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Yamaguchi J, Kinoshita K. The threat of a new tetanus outbreak due to urban flooding disaster requires vigilance: a narrative review. Acute Med Surg 2023; 10:e839. [PMID: 37077453 PMCID: PMC10106935 DOI: 10.1002/ams2.839] [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: 01/30/2023] [Accepted: 03/28/2023] [Indexed: 04/21/2023] Open
Abstract
Vaccines for tetanus prevention have rapidly progressed, and the number of outbreaks, especially the incidence of tetanus in developed countries, has decreased dramatically. However, the mortality rate associated with severe tetanus remains high. Tetanus eradication is difficult owing to the widespread presence of the spores of tetanus bacteria in the environment, but tetanus can be prevented by acquired immunity from vaccines. Older people, intravenous drug users, and migrants are at a high risk of tetanus in developed countries owing to the lack of booster vaccination programs. Natural disasters, especially floods, often cause an increase in the prevalence of tetanus because of the associated injuries. Precautions should be taken to combat the threat of a new tetanus outbreak due to floods in urban areas owing to global warming. In particular, Japan is facing a high risk of urban flooding-induced tetanus, despite its status as a developed country. This review aims to highlight the data on the epidemiology, causes, treatment, and prevention of tetanus and problems associated with tetanus countermeasures during future floods.
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Affiliation(s)
- Junko Yamaguchi
- Division of Emergency and Critical Care Medicine, Department of Acute MedicineNihon University School of MedicineTokyoJapan
| | - Kosaku Kinoshita
- Division of Emergency and Critical Care Medicine, Department of Acute MedicineNihon University School of MedicineTokyoJapan
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2
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Morrell EL, Odriozola E, Dorsch MA, Fiorentino MA, Rivera ME, Poppenga R, Navarro MA, Uzal FA, Cantón G. A review of cardiac blackleg in cattle, and report of 2 cases without skeletal muscle involvement in Argentina. J Vet Diagn Invest 2022; 34:929-936. [PMID: 36039784 PMCID: PMC9597342 DOI: 10.1177/10406387221120816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Blackleg is an infectious disease caused by Clostridium chauvoei. Cardiac blackleg has been reported in ruminants as an uncommon presentation of the disease; its pathogenesis is not understood completely. We include here a literature review of cardiac blackleg and a description of 2 cases in 12-15-mo-old feedlot steers in Argentina. Fourteen of 1,190 steers died suddenly over a period of 10 d. Postmortem examinations were performed on 5 of these animals. Grossly, severe, diffuse, fibrinous pericarditis and pleuritis, multifocal necrohemorrhagic myocarditis, diffuse pulmonary congestion, mild splenomegaly, and moderate congestion of meningeal vessels were observed. No significant gross lesions were observed in the skeletal muscles of any animal. Histology was performed on 2 of the steers. The main microscopic features were necrotizing myocarditis with myriad intralesional gram-positive rods with subterminal spores plus fibrinosuppurative pericarditis and pleuritis. C. chauvoei was detected by immunohistochemistry and PCR in the myocardium of both animals. These findings confirm a diagnosis of cardiac blackleg in these 2 steers and presumptively in the other affected animals.
