Dengue fever in travelers to the tropics, 1998 and 1999

Dengue fever (DF) has become common in western travelers to the tropics. To improve the basis for travel advice, risk factors and dengue manifestations were assessed in 107 Swedish patients for whom DF was diagnosed after return from travel in 1998 and 1999. Patient data were compared with data on a sample of all Swedish travelers to dengue-endemic countries in the same years. Only three of the patients had received pretravel advice concerning DF from their physicians. Hemorrhagic manifestations were common (21 of 74 patients) but caused no deaths. Risk factors for a DF diagnosis were travel to the Malay Peninsula (odds ratio [OR] 4.95; confidence interval [CI] 2.92 to 8.46), age 15-29 years (OR 3.03; CI 1.87 to 4.92), and travel duration >25 days (OR 8.75; CI 4.79 to 16.06). Pretravel advice should be given to all travelers to DF-endemic areas, but young persons traveling to southern and Southeast Asia for >3 weeks (who constituted 31% of the patients in our study) may be more likely to benefit by adhering to it.     

First outbreak of dengue hemorrhagic fever,Bangladesh

During the first countrywide outbreak of dengue hemorrhagic fever in Bangladesh, we conducted surveillance for dengue at a hospital in Dhaka. Of 176 patients, primarily adults, found positive for dengue, 60.2% had dengue fever, 39.2% dengue hemorrhagic fever, and 0.6% dengue shock syndrome. The Dengue virus 3 serotype was detected in eight patients.     

Myanmar dengue outbreak associated with displacement of serotypes 2, 3, and 4 by dengue 1

In 2001, Myanmar (Burma) had its largest outbreak of dengue-15,361 reported cases of dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS), including 192 deaths. That year, 95% of dengue viruses isolated from patients were serotype 1 viruses belonging to two lineages that had diverged from an earlier, now extinct, lineage sometime before 1998. The ratio of DHF to DSS cases in 2001 was not significantly different from that in 2000, when 1,816 cases of DHF/DSS were reported and dengue 1 also was the most frequently isolated serotype. However, the 2001 ratio was significantly higher than that in 1998 (also an outbreak year) and in 1999, when all four serotypes were detected and serotypes 1, 2, and 3 were recovered in similar numbers. The large number of clinical cases in 2001 may have been due, in part, to a preponderance of infections with dengue 1 viruses.     

Dengue and dengue hemorrhagic fever, Brazil, 1981-2002

In the last 5 years, Brazil has accounted for approximately 70% of reported dengue fever cases in the Americas. We analyzed trends of dengue and dengue hemorrhagic fever (DHF) from the early 1980s to 2002 by using surveillance data from the Brazilian Ministry of Health. Two distinct epidemiologic patterns for dengue were observed: localized epidemics (1986-1993), and endemic and epidemic virus circulation countrywide (1994-2002). Currently, serotypes 1, 2, and 3 cocirculate in 22 of 27 states. Dengue and DHF affected mainly adults; however, an increase in occurrence of DHF among children has been recently detected in northern Brazil, which suggests a shift in the occurrence of severe disease to younger age groups. In 2002, hospitalizations increased, which points out the change in disease severity compared to that seen in the 1990s. We describe the epidemiology of dengue in Brazil, characterizing the changing patterns of it and DHF during the last 20 years.     

47例登革热患者临床特征分析及护理体会

目的分析2010年我院收治的47例登革热患者的临床及实验室特征并观察护理效果。方法回顾性分析47例登革热患者的临床特征以及采取的护理措施。结果47例患者症状典型,主要的临床特征为发热（100％）、头痛（43．9％）、肌肉痛（56．09％）、骨关节痛（19．51％）以及皮疹（53．66％）,实验室特征为白细胞、血小板计数减少（各80．49％、39．02％）以及肝脏转氨酶升高（丙氨酸转氨酶和天冬氨酸转氨酶升高分别为23．4％和36．2％）,47例患者均无发生继发感染和院内感染。结论针对患者的临床及实验室特征采取相应的护理措施,可减轻患者痛苦,防止并发症的发生,提高护理质量。     

