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Bramlett KE, Witt LE, Meyer MM, Zellars K, Dye-Braumuller KC, Nolan MS. Evidence of Incomplete Feeding Behaviors among South Carolina Tick Populations. INSECTS 2024; 15:385. [PMID: 38921100 PMCID: PMC11203686 DOI: 10.3390/insects15060385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/20/2024] [Accepted: 05/22/2024] [Indexed: 06/27/2024]
Abstract
Dynamic environmental conditions, such as climate change and host availability, have greatly influenced the expansion of medically relevant tick vectors into new regions throughout the southeastern United States of America. As tick populations migrate into new areas, it has been suggested they can exhibit a phenomenon known as incomplete feeding. With this phenomenon, tick vectors feed on more than one host at each life stage, thus increasing the likelihood of pathogen transmission. Although this behavior is not well understood, it presents an important threat to human health. Here we present evidence of incomplete feeding behaviors in multiple tick species in South Carolina. Engorged, blood-fed female ticks were collected from feral dogs at animal shelters across South Carolina in 2022. All ticks were tested for human blood meals using rapid stain identification blood tests. Approximately one third (33.78%) of all ticks tested positive for a human blood meal, with various patterns seen across species, geographic location, and collection month. The results of this pilot study follow the current national trend of increasing rates of tick-borne disease incidence in the southeastern United States of America and warrant further investigation into the relationship between seasonality, geographic distribution, species, and incomplete feeding among tick populations in South Carolina.
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Affiliation(s)
- Kayla E. Bramlett
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (K.E.B.); (L.E.W.); (M.M.M.); (K.Z.); (K.C.D.-B.)
| | - Laura E. Witt
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (K.E.B.); (L.E.W.); (M.M.M.); (K.Z.); (K.C.D.-B.)
| | - Madeleine M. Meyer
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (K.E.B.); (L.E.W.); (M.M.M.); (K.Z.); (K.C.D.-B.)
- Department of Environmental Health, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Kia Zellars
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (K.E.B.); (L.E.W.); (M.M.M.); (K.Z.); (K.C.D.-B.)
| | - Kyndall C. Dye-Braumuller
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (K.E.B.); (L.E.W.); (M.M.M.); (K.Z.); (K.C.D.-B.)
| | - Melissa S. Nolan
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (K.E.B.); (L.E.W.); (M.M.M.); (K.Z.); (K.C.D.-B.)
- Institute for Infectious Disease Translational Research, University of South Carolina, Columbia, SC 29208, USA
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Srichawla BS, Manan MR, Kipkorir V, Dhali A, Diebel S, Sawant T, Zia S, Carrion-Alvarez D, Suteja RC, Nurani K, Găman MA. Neuroinvasion of emerging and re-emerging arboviruses: A scoping review. SAGE Open Med 2024; 12:20503121241229847. [PMID: 38711470 PMCID: PMC11072077 DOI: 10.1177/20503121241229847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 01/16/2024] [Indexed: 05/08/2024] Open
Abstract
Background Arboviruses are RNA viruses and some have the potential to cause neuroinvasive disease and are a growing threat to global health. Objectives Our objective is to identify and map all aspects of arbovirus neuroinvasive disease, clarify key concepts, and identify gaps within our knowledge with appropriate future directions related to the improvement of global health. Methods Sources of Evidence: A scoping review of the literature was conducted using PubMed, Scopus, ScienceDirect, and Hinari. Eligibility Criteria: Original data including epidemiology, risk factors, neurological manifestations, neuro-diagnostics, management, and preventive measures related to neuroinvasive arbovirus infections was obtained. Sources of evidence not reporting on original data, non-English, and not in peer-reviewed journals were removed. Charting Methods: An initial pilot sample of 30 abstracts were reviewed by all authors and a Cohen's kappa of κ = 0.81 (near-perfect agreement) was obtained. Records were manually reviewed by two authors using the Rayyan QCRI software. Results A total of 171 records were included. A wide array of neurological manifestations can occur most frequently, including parkinsonism, encephalitis/encephalopathy, meningitis, flaccid myelitis, and Guillain-Barré syndrome. Magnetic resonance imaging of the brain often reveals subcortical lesions, sometimes with diffusion restriction consistent with acute ischemia. Vertical transmission of arbovirus is most often secondary to the Zika virus. Neurological manifestations of congenital Zika syndrome, include microcephaly, failure to thrive, intellectual disability, and seizures. Cerebrospinal fluid analysis often shows lymphocytic pleocytosis, elevated albumin, and protein consistent with blood-brain barrier dysfunction. Conclusions Arbovirus infection with neurological manifestations leads to increased morbidity and mortality. Risk factors for disease include living and traveling in an arbovirus endemic zone, age, pregnancy, and immunosuppressed status. The management of neuroinvasive arbovirus disease is largely supportive and focuses on specific neurological complications. There is a need for therapeutics and currently, management is based on disease prevention and limiting zoonosis.