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Affiliation(s)
| | | | - Matías A. Dorsch
- Faculty of Agricultural Sciences,
National University of Mar del Plata, Balcarce, Argentina
- Animal Health Research Platform,
National Institute of Agricultural Research, La Estanzuela,
Colonia, Uruguay
| | - María A. Fiorentino
- National Institute of Agricultural
Technology, Balcarce, Argentina
- Faculty of Agricultural Sciences,
National University of Mar del Plata, Balcarce, Argentina
| | - María E. Rivera
- National Institute of Agricultural
Technology, Balcarce, Argentina
| | - Robert Poppenga
- Davis Laboratories, School of
Veterinary Medicine, University of California–Davis, CA,
USA
| | - Mauricio A. Navarro
- California Animal Health and Food
Safety Laboratory System, San Bernardino, CA, USA
- Instituto de Patología Animal,
Facultad de Ciencias Veterinarias, Universidad Austral de Chile,
Valdivia, Chile
| | - Francisco A. Uzal
- California Animal Health and Food
Safety Laboratory System, San Bernardino, CA, USA
| | - Germán Cantón
- National Institute of Agricultural
Technology, Balcarce, Argentina
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3
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Blokhin AA, Toropova NN, Burova OA, Iashin IV, Zakharova OI. Blackleg in Cattle in the Irkutsk Region. Front Vet Sci 2022; 9:872386. [PMID: 35647103 PMCID: PMC9133737 DOI: 10.3389/fvets.2022.872386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
Blackleg is an acute, toxic, infectious, non-contagious disease of domestic and wild ruminants that occurs while the animals are pastured. This article describes an outbreak of blackleg on a farm in Siberia (Russia) in 2019. We provide a detailed description of the cases based on the results of comprehensive diagnostic and epidemiological investigations. For description of case and evaluation, we used the following methods: owner observations, descriptive epidemiology, clinical diagnostics, pathological examination and bacteriology. The distinctive features (in addition to the characteristic features) were as follows: the outbreak of the disease occurred in early spring when there was abundant snow cover and under unfavorable living conditions of animals and traumas; the disease appeared in both vaccinated and unvaccinated cattle; the characteristic clinical signs were low-grade fever, the absence of crepitus, and the presence of haematomas containing erythrocytes with basophilic granularity; thrombs in vessel and vacuolization in tissue of the adrenal gland. This paper aimed to present classical and new clinical and pathology changes in cattle with blackleg in winter conditions of Russian Siberia.
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Gaviglio A, Corradini A, Marescotti ME, Demartini E, Filippini R. A Theoretical Framework to Assess the Impact of Flooding on Dairy Cattle Farms: Identification of Direct Damage from an Animal Welfare Perspective. Animals (Basel) 2021; 11:1586. [PMID: 34071330 PMCID: PMC8229036 DOI: 10.3390/ani11061586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 05/24/2021] [Accepted: 05/25/2021] [Indexed: 11/16/2022] Open
Abstract
For the economic sectors, the need to address the challenges posed by natural disasters due to climate change is an outstanding issue. To date, according to the European Commission (2019), there is still a gap in the estimation of the costs of flood in all European countries and the direct impact that these floods have on agricultural activities. More specifically, the damage to livestock has been minimally studied. The aim of this study is is therefore to identify the flood damage that affects dairy cattle farms, focusing on the damage to herds caused by a flood event; in fact, poor welfare conditions of dairy cattle directly affect production and thus farm revenue. To accomplish the aim of this study, a framework was first developed to identify possible damage types. Then, scientific literature focusing on the identification of flood damage to dairy herds was reviewed, and to quantify this damage to herds, literature sources providing information on the magnitude of variation in the identified damage types were used. Thus, our results provide relevant information on the variables that should be taken into account when assessing of the direct damage affecting the overall welfare of a dairy herd after a flood event. This evidence could then contribute to the development of tools aimed at assessing damage to dairy cattle on flood-affected farms.