深圳市宝安区一起输入性登革热疫情的调查处理报告

目的明确深圳市宝安区疑似登革热疫情波及范围,以对疫情的发展趋势进行风险评估。方法建立病例定义,运用描述流行病学对患者的流行病学联系进行分析,并对疫情的扩散风险进行评估。结果该起登革热疫情共有2名病例,发病原因均为参加同次旅行团在印尼旅游期间感染后回国的输入性病例。对其中1名患者家庭周围的91户居民调查后发现,存在播散登革热疫情的可能（灭蚊前后布雷图指数分别为18.68和6.98）。结论该疫情为一起输入性登革热疫情。     

Dengue outbreak in Karachi, Pakistan, 2006: experience at a tertiary care center

This is the first report of the largest epidemic of dengue hemorrhagic fever (DHF) virus infection (2006) with IgM-confirmed cases from Karachi, Pakistan. Medical records of 172 IgM-positive patients were reviewed retrospectively for demographic, clinical and laboratory data. Patients were categorized into dengue fever (DF) and DHF according to the WHO severity grading scale. The mean+/-SD age of the patients was 25.9+/-12.8 years, 55.8% were males and the hemoconcentration was recorded in a small number of patients [10 (7.0%)]. Male gender [odds ratio (OR)=14.7, P=0.003), positive history of vomiting (OR=4.3, P=0.047), thrombocytopenia at presentation (OR=225.2, P<0.001) and monocytosis (OR=5.8, P=0.030) were independently associated with DHF, but not with DF. Five cases (2.9%) had a fatal outcome, with a male-to-female ratio of 1:4. Three were from a pediatric group (<15 years). Pulmonary hemorrhages, disseminated intravascular coagulation and cerebral edema preceded death in these patients. The results have highlighted significant findings, such as adult susceptibility to DHF, pronounced abdominal symptoms and lack of hemoconcentration at time of presentation in the study population. These findings may play an important role in the case definitions of future studies from this part of the world.     

A Study on Risk Factors of Breast Cancer Among Patients Attending the Tertiary Care Hospital,in Udupi District

Background:

Cancer has become one of the ten leading causes of death in India. Breast cancer is the most common diagnosed malignancy in India, it ranks second to cervical cancer. An increasing trend in incidence is reported from various registries of national cancer registry project and now India is a country with largest estimated number of breast cancer deaths worldwide.

Aim:

To study the factors associated with breast cancer.

Objectives:

To study the association between breast cancer and selected exposure variables and to identify risk factors for breast cancer.

Materials and Methods:

A hospital based Case control study was conducted at Shirdi Sai Baba Cancer Hospital and Research Center, Manipal, Udupi District.

Results:

Total 188 participants were included in the study, 94 cases and 94 controls. All the study participants were between 25 to 69 years of age group. The cases and controls were matched by ± 2 years age range. Non vegetarian diet was one of the important risk factors (OR 2.80, CI 1.15-6.81). More than 7 to 12 years of education (OR 4.84 CI 1.51-15.46) had 4.84 times risk of breast cancer as compared with illiterate women.

Conclusion:

The study suggests that non vegetarian diet is the important risk factor for Breast Cancer and the risk of Breast Cancer is more in educated women as compared with the illiterate women.

Limitation:

This is a Hospital based study so generalisability of the findings could be limited.     

Seven native cases of dengue in Abidjan,Ivory Coast

Objective

We had for aim to describe the epidemiological, clinical, biological, and outcome features of dengue fever in Abidjan, in 2010.

Patients and methods

We retrospectively studied the files of patients hospitalized for dengue fever in 2010, in Abidjan. The diagnosis was made on clinical symptoms and positive dengue PCR and/or IgM.

Results

Seven patients were included (5 men, 2 women, median age of 51 years [31–65 years]). They presented with a febrile pain syndrome (n = 7), jaundice (n = 3), rash (n = 2), and hematemesis complicated by thrombocytopenia (n = 6) and leukopenia (n = 5). Three patients had a positive IgM serology and 4 had a positive dengue PCR for DENV-3. The outcome was favorable for 6 patients, and 1 patient died of severe hemorrhage.

Conclusion

The authors advocate the implementation of epidemiological surveillance of dengue and vector control in the Ivory Coast.     