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Affiliation(s)
- Bahadar S Srichawla
- Department of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | | | - Vincent Kipkorir
- Department of Human Anatomy and Physiology, University of Nairobi, Nairobi, Kenya
| | - Arkadeep Dhali
- Department of Internal Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Sebastian Diebel
- Department of Family Medicine, Northern Ontario School of Medicine University, Sudbury, ON, Canada
| | - Tirtha Sawant
- Department of Neurology, Spartan Health Sciences University, Spartan Drive St, Saint Lucia
| | - Subtain Zia
- Department of Infectious Diseases, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | | | - Richard C Suteja
- Faculty of Medicine, Udayana University, Kampus Bukit, Jl, Raya Kampus Unud Jimbaran, Kec, Kuta Sel, Kabupaten Badung, Bukit Jimbaran, Bali, Indonesia
| | - Khulud Nurani
- Department of Human Anatomy and Physiology, University of Nairobi, Nairobi, Kenya
| | - Mihnea-Alexandru Găman
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, București, Romania
- Bucharest, Romania and Department of Hematology, Center of Hematology and Bone Marrow Transplantation, Fundeni Clinical Institute, București, Romania
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Relationship between the Incidence of Dengue Virus Transmission in Traditional Market and Climatic Conditions in Kaohsiung City. ACTA ACUST UNITED AC 2021; 2021:9916642. [PMID: 34422144 PMCID: PMC8371670 DOI: 10.1155/2021/9916642] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 07/31/2021] [Indexed: 11/18/2022]
Abstract
In 2014 and 2015, Southern Taiwan experienced two unprecedented outbreaks, with more than 10,000 laboratory-confirmed dengue cases in each outbreak. The present study was aimed to investigate the influence of meteorological and spatial factors on dengue outbreaks in Southern Taiwan and was conducted in Kaohsiung City, which is the most affected area in Taiwan. The distributed lag nonlinear model was used to investigate the role of climatic factors in the 2014 and 2015 dengue outbreaks. Spatial statistics in the Geographic Information System was applied to study the relationship between the dengue spreading pattern and locations of traditional markets (human motility) in the 2015 dengue outbreak. Meteorological analysis results suggested that the relative risk of dengue fever increased when the weekly average temperature was more than 15°C at lagged weeks 5 to 18. Elevated relative risk of dengue was observed when the weekly average rainfall was more than 150 mm at lagged weeks 12 to 20. The spatial analysis revealed that approximately 83% of dengue cases were located in the 1000 m buffer zone of traditional market, with statistical significance. These findings support the influence of climatic factors and human motility on dengue outbreaks. Furthermore, the study analysis may help authorities to identify hotspots and decide the timing for implementation of dengue control programs.
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Abd El Ghany M, Fouz N, Hill-Cawthorne GA. Human Movement and Transmission of Antimicrobial-Resistant Bacteria. THE HANDBOOK OF ENVIRONMENTAL CHEMISTRY 2020:311-344. [DOI: 10.1007/698_2020_560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Guzmán C, Calderón A, Martinez C, Oviedo M, Mattar S. Eco-epidemiology of the Venezuelan equine encephalitis virus in bats of Córdoba and Sucre, Colombia. Acta Trop 2019; 191:178-184. [PMID: 30578748 PMCID: PMC7172953 DOI: 10.1016/j.actatropica.2018.12.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 12/01/2018] [Accepted: 12/08/2018] [Indexed: 12/02/2022]
Abstract
Alphavirus infection associated encephalitis is an emerging infectious disease with a high impact on public health in Latin America. OBJECTIVE To study the eco-epidemiology of alphaviruses in bats of departments of Córdoba and Sucre, Colombia. METHODOLOGY A prospective descriptive cross-sectional study with a non-probabilistic sampling, in 12 localities of Córdoba and Sucre was carried out. Using mist nets capture of the specimens was carried out. The size of the sample was 286 bats, each specimen captured was taxonomically classified. The bats were immobilized with anesthetic and analgesic treatment according to the ethics committee of the University of Córdoba, morphometric measurements and blood samples were taken, later they were necropsied in the field to obtain a collection of tissues which were preserved in liquid N2 -190 °C. The averages of the climatic conditions of the sampling sites were extracted from the WorldClim database (http://www.worldclim.org/). The open source software QGIS (Quantum GIS Development Team.2015) was used to map and visualize bioclimatic regions of Córdoba. We used descriptive and retrospective information about the equine population and reports of foci of equine encephalitis. RESULTS In Córdoba and Sucre, 286 bats were captured and 23 species were classified, Artibeus and Phyllostomus discolor were the most frequent captured genus. The geographic ranges of the captured species were variable, some had a wide distribution and others were restricted to some areas. Venezuelan equine encephalitis virus RNA was detected in Artibeus planirostris and Sturnira lilium (2/286 = 0.70%) from Cordoba - Colombia. The univariate descriptive analysis showed no significant association for any of the analyzed variables climatic. CONCLUSIONS Frugivorous bats from the Caribbean area of Colombia may be involved in the Venezuelan equine encephalitis virus enzootic cycle.
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Affiliation(s)
- Camilo Guzmán
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Montería, Colombia; Doctorado en Medicina Tropical SUE-Caribe, Universidad de Córdoba, Colombia
| | - Alfonso Calderón
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Montería, Colombia; Doctorado en Medicina Tropical SUE-Caribe, Universidad de Córdoba, Colombia
| | - Catty Martinez
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Montería, Colombia
| | - Misael Oviedo
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Montería, Colombia
| | - Salim Mattar
- Universidad de Córdoba, Instituto de Investigaciones Biológicas del Trópico, Montería, Colombia.
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Akter R, Hu W, Naish S, Banu S, Tong S. Joint effects of climate variability and socioecological factors on dengue transmission: epidemiological evidence. Trop Med Int Health 2017; 22:656-669. [PMID: 28319296 DOI: 10.1111/tmi.12868] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To assess the epidemiological evidence on the joint effects of climate variability and socioecological factors on dengue transmission. METHODS Following PRISMA guidelines, a detailed literature search was conducted in PubMed, Web of Science and Scopus. Peer-reviewed, freely available and full-text articles, considering both climate and socioecological factors in relation to dengue, published in English from January 1993 to October 2015 were included in this review. RESULTS Twenty studies have met the inclusion criteria and assessed the impact of both climatic and socioecological factors on dengue dynamics. Among those, four studies have further investigated the relative importance of climate variability and socioecological factors on dengue transmission. A few studies also developed predictive models including both climatic and socioecological factors. CONCLUSIONS Due to insufficient data, methodological issues and contextual variability of the studies, it is hard to draw conclusion on the joint effects of climate variability and socioecological factors on dengue transmission. Future research should take into account socioecological factors in combination with climate variables for a better understanding of the complex nature of dengue transmission as well as for improving the predictive capability of dengue forecasting models, to develop effective and reliable early warning systems.
