In January 2011, FMDV‐positive wild boars were found in Bulgaria, where the disease last occurred in 1996, followed by 12 outbreaks in livestock infected with FMDV O/ME‐SA/PanAsia2. In 2012, FMDV SAT2 caused outbreaks in Egypt and the Palestinian Autonomous Territories. Another significant event was the emergence of FMDV Asia1 Sindh‐08 in the Middle East. In South America, one outbreak of FMDV serotype O, topotype Euro‐SA was reported in Paraguay in 2011, which was recognized as FMD‐free with vaccination at the time. Lessons learned from past events, point out the need for an integrated strategy that comprises coordinated global and regional efforts for FMDV control and surveillance. Specific local characteristics related to host, environment and virus that condition FMD occurrence should be carefully considered and incorporated to adapt appropriate strategies into local plans. In this review, we compiled relevant epidemiological FMD events to provide a global overview of the current situation. We further discussed current challenges present in different FMD areas.