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Affiliation(s)
- Anna Gaviglio
- Animal Science and Food Safety (VESPA), Department of Health, University of Milan, 26900 Lodi, Italy
| | - Annafrancesca Corradini
- Animal Science and Food Safety (VESPA), Department of Health, University of Milan, 26900 Lodi, Italy
| | - Maria Elena Marescotti
- Animal Science and Food Safety (VESPA), Department of Health, University of Milan, 26900 Lodi, Italy
| | - Eugenio Demartini
- Animal Science and Food Safety (VESPA), Department of Health, University of Milan, 26900 Lodi, Italy
| | - Rosalia Filippini
- Animal Science and Food Safety (VESPA), Department of Health, University of Milan, 26900 Lodi, Italy
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Zhuang QQ, Chen RT, Zheng YJ, Huang KY, Peng HP, Lin Z, Xia XH, Chen W, Deng HH. Detection of tetanus toxoid with fluorescent tetanus human IgG-AuNC-based immunochromatography test strip. Biosens Bioelectron 2021; 177:112977. [PMID: 33434779 DOI: 10.1016/j.bios.2021.112977] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/31/2020] [Accepted: 01/03/2021] [Indexed: 11/29/2022]
Abstract
Assays for detecting tetanus toxoid are of great significance to be applied in the research of the safety testing of tetanus vaccine. Currently, guinea pigs or mice are usually used to evaluate the toxicity in these assays. Herein, a facile and quick biomineralization process was carried out to generate tetanus human immunoglobulin G (Tet-IgG)-functionalized Au nanoclusters (Tet-IgG-AuNCs). The obtained Tet-IgG-AuNCs exhibited strong red emission with a photoluminescence quantum yield of 13%. Based on surface plasmon resonance measurements, the apparent dissociation constant of the Tet-IgG-AuNC-tetanus toxoid complexes was measured to be 2.27 × 10-8 M. A facile detection approach was developed using a fluorescent Tet-IgG-AuNC-based immunochromatography test strip. By utilizing the high-brightness fluorescent Tet-IgG-AuNCs, this immunosensor showed favorable sensitivity with a detection limit at the level of 0.03 μg/mL. Further results demonstrated that this assay can reliably detect tetanus toxoid and therefore might provide a novel method to replace animal tests for the quantification of tetanus toxicity. Moreover, the antibody-AuNC-based immunochromatography test strip platform serves as a promising candidate to develop new approaches for detecting targeted antigens and biological events of interest.
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Affiliation(s)
- Quan-Quan Zhuang
- Higher Educational Key Laboratory for Nano Biomedical Technology of Fujian Province, Department of Pharmaceutical Analysis, Fujian Medical University, Fuzhou, 350004, China; Department of Pharmacy, Affiliated Quanzhou First Hospital of Fujian Medical University, Quanzhou, 362000, China
| | - Rui-Ting Chen
- Higher Educational Key Laboratory for Nano Biomedical Technology of Fujian Province, Department of Pharmaceutical Analysis, Fujian Medical University, Fuzhou, 350004, China
| | - Yi-Jing Zheng
- Higher Educational Key Laboratory for Nano Biomedical Technology of Fujian Province, Department of Pharmaceutical Analysis, Fujian Medical University, Fuzhou, 350004, China
| | - Kai-Yuan Huang
- Higher Educational Key Laboratory for Nano Biomedical Technology of Fujian Province, Department of Pharmaceutical Analysis, Fujian Medical University, Fuzhou, 350004, China
| | - Hua-Ping Peng
- Higher Educational Key Laboratory for Nano Biomedical Technology of Fujian Province, Department of Pharmaceutical Analysis, Fujian Medical University, Fuzhou, 350004, China
| | - Zhen Lin
- Higher Educational Key Laboratory for Nano Biomedical Technology of Fujian Province, Department of Pharmaceutical Analysis, Fujian Medical University, Fuzhou, 350004, China
| | - Xing-Hua Xia
- State Key Laboratory of Analytical Chemistry for Life Science and Collaborative Innovation Center of Chemistry for Life Sciences, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing, 210093, China
| | - Wei Chen
- Higher Educational Key Laboratory for Nano Biomedical Technology of Fujian Province, Department of Pharmaceutical Analysis, Fujian Medical University, Fuzhou, 350004, China.
| | - Hao-Hua Deng
- Higher Educational Key Laboratory for Nano Biomedical Technology of Fujian Province, Department of Pharmaceutical Analysis, Fujian Medical University, Fuzhou, 350004, China.