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Affiliation(s)
- Rokeya Akter
- School of Public Health and Social Work, Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia
| | - Wenbiao Hu
- School of Public Health and Social Work, Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia
| | - Suchithra Naish
- School of Public Health and Social Work, Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia
| | - Shahera Banu
- School of Public Health and Social Work, Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia
| | - Shilu Tong
- School of Public Health and Social Work, Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia
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Feng J, Xia Z, Zhang L, Cheng S, Wang R. Risk Assessment of Malaria Prevalence in Ludian, Yongshan, and Jinggu Counties, Yunnan Province, After 2014 Earthquake Disaster. Am J Trop Med Hyg 2016; 94:674-678. [PMID: 26711514 PMCID: PMC4775906 DOI: 10.4269/ajtmh.15-0624] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 10/20/2015] [Indexed: 11/18/2022] Open
Abstract
The objective of this study was to investigate malaria prevalence after the 2014 earthquakes in Ludian, Yongshan, and Jinggu counties, Yunnan Province, China. We collected and analyzed epidemiological data and made a risk assessment of transmission probability. From January 2005 to July 2015, 87 malaria cases were reported in the three counties, most of which (81.6%) occurred between 2005 and 2009, with five cases reported in Jinggu County between January 2014 and July 2015, of which one case was reported after the earthquake. In addition, no local transmission occurred in the three counties from 2010, and 95.5% of imported malaria occurred in patients who had returned from Myanmar. The townships of Lehong, Qingsheng, and Weiyuan were the main endemic areas in the three counties. The probability of malaria transmission in the three counties was low, but Jinggu County had a higher risk due to the existence of infected patients and an appropriate vector. With sporadic cases reported annually, close monitoring should continue to enhance early detection of a possible malaria outbreak.
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Affiliation(s)
| | | | | | | | - Rubo Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, China; Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China; World Health Organization Collaborating Centre for Tropical Diseases, Shanghai, China; National Center for International Research on Tropical Diseases, Shanghai, China; GeneScience Pharmaceuticals Co., Ltd., Changchun, China
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Gao L, Zhang Y, Ding G, Liu Q, Jiang B. Identifying Flood-Related Infectious Diseases in Anhui Province, China: A Spatial and Temporal Analysis. Am J Trop Med Hyg 2016; 94:741-9. [PMID: 26903612 DOI: 10.4269/ajtmh.15-0338] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 12/28/2015] [Indexed: 11/07/2022] Open
Abstract
The aim of this study was to explore infectious diseases related to the 2007 Huai River flood in Anhui Province, China. The study was based on the notified incidences of infectious diseases between June 29 and July 25 from 2004 to 2011. Daily incidences of notified diseases in 2007 were compared with the corresponding daily incidences during the same period in the other years (from 2004 to 2011, except 2007) by Poisson regression analysis. Spatial autocorrelation analysis was used to test the distribution pattern of the diseases. Spatial regression models were then performed to examine the association between the incidence of each disease and flood, considering lag effects and other confounders. After controlling the other meteorological and socioeconomic factors, malaria (odds ratio [OR] = 3.67, 95% confidence interval [CI] = 1.77-7.61), diarrhea (OR = 2.16, 95% CI = 1.24-3.78), and hepatitis A virus (HAV) infection (OR = 6.11, 95% CI = 1.04-35.84) were significantly related to the 2007 Huai River flood both from the spatial and temporal analyses. Special attention should be given to develop public health preparation and interventions with a focus on malaria, diarrhea, and HAV infection, in the study region.
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Affiliation(s)
- Lu Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Shandong Province, People's Republic of China; School of Public Health, China Studies Centre, The University of Sydney, New South Wales, Australia; School of Public Health, Center for Climate Change and Health, Shandong University, Shandong Province, People's Republic of China; Department of Occupational and Environmental Health, School of Public Health, Taishan Medical College, Shandong Province, People's Republic of China; State Key Laboratory for Infectious Diseases Prevention and Control, National Institute for Communicable Disease Control and Prevention, China Centers for Disease Control and Prevention, Beijing City, People's Republic of China
| | - Ying Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Shandong Province, People's Republic of China; School of Public Health, China Studies Centre, The University of Sydney, New South Wales, Australia; School of Public Health, Center for Climate Change and Health, Shandong University, Shandong Province, People's Republic of China; Department of Occupational and Environmental Health, School of Public Health, Taishan Medical College, Shandong Province, People's Republic of China; State Key Laboratory for Infectious Diseases Prevention and Control, National Institute for Communicable Disease Control and Prevention, China Centers for Disease Control and Prevention, Beijing City, People's Republic of China
| | - Guoyong Ding
- Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Shandong Province, People's Republic of China; School of Public Health, China Studies Centre, The University of Sydney, New South Wales, Australia; School of Public Health, Center for Climate Change and Health, Shandong University, Shandong Province, People's Republic of China; Department of Occupational and Environmental Health, School of Public Health, Taishan Medical College, Shandong Province, People's Republic of China; State Key Laboratory for Infectious Diseases Prevention and Control, National Institute for Communicable Disease Control and Prevention, China Centers for Disease Control and Prevention, Beijing City, People's Republic of China
| | - Qiyong Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Shandong Province, People's Republic of China; School of Public Health, China Studies Centre, The University of Sydney, New South Wales, Australia; School of Public Health, Center for Climate Change and Health, Shandong University, Shandong Province, People's Republic of China; Department of Occupational and Environmental Health, School of Public Health, Taishan Medical College, Shandong Province, People's Republic of China; State Key Laboratory for Infectious Diseases Prevention and Control, National Institute for Communicable Disease Control and Prevention, China Centers for Disease Control and Prevention, Beijing City, People's Republic of China
| | - Baofa Jiang
- Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Shandong Province, People's Republic of China; School of Public Health, China Studies Centre, The University of Sydney, New South Wales, Australia; School of Public Health, Center for Climate Change and Health, Shandong University, Shandong Province, People's Republic of China; Department of Occupational and Environmental Health, School of Public Health, Taishan Medical College, Shandong Province, People's Republic of China; State Key Laboratory for Infectious Diseases Prevention and Control, National Institute for Communicable Disease Control and Prevention, China Centers for Disease Control and Prevention, Beijing City, People's Republic of China
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Chien LC, Yu HL. Impact of meteorological factors on the spatiotemporal patterns of dengue fever incidence. ENVIRONMENT INTERNATIONAL 2014; 73:46-56. [PMID: 25084561 DOI: 10.1016/j.envint.2014.06.018] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 06/17/2014] [Accepted: 06/22/2014] [Indexed: 05/05/2023]
Abstract
Dengue fever is one of the most widespread vector-borne diseases and has caused more than 50 million infections annually over the world. For the purposes of disease prevention and climate change health impact assessment, it is crucial to understand the weather-disease associations for dengue fever. This study investigated the nonlinear delayed impact of meteorological conditions on the spatiotemporal variations of dengue fever in southern Taiwan during 1998-2011. We present a novel integration of a distributed lag nonlinear model and Markov random fields to assess the nonlinear lagged effects of weather variables on temporal dynamics of dengue fever and to account for the geographical heterogeneity. This study identified the most significant meteorological measures to dengue fever variations, i.e., weekly minimum temperature, and the weekly maximum 24-hour rainfall, by obtaining the relative risk (RR) with respect to disease counts and a continuous 20-week lagged time. Results show that RR increased as minimum temperature increased, especially for the lagged period 5-18 weeks, and also suggest that the time to high disease risks can be decreased. Once the occurrence of maximum 24-hour rainfall is >50 mm, an associated increased RR lasted for up to 15 weeks. A temporary one-month decrease in the RR of dengue fever is noted following the extreme rain. In addition, the elevated incidence risk is identified in highly populated areas. Our results highlight the high nonlinearity of temporal lagged effects and magnitudes of temperature and rainfall on dengue fever epidemics. The results can be a practical reference for the early warning of dengue fever.