1978～1998年佛山市登革热流行病学调查分析

根据佛山市法定传染病报告年报表 ,对佛山市 1 978～ 1 998年登革热的流行病学特征进行了分析。 2 1年间佛山市共发生五次有病毒学诊断依据的登革热大流行 ,共报告病例 2 541 8例 ,死亡 1 4例。疫情高度集中在顺德市、佛山市区 (城区和石湾区 )和南海市等旧疫区。 8～ 1 0月是流行的高峰季节 ,白纹伊蚊是佛山市登革热的传播媒介 ,人群普遍易感 ,旧疫区内健康人群血抑抗体水平较非疫区健康人群高 ,登革热旧患者血抑抗体水平逐年下降。今后预防工作的重点应在旧疫区。根据流行病学及病毒流行型别特点 ,登革热在佛山市可能已经形成地方性流行     

1991年中山市沙溪镇登革热局部流行的调查

1991年8月下旬,中山市沙溪镇圣狮村发生登革热。流行初期,由于患者症状不够典型及调查工作不够深入细致,致误诊,未能及时采取有效的防疫措施,造成疫情扩散蔓延,波及紧邻的龙头环、龙聚环、象角三村及圩镇。整个流行历时64天,共发生112例。本次流行经病原学证实为I型登革病毒所引起。本文还就传染来源、传播因素及临床表现与致病毒株型别的关系等问题进行了讨论。     

广州市2002年与2006年登革热疫情流行特征比较

为探明近年广州市登革热的流行特征及变化趋势,将广州市2002年与2006年登革热疫情流行病学特征比较分析如下.     

2012年四川省入境人群疟疾、登革热、乙脑、基孔肯雅热疫情监测分析

目的 了解四川省入境人群疟疾、登革热、乙脑、基孔肯雅热的疫情动态,为入境人群疟疾、登革热、乙脑、基孔肯雅热流行趋势的预测、预警和制定防治对策、措施提供科学依据.方法 采集入境人员血液,用镜检、胶体金、ELISA、RT-PCR等方法进行疟疾、登革热、乙脑、基孔肯雅热的检测.结果 2012年四川省入境人群疟疾监测阳性率达2.62％,均为赴非洲的劳务人群.登革热、乙脑、基孔肯雅热阳性率均为0.结论 2012年四川省入境人群蚊媒病感染以疟疾尤其是恶性疟为主,感染者主要是赴非洲务工的劳务人员,因此应进一步加大对赴非洲劳务人员关于防疟知识的宣教和防疟措施的推广;出入境检验检疫局应对来自蚊媒病高发地区的国际航班进行重点监控,加大入境人群的传染病监管力度,及早发现输入性蚊媒传染病;本次虽未检出登革热、乙脑和基孔肯雅热,但这些传染病仍有潜在存在的可能性,应高度重视.     

Corticosteroids in the treatment of dengue illness

Dengue infection results in significant morbidity and mortality worldwide. Current recommended treatment is largely supportive with careful fluid replacement, with no specific treatment available. Although corticosteroids are not mentioned in the WHO guidelines on the management of dengue, clinicians use corticosteroids empirically based on the presumed immunological basis of the complications of dengue. The evidence base for the benefit or lack of benefit of corticosteroids in dengue is limited; previous studies have been small, with methodological flaws, less stringent randomisation and unclear allocation concealment, and were performed a long time ago. Studies so far have only been in patients with shock syndrome, and the possible effects of corticosteroids on thrombocytopenia and bleeding as well as other complications of dengue are unknown. All previous studies have been in children; the effect of corticosteroid treatment in adults with dengue infection has not been evaluated. The possible beneficial effects of corticosteroids on the various manifestations of dengue infection need evaluation by adequately powered, well designed, randomised controlled trials.     

Confirmation of dengue virus infection by detection of dengue virus type 1 genome in urine and saliva but not in plasma

We successfully detected dengue virus (DENV) genome in urine and saliva but not in plasma samples from a Japanese dengue fever patient. The results of the present study suggest that detection of DENV genome in urine and saliva can be an effective diagnostic method, particularly for children with viral hemorrhage.