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Abstract
Abstract
Tetanus is a neurologic non-transmissible disease (often fatal) of humans and other animals with a worldwide occurrence. Clostridium tetani is the spore producing bacillus which causes the bacterial disease. In deep penetrating wounds the spores germinate and produce a toxin called tetanospasmin. The main characteristic sign of tetanus is a spastic paralysis. A diagnosis is usually based on the clinical signs because the detection in the wound and the cultivation of C. tetani is very difficult. Between animal species there is considerable variability in the susceptibility to the bacillus. The most sensitive animal species to the neurotoxin are horses. Sheep and cattle are less sensitive and tetanus in these animal species are less common. Tetanus in cats and dogs are rare and dogs are less sensitive than cats. Clinically two forms of tetanus have been recognized, i. e. localized and generalized. The available treatment is not specific because the toxin in neuronal cells cannot be accessed by antitoxin antibodies. The aim of the therapy is to: neutralise the unbound neurotoxin, inhibit C. tetani growth in the wound, and provide supportive care to mitigate the effects of the neurotoxin. The treatment is difficult with an unclear prognosis.
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Crist S, Mori J, Smith RL. Flooding on Beef and Swine Farms: A Scoping Review of Effects in the Midwestern United States. Prev Vet Med 2020; 184:105158. [PMID: 33045630 DOI: 10.1016/j.prevetmed.2020.105158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/18/2020] [Accepted: 09/19/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Increasing uncertainty and variability in weather due to climate change puts enormous stress on the sustainability of agricultural communities in several parts of the continental United States. Rural agriculture-based communities, such as those in North Carolina, Nebraska, and Illinois are particularly vulnerable to the impacts of flooding. These extreme weather events affect many animal facilities, and flooding can cause long-term impacts on animal health and productivity. OBJECTIVES This scoping review investigated the potential short- and long-term ramifications of flooding on beef cattle and swine farms with theoretical locations in the Midwestern U.S. The goal of this review is to create a concept map to identify research gaps related to efforts to support those animals and peoples ravaged by floods. This was accomplished by performing a scoping review using search terms "beef OR swine AND flood" to assess direct effects and then "beef OR swine AND direct effect" to evaluate secondary and tertiary effects. RESULTS Our findings were based on a total of 89 peer-reviewed publications, with 50 publications relating to beef cattle, 24 relating to swine, and 15 containing information applicable to both. On beef farms, the effects of flooding can be broad and long-lasting. The short-term risks of flooding are reasonably well-understood, including the comingling of unfamiliar cattle, nutritional restriction, and disease transmission. However, long-term impacts, including potential effects on reproduction, nutrition, and carcass quality, have been less studied. In particular, further research is needed on mold species that contaminate hay post-flood, the effect of moldy hay ingestion on cattle, and the effects of heavy metal consumption on cattle and consumers. Little research is available regarding the effects of flooding on swine farms, likely due to the highly intensive nature of swine operations. In general, swine farms suffer from acute infectious diseases and biosecurity risks after flooding events. CONCLUSIONS The potential ramifications of flooding on livestock farms differ among farm operations. Beef farms should prepare for long-term impacts on nutrition and reproduction, while swine farms should prepare for short-term impacts on biosecurity.
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Affiliation(s)
- Samantha Crist
- Department of Pathobiology, University of Illinois College of Veterinary Medicine, 2001 S Lincoln Ave, Urbana, IL 61802, United States.
| | - Jameson Mori
- Department of Pathobiology, University of Illinois College of Veterinary Medicine, 2001 S Lincoln Ave, Urbana, IL 61802, United States.
| | - Rebecca Lee Smith
- Department of Pathobiology, University of Illinois College of Veterinary Medicine, 2001 S Lincoln Ave, Urbana, IL 61802, United States.