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Affiliation(s)
- Lung-Chang Chien
- Division of Biostatistics, University of Texas School of Public Health at San Antonio Regional Campus, San Antonio, TX 78229, USA; Research to Advance Community Health Center, University of Texas Health Science Center at San Antonio Regional Campus, San Antonio, TX 78229, USA
| | - Hwa-Lung Yu
- Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei 10617, Taiwan.
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A probabilistic spatial dengue fever risk assessment by a threshold-based-quantile regression method. PLoS One 2014; 9:e106334. [PMID: 25302582 PMCID: PMC4193740 DOI: 10.1371/journal.pone.0106334] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 08/04/2014] [Indexed: 11/19/2022] Open
Abstract
Understanding the spatial characteristics of dengue fever (DF) incidences is crucial for governmental agencies to implement effective disease control strategies. We investigated the associations between environmental and socioeconomic factors and DF geographic distribution, are proposed a probabilistic risk assessment approach that uses threshold-based quantile regression to identify the significant risk factors for DF transmission and estimate the spatial distribution of DF risk regarding full probability distributions. To interpret risk, return period was also included to characterize the frequency pattern of DF geographic occurrences. The study area included old Kaohsiung City and Fongshan District, two areas in Taiwan that have been affected by severe DF infections in recent decades. Results indicated that water-related facilities, including canals and ditches, and various types of residential area, as well as the interactions between them, were significant factors that elevated DF risk. By contrast, the increase of per capita income and its associated interactions with residential areas mitigated the DF risk in the study area. Nonlinear associations between these factors and DF risk were present in various quantiles, implying that water-related factors characterized the underlying spatial patterns of DF, and high-density residential areas indicated the potential for high DF incidence (e.g., clustered infections). The spatial distributions of DF risks were assessed in terms of three distinct map presentations: expected incidence rates, incidence rates in various return periods, and return periods at distinct incidence rates. These probability-based spatial risk maps exhibited distinct DF risks associated with environmental factors, expressed as various DF magnitudes and occurrence probabilities across Kaohsiung, and can serve as a reference for local governmental agencies.
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Malhotra R, Singh L, Bundela RK, Garg P, Kant D, Garg A, Lal BB. Retinal profile: a clinical indicator of severity in dengue fever in a suburban Indian environment. Trop Doct 2014; 44:143-7. [DOI: 10.1177/0049475514529759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose To study the retinal changes in subjects suffering from dengue fever and check if these changes can be taken as sufficient indicator of severity and progression of the disease. Patients/Methods A detailed history was recorded of 118 patients on whom ocular examination, including direct ophthalmoscopy, indirect ophthalmoscopy and coloured fundus photography, was performed. Results Forty-seven percent of patients were found to have posterior segment abnormalities. Retinal vein dilatation or tortuosity was the most common finding followed by changes in the optic disc (8.4% of patients) and background haemorrhage (6.7% of patients). With increasing severity of thrombocytopenia, the proportion of patients with retinal abnormalities increased. In patients with grade I thrombocytopenia, no fundal abnormality was found. In those with grade II thrombocytopenia, fundal abnormality was found in 13.63% patients, whereas in the grade III category it was 27.90%. Conclusions Severity of thrombocytopenia had a significant association with retinal abnormalities. Occurrence of fundus changes increases with an increase in severity of thrombocytopenia. Fundus changes were found in all patients with grade IV thrombocytopenia.
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Affiliation(s)
- Rubii Malhotra
- Associate Professor, Ophthalmology Department, Era’s Lucknow Medical College & Hospital, Lucknow, India
| | - Luxmi Singh
- Professor, Ophthalmology Department, Era’s Lucknow Medical College & Hospital, Lucknow, India
| | - RK Bundela
- Associate Professor, Ophthalmology Department, Era’s Lucknow Medical College & Hospital, Lucknow, India
| | - Pragati Garg
- Professor, Ophthalmology Department, Era’s Lucknow Medical College & Hospital, Lucknow, India
| | - Diva Kant
- Resident, Ophthalmology Department, Era’s Lucknow Medical College & Hospital, Lucknow, India
| | - Ankit Garg
- Resident, Ophthalmology Department, Era’s Lucknow Medical College & Hospital, Lucknow, India
| | - BB Lal
- Professor & Head, Ophthalmology Department, Era’s Lucknow Medical College & Hospital, Lucknow, India
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Vinner L, Domingo C, Ostby ACB, Rosenberg K, Fomsgaard A. Cases of travel-acquired dengue fever in Denmark 2001-2009. Clin Microbiol Infect 2011; 18:171-6. [PMID: 21745259 DOI: 10.1111/j.1469-0691.2011.03543.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Dengue fever (DF) remains one of the most important emerging infectious diseases. Whereas DF is well recognized in endemic countries, there are indications that the disease is underdiagnosed among travellers to endemic regions. Here, we present the first descriptive survey on cases of travel-acquired DF imported to Denmark diagnosed at the national reference laboratory for dengue virus diagnostics during a 9-year period. In our study, 16 - 46 travel-acquired dengue virus infections were diagnosed per year. DF is mainly imported by adults, mostly men, returning from Southeast Asian countries. The minimum incidence of dengue virus infection among Danish travellers is estimated to be 4.9 per 100,000 travellers. Our results confirm and expand studies from other European countries, and underline the importance of surveillance based on relevant diagnostic analyses.
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Affiliation(s)
- L Vinner
- Department of Virology, Statens Serum Institut, Copenhagen S, Denmark.
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Tuiskunen A, Hjertqvist M, Vene S, Lundkvist A. Dengue fever in returned Swedish travelers from Thailand. Infect Ecol Epidemiol 2011; 1:IEE-1-7240. [PMID: 22957112 PMCID: PMC3426329 DOI: 10.3402/iee.v1i0.7240] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Revised: 08/11/2011] [Accepted: 08/25/2011] [Indexed: 11/28/2022] Open
Abstract
The dengue viruses (DENV) are endemic in the tropical and sub-tropical countries and cause the most common arthropod-borne viral disease in humans. Travelers visiting endemic areas may both acquire and spread DENV infections, and this is the reason why prevention of mosquito bites is of crucial importance. Dengue fever (DF) has become the most common cause for tropical fever in Swedish tourists. Swedish data from 1995 to 2010 show that the number of DF cases has increased since the beginning of 2000; partly due to improved diagnostics based on IgM detection, and partly due to an increase in the number of tourists traveling to, and between, endemic areas. Young adults aged 20–29 are mostly affected, and epidemiological data indicate increased incidence rates from 2008 onwards. Our data pose a call for attention when traveling to DENV endemic areas as well as an increased awareness among physicians when treating returning travelers.
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Affiliation(s)
- Anne Tuiskunen
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
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Choi SH, Kim YJ, Shin JH, Yoo KH, Sung KW, Koo HH. International travel of Korean children and Dengue fever: A single institutional analysis. KOREAN JOURNAL OF PEDIATRICS 2010; 53:701-4. [PMID: 21189941 PMCID: PMC2994129 DOI: 10.3345/kjp.2010.53.6.701] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2009] [Revised: 09/24/2009] [Accepted: 10/19/2009] [Indexed: 11/30/2022]
Abstract
Purpose Dengue fever occurs in many popular tourist destinations and is increasingly imported by returning travelers in Korea. Since Korea is not an endemic country for dengue fever, pediatricians do not usually suspect dengue fever in febrile children even with typical presentation and exposure history. This study was performed to describe the international travel experiences and dengue fever in Korean children. Methods Travel histories were collected based on questionnaires completed by all patients' guardians who visited the pediatric infectious diseases clinic at Samsung Medical Center from January 2008 to December 2008. For patients who were suspected of dengue fever, a serological test was performed. Results Five hundred and seventeen children visited the pediatric infectious diseases clinic for the first time during this period. About 30% of patients who responded to the questionnaire (101/339) had experienced international travel within the last 2 years. Four patients were diagnosed with dengue fever by serological test. Conclusion Increasing numbers of Korean children visit dengue endemic areas and they may return home with dengue fever. Dengue fever should be suspected in patients who have a travel history to endemic areas.
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Affiliation(s)
- Soo Han Choi
- Department of Pediatrics, School of Medicine, Sungkyunkwan University Samsung Medical Center, Seoul, Korea
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Wen TH, Lin NH, Chao DY, Hwang KP, Kan CC, Lin KCM, Wu JTS, Huang SYJ, Fan IC, King CC. Spatial-temporal patterns of dengue in areas at risk of dengue hemorrhagic fever in Kaohsiung, Taiwan, 2002. Int J Infect Dis 2009; 14:e334-43. [PMID: 19716331 DOI: 10.1016/j.ijid.2009.06.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2008] [Revised: 04/20/2009] [Accepted: 06/02/2009] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE This study aimed to examine whether spatial-temporal patterns of dengue can be used to identify areas at risk of dengue hemorrhagic fever (DHF). METHODS Three indices - probability of case-occurrence, mean duration per wave, and transmission intensity - were used to differentiate eight local spatial-temporal patterns of dengue during the 2002 epidemic in Kaohsiung, Taiwan. DHF densities (DHF cases/km(2) per 100 dengue cases) in each spatial-temporal typed area were compared. RESULTS Areas with three high indices correlated with the highest DHF density: (1) high transmission intensity only; (2) long duration of wave only, and (3) high transmission intensity plus long duration of wave. However, cumulative incidences of dengue cases were not correlated with DHF densities. CONCLUSION Three spatial-temporal indices of dengue could provide useful information to identify areas at high risk of DHF.
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Affiliation(s)
- Tzai-Hung Wen
- Department of Geography, College of Science, National Taiwan University, Taipei, Taiwan
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Affiliation(s)
- A Desiree LaBeaud
- Department of Pediatrics and Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, USA.
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Melo PRSD, Reis EAG, Ciuffo IA, Góes M, Blanton RE, Reis MGD. The dynamics of dengue virus serotype 3 introduction and dispersion in the state of Bahia, Brazil. Mem Inst Oswaldo Cruz 2008; 102:905-12. [PMID: 18209927 DOI: 10.1590/s0074-02762007000800003] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2007] [Accepted: 11/28/2007] [Indexed: 11/21/2022] Open
Abstract
By 2002, dengue virus serotype 1 (DENV-1) and DENV-2 had circulated for more than a decade in Brazil. In 2002, the introduction of DENV-3 in the state of Bahia produced a massive epidemic and the first cases of dengue hemorrhagic fever. Based on the standardized frequency, timing and location of viral isolations by the state's Central Laboratory, DENV-3 probably entered Bahia through its capital, Salvador, and then rapidly disseminated to other cities, following the main roads. A linear regression model that included traffic flow, distance from the capital and DENV-1 circulation (r2 = 0.24, p = 0.001) supported this hypothesis. This pattern was not seen for serotypes already in circulation and was not seen for DENV-3 in the following year. Human population density was another important factor in the intensity of viral circulation. Neither DENV-1 nor DENV-2 fit this model for 2001 or 2003. Since the vector has limited flight range and vector densities fail to correlate with intensity of viral circulation, this distribution represents the movement of infected people and to some extent mosquitoes. This pattern may mimic person-to-person spread of a new infection.