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Nawfal Dagher T, Al-Bayssari C, Diene SM, Azar E, Rolain JM. Bacterial infection during wars, conflicts and post-natural disasters in Asia and the Middle East: a narrative review. Expert Rev Anti Infect Ther 2020; 18:511-529. [PMID: 32267179 DOI: 10.1080/14787210.2020.1750952] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction: Bacterial infections resulting from wars and natural disasters represent a major public health problem. Over the past 50 years, Asia and the Middle East have suffered several wars. Moreover, East-Asian countries are considered the most natural disaster-prone countries in the world.Areas covered: This review focuses on bacterial infection occurring during wars and after natural disasters, among refugees, wounded citizens and soldiers as well as the prevention and control measures that must be taken.Expert opinion: During wars, refugees and soldiers represent the two main sources of bacterial infections. Refugees coming from countries with a high prevalence of antimicrobial resistance can spread these pathogens to their final destination. In addition, these refugees living in inadequate shelters can contribute to the spread of bacterial infections. Moreover, some factors including the presence of fixed imported fragments; environmental contamination and nosocomial transmissions, play a key role in the dissemination of bacteria among soldiers. As for natural disasters, several factors are associated with increased bacterial transmissions such as the displacement of large numbers of people into over-crowded shelters, high exposure to disease vectors, lack of water and sanitation. Here, we carry out a systematic review of the bacterial infections that follow these two phenomena.
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Affiliation(s)
- Tania Nawfal Dagher
- Faculté de Médecine et de Pharmacie, Aix Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France.,Saint George Hospital University Medical Center, University of Balamand, Beirut, Lebanon
| | - Charbel Al-Bayssari
- Faculty of Sciences 3, Lebanese University, Michel Slayman Tripoli Campus, Ras Maska, Lebanon
| | - Seydina M Diene
- Faculté de Médecine et de Pharmacie, Aix Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
| | - Eid Azar
- Saint George Hospital University Medical Center, University of Balamand, Beirut, Lebanon
| | - Jean-Marc Rolain
- Faculté de Médecine et de Pharmacie, Aix Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France
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Abstract
Tetanus is a neurologic disease of humans and animals characterized by spastic paralysis. Tetanus is caused by tetanus toxin (TeNT) produced by Clostridium tetani, an environmental soilborne, gram-positive, sporulating bacterium. The disease most often results from wound contamination by soil containing C. tetani spores. Horses, sheep, and humans are highly sensitive to TeNT, whereas cattle, dogs, and cats are more resistant. The diagnosis of tetanus is mainly based on the characteristic clinical signs. Identification of C. tetani at the wound site is often difficult.
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Makino A, Xu J, Nishimura J, Isogai E. Detection of Clostridium perfringens in tsunami deposits after the Great East Japan Earthquake. Microbiol Immunol 2019; 63:179-185. [PMID: 31045261 DOI: 10.1111/1348-0421.12682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 04/02/2019] [Accepted: 04/09/2019] [Indexed: 11/27/2022]
Abstract
The Great East Japan Earthquake struck off the Tohoku and caused a tsunami in 2011. Most of the microbial characteristics of tsunami-affected soil remain unknown and no published study has shown how a tsunami affects the risk of infection by Clostridium perfringens living in soil. In 2011 and 2015, C. perfringens was assessed in deposits in soil from tsunami-damaged areas and undamaged areas of Miyagi. It was found that the number of C. perfringens was overwhelmingly greater in 2011 than in 2015 in the tsunami-damaged areas. According to real-time PCR, the prevalence C. perfringens organisms (%) was 103 fold greater in the damaged than in the undamaged areas.
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Affiliation(s)
- Asuka Makino
- Laboratory of Animal Microbiology, Graduate School of Agricultural Science, Tohoku University, Sendai, Japan
| | - Jun Xu
- Laboratory of Animal Microbiology, Graduate School of Agricultural Science, Tohoku University, Sendai, Japan
| | - Junko Nishimura
- Department of Life and Environmental Science, Hachinohe Institute of Technology, Hachinohe, Japan.,Cluster of Agricultural Sciences, Fukushima University, Kanayagawa, Fukushima, Japan
| | - Emiko Isogai
- Laboratory of Animal Microbiology, Graduate School of Agricultural Science, Tohoku University, Sendai, Japan
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Idrees MA, Younus M, Farooqi SH, Khan AU. Blackleg in cattle: Current understanding and future research perspectives- A review. Microb Pathog 2018; 120:176-180. [PMID: 29733903 DOI: 10.1016/j.micpath.2018.04.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 04/21/2018] [Accepted: 04/23/2018] [Indexed: 11/29/2022]
Abstract
Blackleg is an endogenous acute infection that principally affects cattle. The disease is caused by Clostridium chauvoei (C. chauvoei), an anaerobic spore forming bacterium. Control of this disease is based on stringent husbandry measures and scheduled vaccination plan. In recent years, the major virulence factors of C. chauvoei have been discovered and described. However, the pathogenesis of blackleg in cattle and in particular, circulation of the pathogen from point of entry to target tissues is yet not fully elucidated. This review summarizes the latest review of literature that significantly contributed for understanding the disease in cattle, and provides a foundation to preventive strategies.