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Ito M, Yamada KI, Takasaki T, Pandey B, Nerome R, Tajima S, Morita K, Kurane I. Phylogenetic analysis of dengue viruses isolated from imported dengue patients: possible aid for determining the countries where infections occurred. J Travel Med 2007; 14:233-44. [PMID: 17617845 DOI: 10.1111/j.1708-8305.2007.00130.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Molecular epidemiology of dengue viruses in endemic countries have been reported, but few were reported on the imported dengue cases among travelers. We analyzed dengue viruses isolated from imported dengue cases in Japan who were infected while traveling in endemic regions of the world. METHOD We sequenced the complete envelope (E) gene of 33 dengue virus strains isolated from patients returning from Asia, Oceania, South Pacific islands, and South America to Japan where no domestic dengue virus infection occurs. We then performed phylogenetic analysis to define the geographic origin of isolated viruses. Moreover, we compared the genomes of isolated dengue viruses with those of the strains already deposited in the GenBank database. RESULT The isolates are clustered into expected genotypes, confirming that the viruses originated from the visited countries. When patients visited more than one country during a single trip, the countries where the infection occurred were also determined for four of the six patients. There were three isolates, which were different genotypes from those previously isolated in visited countries. CONCLUSIONS The study demonstrates that many dengue virus strains are introduced into Japan and that phylogenic analysis of isolated dengue viruses is a unique technique to determine the countries where infection occurred. Travelers carry viruses and provide important and unique information for clarifying dengue virus trait and its dissemination.
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Affiliation(s)
- Mikako Ito
- Department of Virology 1, National Institute of Infectious Disease, Tokyo, Japan
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Bulugahapitiya U, Siyambalapitiya S, Seneviratne SL, Fernando DJ. Dengue fever in travellers: A challenge for European physicians. Eur J Intern Med 2007; 18:185-92. [PMID: 17449389 PMCID: PMC7127095 DOI: 10.1016/j.ejim.2006.12.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2006] [Revised: 11/04/2006] [Accepted: 12/15/2006] [Indexed: 11/02/2022]
Abstract
Dengue fever (DF) is one of the world's emerging infectious diseases. The steady increase in European tourists, as well as soldiers serving on peacekeeping duties, in endemic areas, coupled with the present resurgence of dengue, raises the risk of exposure for a large number of European travellers. Significant numbers of travellers have, in fact, developed DF. There is a risk of dengue haemorrhagic fever (DHF) in travellers who revisit the same place, and they have the potential not only to acquire, but also to spread, the dengue viral infection. Of concern is the potential for a dengue outbreak in a previously dengue-free country through imported cases. Another major concern is the potential area of dengue transmission, due to spread of its vectors through sizeable parts of southern Europe. In addition to the risk of haemorrhagic fever in returning tourists, the introduction of DF by returning travellers, whether they have symptoms or are unaffected by signs and symptoms of the disease, poses a threat to health systems in Europe.
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Affiliation(s)
| | | | | | - Devaka J.S. Fernando
- Sherwood Forest Hospitals NHS Trust & University of Sheffield, United Kingdom
- Corresponding author.
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Abstract
The relationship between natural disasters and communicable diseases is frequently misconstrued. The risk for outbreaks is often presumed to be very high in the chaos that follows natural disasters, a fear likely derived from a perceived association between dead bodies and epidemics. However, the risk factors for outbreaks after disasters are associated primarily with population displacement. The availability of safe water and sanitation facilities, the degree of crowding, the underlying health status of the population, and the availability of healthcare services all interact within the context of the local disease ecology to influence the risk for communicable diseases and death in the affected population. We outline the risk factors for outbreaks after a disaster, review the communicable diseases likely to be important, and establish priorities to address communicable diseases in disaster settings.
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Affiliation(s)
- John T Watson
- Disease Control in Humanitarian Emerfencies, Communicable Disease Cluster, World Health Organization, Geneva, Switzerland.
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Kapoor HK, Bhai S, John M, Xavier J. Ocular manifestations of dengue fever in an East Indian epidemic. Can J Ophthalmol 2007; 41:741-6. [PMID: 17224957 DOI: 10.3129/i06-069] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND The incidence and geographic distribution of dengue has increased dramatically in recent years. Previously, ocular findings in dengue fever were considered rare. We report a spectrum of ocular manifestations of this potentially fatal disease and its association with laboratory parameters. METHODS 134 patients hospitalized with a diagnosis of dengue fever during an epidemic were included. Systemic and ophthalmic examinations were completed on all patients. RESULTS The mean age was 31.3 years and 63.4% were males. All patients presented with fever. Six (4.5%) patients had retrobulbar pain and none of the patients presented with any visual complaints. Ocular findings were present in 54 (40.3%) patients. Subconjunctival haemorrhage was the commonest eye finding seen in 50 patients, of whom 84% had characteristic petechial type of haemorrhages. Fundus findings present in 10 (7.5%) patients included dilatation and tortuosity of vessels, superficial retinal haemorrhages, cotton-wool spots, and hard exudates; the macula, however, was spared in all patients. Only 6 of the patients with posterior segment involvement returned for follow-up examination and it was found that retinal changes had resolved without any specific treatment within 2 to 8 weeks time. Of all laboratory parameters evaluated, marked thrombocytopenia (platelet count <50,000/microL) emerged to be significantly associated with ocular haemorrhage. INTERPRETATION Multiple subconjunctival haemorrhages, especially petechial type, are a common manifestation of dengue infection. Dengue fever patients with marked thrombocytopenia are predisposed to spontaneous ocular haemorrhages.