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Affiliation(s)
- M A Idrees
- Department of Pathobiology, KBCMA, College of Veterinary and Animal Sciences, 51600, Narowal, Pakistan
| | - M Younus
- Department of Clinical Studies, KBCMA, College of Veterinary and Animal Sciences, 51600, Narowal, Pakistan
| | - S H Farooqi
- Department of Clinical Studies, KBCMA, College of Veterinary and Animal Sciences, 51600, Narowal, Pakistan.
| | - A U Khan
- Department of Pathobiology, College of Veterinary and Animal Sciences, 35200, Jhang, Pakistan
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Wolf R, Hiesel J, Kuchling S, Deutz A, Kastelic J, Barkema HW, Wagner P. Spatial-temporal cluster analysis of fatal Clostridium chauvoei cases among cattle in Styria, Austria between 1986 and 2013. Prev Vet Med 2017; 138:134-138. [DOI: 10.1016/j.prevetmed.2017.01.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 01/05/2017] [Accepted: 01/31/2017] [Indexed: 12/01/2022]
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13
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Abstract
Maternal and neonatal tetanus is still a substantial but preventable cause of mortality in many developing countries. Case fatality from these diseases remains high and treatment is limited by scarcity of resources and effective drug treatments. The Maternal and Neonatal Tetanus Elimination Initiative, launched by WHO and its partners, has made substantial progress in eliminating maternal and neonatal tetanus. Sustained emphasis on improvement of vaccination coverage, birth hygiene, and surveillance, with specific approaches in high-risk areas, has meant that the incidence of the disease continues to fall. Despite this progress, an estimated 58,000 neonates and an unknown number of mothers die every year from tetanus. As of June, 2014, 24 countries are still to eliminate the disease. Maintenance of elimination needs ongoing vaccination programmes and improved public health infrastructure.
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Affiliation(s)
- C Louise Thwaites
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
| | - Nicholas J Beeching
- Liverpool School of Tropical Medicine, and Tropical and Infectious Disease Unit, Royal Liverpool University Hospital, and National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, Liverpool, UK
| | - Charles R Newton
- Kenya Medical Research Institute - Wellcome Trust Collaborative Programme, Kilifi, Kenya; Department of Psychiatry, University of Oxford, Oxford, UK
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Abstract
INTRODUCTION The causative agent of tetanus, Clostridium tetani is widespread in the environment throughout the world and cannot be eradicated. To reduce the number of cases of tetanus efforts are focussed on prevention using vaccination and post-exposure wound care. SOURCES OF DATA Medline, Pubmed and Cochrane databases; World Health Organization and United Nations Children's Fund publications. AREAS OF AGREEMENT The maternal and neonatal tetanus elimination initiative has resulted in significant reductions in mortality from neonatal tetanus throughout the world. AREAS OF CONTROVERSY Although there are few data available it is likely that large numbers of children and adults, particularly men, remain unprotected due to lack of booster immunization. AREAS TIMELY FOR DEVELOPING RESEARCH It remains unclear how HIV and malaria affect both responses to vaccination and transplacental transfer of antibodies or how this might affect timing of vaccination doses.
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Affiliation(s)
- C L Thwaites
- Oxford University Clinical Research Unit, Hospital for Tropical Diseases, 764 Vo Van Kiet, Ho Chi Minh City, Vietnam Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK
| | - H T Loan
- Hospital for Tropical Diseases, 764 Vo Van Kiet, Ho Chi Minh City, Vietnam
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