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Midega JT, Nzovu J, Kahindi S, Sang RC, Mbogo C. Application of the pupal/demographic-survey methodology to identify the key container habitats of Aedes aegypti (L.) in Malindi district, Kenya. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2006; 100 Suppl 1:S61-S72. [PMID: 16630392 DOI: 10.1179/136485906x105525] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The pupal/demographic-survey methodology was evaluated in three coastal areas (one urban, one peri-urban and one rural) of Malindi district, Kenya, in attempts to identify the types of domestic container that are most productive for Aedes aegypti (L.) pupae. The results demonstrated the practicality and consistency of the methodology, as a tool both for identifying and guiding the targeted control of the most productive container habitats, and for determining the mean numbers of pupae/person, as measures of the risk of dengue transmission.Twenty-five types of container were identified indoors and 50 types outdoors. In total, only 4,178 pupae were seen indoors and 795 outdoors. Pupal productivity was dependent on the type, location and volume of the container and the season of the year. Metallic drums and jerricans contributed >70% of the pupae encountered indoors in the wet season whereas, in the rural area, plastic drums contributed 83.7% of all the larvae seen outdoors during the dry season. Container productivity was not consistent during the different surveys. The highest mean numbers of pupae/person (7.61) and of pupae/household (18.12) were recorded in the rural area.
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Affiliation(s)
- J T Midega
- Centre for Geographic Medicine Research - Coast, Kenya Medical Research Institute, P.O. Box 428, Kilifi, Kenya.
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Desenclos JC, De Valk H. [Emergent infectious diseases: importance for public health, epidemiology, promoting factors, and prevention]. Med Mal Infect 2005; 35:49-61. [PMID: 15780893 PMCID: PMC7127485 DOI: 10.1016/j.medmal.2004.09.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2004] [Accepted: 09/06/2004] [Indexed: 11/17/2022]
Abstract
À la fin des années 1970 on a parlé « de la fin des maladies infectieuses ». Avec l'apparition du sida et la découverte de nouveaux agents infectieux le « retour des maladies infectieuses » a été prononcé 15 à 20 ans après, donnant naissance aux « infections émergentes ». L'émergence est ce qui « dépasse le niveau moyen, retient l'attention ou sort du lot… ». En terme épidémiologique il s'agit d'une maladie qui apparaît ou dont l'incidence augmente en un lieu donné. Les infections dont l'incidence pourrait augmenter du fait de conditions propices à leur transmission doivent y être ajoutées. Différents scénarios peuvent être proposés selon que la maladie apparaît de novo (sida ou SRAS) ; apparaît là où elle n'existait pas (West Nile aux États-Unis) ; existait sans pouvoir être diagnostiquée de manière précise ou être rattachée à un agent infectieux donné (hépatite C avant la découverte du VHC) ; sort plus ou moins rapidement des fluctuations habituelles (épidémie) ; est causée par un agent dont les conditions de transmission sont propices à sa résurgence (baisse de la couverture vaccinale...). Le bioterrorisme fait partie des scénarios d'émergence. Des modifications qualitatives des agents infectieux (résistance aux anti-infectieux…) peuvent par un mécanisme de sélection donner lieu à des émergences. Les émergences infectieuses résultent de l'interaction entre l'agent, l'hôte et l'environnement qui évolue avec l'activité humaine. La lutte contre les infections émergentes est fondée sur la surveillance, l'expertise microbiologique de haut niveau et la capacité de réponse du système de santé publique.
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Affiliation(s)
- J-C Desenclos
- Département des maladies infectieuses, institut de veille sanitaire, 12, rue du Val-d'Osne, 94415 Saint-Maurice, France.
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Abstract
The container-breeding mosquito, Aedes aegypti, is the major global vector of dengue viruses, causing around 50 million infections annually. We have developed a mosquito control strategy, incorporating four elements: (1) a combined vertical and horizontal approach that depends on community understanding; (2) prioritised control according to the larval productivity of major habitat types; (3) use of predacious copepods of the genus Mesocyclops as a biological control agent; delivered by (4) community activities of health volunteers, schools, and the public. We have previously reported that, from 1998 to 2003, community-based vector control had resulted in A aegypti elimination in six of nine communes, with only small numbers of larvae detected in the others. Here, we report eradication in two further communes and, as a result of local expansion after the project in three northern provinces, elimination from 32 of 37 communes (309730 people). As a result, no dengue cases have been detected in any commune since 2002. These findings suggest that this strategy is sustainable in Vietnam and applicable where the major sources of A aegypti are large water storage containers.
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Affiliation(s)
- Brian Kay
- Australian Centre for International & Tropical Health & Nutrition, Queensland Institute of Medical Research, Australia.
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Affiliation(s)
- Ole Wichmann
- Institute of Tropical Medicine, Humboldt University, Berlin, Germany
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Abstract
Global change includes climate change and climate variability, land use, water storage and irrigation, human population growth and urbanization, trade and travel, and chemical pollution. Impacts on vector-borne diseases, including malaria, dengue fever, infections by other arboviruses, schistosomiasis, trypanosomiasis, onchocerciasis, and leishmaniasis are reviewed. While climate change is global in nature and poses unknown future risks to humans and natural ecosystems, other local changes are occurring more rapidly on a global scale and are having significant effects on vector-borne diseases. History is invaluable as a pointer to future risks, but direct extrapolation is no longer possible because the climate is changing. Researchers are therefore embracing computer simulation models and global change scenarios to explore the risks. Credible ranking of the extent to which different vector-borne diseases will be affected awaits a rigorous analysis. Adaptation to the changes is threatened by the ongoing loss of drugs and pesticides due to the selection of resistant strains of pathogens and vectors. The vulnerability of communities to the changes in impacts depends on their adaptive capacity, which requires both appropriate technology and responsive public health systems. The availability of resources in turn depends on social stability, economic wealth, and priority allocation of resources to public health.
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Stephenson I, Roper J, Fraser M, Nicholson K, Wiselka M. Dengue fever in febrile returning travellers to a UK regional infectious diseases unit. Travel Med Infect Dis 2003; 1:89-93. [PMID: 17291893 DOI: 10.1016/s1477-8939(03)00061-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2003] [Revised: 06/12/2003] [Accepted: 06/12/2003] [Indexed: 11/21/2022]
Abstract
Background. Dengue occurs in many tourist destinations, and is increasingly imported by returning travellers. We review the epidemiology and clinical features of confirmed dengue in returning travellers presenting to a UK regional infectious diseases unit. Methods. A retrospective, case-record review of febrile returning travellers, admitted to Leicester Royal Infirmary during 2000-2002. The presenting clinical features of patients with positive dengue serology were compared to those who had negative serological tests. Results. Dengue, including two cases of dengue haemorrhagic fever (DHF) and 1 shock syndrome, was diagnosed in 16 of approximately 250 (6.4%) hospitalised returning travellers. 10/16 (62.5%) patients returned from Asia. There was no difference in symptoms between those with or without serological evidence of dengue. Dengue was associated with thrombocytopenia (p=0.001), leucopenia (p=0.03) and elevated alanine transminase (p=0.01). Following multivariate analysis, dengue was associated with first time travel to an endemic area (odds ratio 10.9, 95% CI 1.21-99.9), early onset of symptoms after return (OR 1.91, 95% CI 1.07-3.43), duration of time overseas (OR 1.08, 95% CI 1.01-1.15) and thrombocytopenia (OR 29.4, 95% CI 1.8-494). Conclusions. Dengue is an important cause of illness in hospitalised febrile returning travellers. It should be considered in first-time travellers, with thrombocytopenia and negative malaria films who present with symptoms soon after return.
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Affiliation(s)
- Iain Stephenson
- Infectious Diseases Unit, Leicester Royal Infirmary, Leicester LE1 5WW, UK
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Jelinek T, Mühlberger N, Harms G, Corachán M, Grobusch MP, Knobloch J, Bronner U, Laferl H, Kapaun A, Bisoffi Z, Clerinx J, Puente S, Fry G, Schulze M, Hellgren U, Gjørup I, Chalupa P, Hatz C, Matteelli A, Schmid M, Nielsen LN, da Cunha S, Atouguia J, Myrvang B, Fleischer K. Epidemiology and clinical features of imported dengue fever in Europe: sentinel surveillance data from TropNetEurop. Clin Infect Dis 2002; 35:1047-52. [PMID: 12384837 DOI: 10.1086/342906] [Citation(s) in RCA: 129] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2002] [Revised: 06/06/2002] [Indexed: 11/03/2022] Open
Abstract
Travelers have the potential both to acquire and to spread dengue virus infection. The incidence of dengue fever (DF) among European travelers certainly is underestimated, because few centers use standardized diagnostic procedures for febrile patients. In addition, DF is currently not reported in most European public health systems. Surveillance has commenced within the framework of a European Network on Imported Infectious Disease Surveillance (TropNetEurop) to gain information on the quantity and severity of cases of dengue imported into Europe. Descriptions of 294 patients with DF were analyzed for epidemiological information and clinical features. By far the most infections were imported from Asia, which suggests a high risk of DF for travelers to that region. Dengue hemorrhagic fever occurred in 7 patients (2.4%) all of whom recovered. Data reported by member sites of the TropNetEurop can contribute to understanding the epidemiology and clinical characteristics of imported DF.
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Affiliation(s)
- T Jelinek
- Department of Infectious Diseases and Tropical Medicine, University of Munich, 80802 Munich, Germany.
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Jelinek T. Dengue fever in international travelers. Clin Infect Dis 2000; 31:144-7. [PMID: 10913412 DOI: 10.1086/313889] [Citation(s) in RCA: 91] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2000] [Revised: 04/18/2000] [Indexed: 11/03/2022] Open
Abstract
Dengue virus infection is becoming increasingly recognized as one of the world's major emerging infectious diseases. Although only a few systematic studies have been conducted to assess the incidence and clinical course of dengue fever in travelers, it is now possible to estimate risk factors for travelers to areas of endemicity. Dengue virus and its vector, Aedes mosquitoes, benefit from human habitation and travel-related aspects of human behavior. Thus, travelers serve an important double role as potential victims of the disease and as vehicles for further spread of dengue.
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Affiliation(s)
- T Jelinek
- Department of Infectious Diseases and Tropical Medicine, University of Munich, 80802 Munich, Germany.
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Potasman I, Srugo I, Schwartz E. Dengue seroconversion among Israeli travelers to tropical countries. Emerg Infect Dis 1999; 5:824-7. [PMID: 10603220 PMCID: PMC2640810 DOI: 10.3201/eid0506.990615] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
We tested for dengue seroconversion among 104 Israeli young adults who traveled to tropical countries for at least 3 months. Seven (6. 7%) seroconverted during travel; four (3.8%) had immunoglobulin (Ig) M antibodies; one was symptomatic with borderline IgM and a rise in IgG; two others (1.9%) had a rise in IgG titers, without detectable IgM. All four IgM-positive patients had traveled to Southeast Asia.
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Affiliation(s)
- I Potasman
- Bnai Zion Medicla Center, Haifa, Israel.
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Hales S, Weinstein P, Woodward A. Public health impacts of global climate change. REVIEWS ON ENVIRONMENTAL HEALTH 1997; 12:191-199. [PMID: 9406290 DOI: 10.1515/reveh.1997.12.3.191] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The potential health impacts of climate change are wide-ranging, from direct impacts at familiar local scales, through indirect effects occurring at the regional or ecosystem level, to long term effects on the sustainability of global systems. To assess these potential impacts, there is a need to broaden the scope of health impact assessment. Eco-epidemiology is emerging as a response to this need. Eco-epidemiology entails a shift in focus: from direct (toxicological) to indirect (ecological) mechanisms; and from effects occurring at 'human' temporal and geographical scales to those at regional and geophysical scales. We discuss the potential health impacts of climate change on each scale. At the global scale, interactions and feedbacks between systems are critical determinants of long term outcomes. From an eco-epidemiological perspective, the study of climate change becomes inseparable from the study of global change more generally.
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Affiliation(s)
- S Hales
- Department of Public Health, Wellington School of Medicine, New Zealand.
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