Jamestown Canyon virus-mediated meningoencephalitis with unusual laboratory findings

Jamestown Canyon virus (JCV) is a mosquito-borne orthobunyavirus that causes an acute febrile illness, meningitis or meningoencephalitis. Human infections in the USA are rare. A 59-year-old man was admitted with fever, headache and hallucinations and required transfer to intensive care due to worsening agitation. Lumbar puncture was significant for neutrophilic pleocytosis, low glucose and high protein. Cerebral spinal fluid (CSF) bacterial cultures were negative, however, the CSF analysis via ELISA returned positive for JCV IgM. Plaque reduction neutralisation tests on a serum sample revealed IgM for JCV with titres of 1:160, which confirmed the diagnosis of JCV meningoencephalitis as the titres for other arboviruses were low. The patient improved significantly with supportive care. Our case highlights an atypical laboratory presentation of neutrophilic pleocytosis on CSF in a viral meningoencephalitis and draws attention to the potential cross-reactivity with other arboviruses.

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Zika virus in India: past, present and future

QJM ◽

10.1093/qjmed/hcz273 ◽

2019 ◽

Cited By ~ 4

Author(s):

N Gupta ◽

P Kodan ◽

K Baruah ◽

M Soneja ◽

A Biswas

Keyword(s):

Clinical Features ◽

Zika Virus ◽

Febrile Illness ◽

French Polynesia ◽

Neurological Complications ◽

Cross Reactivity ◽

Madhya Pradesh ◽

Acute Febrile Illness ◽

Aedes Mosquito ◽

Ubiquitous Presence

Abstract Zika virus (ZIKV) is an arthropod-borne flavivirus that presents with acute febrile illness associated with rash, arthralgia and conjunctivitis. After years of sporadic reports in Africa, the three major outbreaks of this disease occurred in Yap Islands (2007), French Polynesia (2013–14) and South Americas (2015–16). Although, serological surveys suggested the presence of ZIKV in India in 1950s, cross-reactivity could not be ruled out. The first four proven cases of ZIKV from India were reported in 2017. This was followed by major outbreaks in the states of Rajasthan and Madhya Pradesh in 2018. Fortunately, the outbreaks in India were not associated with neurological complications. These outbreaks in India highlighted the spread of this disease beyond geographical barriers owing to the growing globalization, increased travel and ubiquitous presence of its vector, the Aedes mosquito. In this review, we discuss the epidemiology, clinical features and management of ZIKV in India.

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Papular-purpuric "gloves and socks" syndrome caused by parvovirus B19

Vojnosanitetski pregled ◽

10.2298/vsp0302223p ◽

2003 ◽

Vol 60 (2) ◽

pp. 223-225 ◽

Cited By ~ 3

Author(s):

Milos Pavlovic

Keyword(s):

Parvovirus B19 ◽

Acute Infection ◽

Febrile Illness ◽

Acute Febrile Illness ◽

Laboratory Findings ◽

Hands And Feet

This paper presents a 15-year-old boy with an acute febrile illness accompanied by purpuric and papular lesions located mostly on the dorsal areas of his hands and feet with the additional changes on his knees and elbows. Serologic studies confirmed the acute infection by parvovirus B19. Apart from mild leukocytosis there were no other abnormalities in hematologic and laboratory findings. The diagnosis of papular-purpuric "gloves and socks" syndrome (PPGSS) was made. Cutaneous changes completely resolved two weeks later. Herein the patient's condition was described together with a brief overview of the PPGSS literature concerning this relatively rare viral exanthema.

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Prediction of disease severity in young children presenting with acute febrile illness in resource-limited settings: a protocol for a prospective observational study

BMJ Open ◽

10.1136/bmjopen-2020-045826 ◽

2021 ◽

Vol 11 (1) ◽

pp. e045826

Author(s):

Arjun Chandna ◽

Endashaw M Aderie ◽

Riris Ahmad ◽

Eggi Arguni ◽

Elizabeth A Ashley ◽

...

Keyword(s):

Observational Study ◽

Prediction Model ◽

Prospective Observational Study ◽

Model Building ◽

Venous Blood ◽

Febrile Illness ◽

Nasopharyngeal Swab ◽

Acute Febrile Illness ◽

Clinical Prediction ◽

Open Access Journals

IntroductionIn rural and difficult-to-access settings, early and accurate recognition of febrile children at risk of progressing to serious illness could contribute to improved patient outcomes and better resource allocation. This study aims to develop a prognostic clinical prediction tool to assist community healthcare providers identify febrile children who might benefit from referral or admission for facility-based medical care.Methods and analysisThis prospective observational study will recruit at least 4900 paediatric inpatients and outpatients under the age of 5 years presenting with an acute febrile illness to seven hospitals in six countries across Asia. A venous blood sample and nasopharyngeal swab is collected from each participant and detailed clinical data recorded at presentation, and each day for the first 48 hours of admission for inpatients. Multianalyte assays are performed at reference laboratories to measure a panel of host biomarkers, as well as targeted aetiological investigations for common bacterial and viral pathogens. Clinical outcome is ascertained on day 2 and day 28.Presenting syndromes, clinical outcomes and aetiology of acute febrile illness will be described and compared across sites. Following the latest guidance in prediction model building, a prognostic clinical prediction model, combining simple clinical features and measurements of host biomarkers, will be derived and geographically externally validated. The performance of the model will be evaluated in specific presenting clinical syndromes and fever aetiologies.Ethics and disseminationThe study has received approval from all relevant international, national and institutional ethics committees. Written informed consent is provided by the caretaker of all participants. Results will be shared with local and national stakeholders, and disseminated via peer-reviewed open-access journals and scientific meetings.Trial registration numberNCT04285021.

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Previous Humoral Immunity to the Endemic Seasonal Alphacoronaviruses NL63 and 229E Is Associated with Worse Clinical Outcome in COVID-19 and Suggests Original Antigenic Sin

Life ◽

10.3390/life11040298 ◽

2021 ◽

Vol 11 (4) ◽

pp. 298

Author(s):

Daniele Focosi ◽

Angelo Genoni ◽

Ersilia Lucenteforte ◽

Silvia Tillati ◽

Antonio Tamborini ◽

...

Keyword(s):

Humoral Immunity ◽

Cross Reactivity ◽

Clinical Severity ◽

World Health ◽

Laboratory Findings ◽

Cellular And Humoral Immunity ◽

Rate Ratios ◽

Original Antigenic Sin

Antibody-dependent enhancement (ADE) of severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) infection has been hypothesized. However, to date, there has been no in vitro or in vivo evidence supporting this. Cross-reactivity exists between SARS CoV-2 and other Coronaviridae for both cellular and humoral immunity. We show here that IgG against nucleocapsid protein of alphacoronavirus NL63 and 229E correlate with the World Health Organization’s (WHO) clinical severity score ≥ 5 (incidence rate ratios was 1.87 and 1.80, respectively, and 1.94 for the combination). These laboratory findings suggest possible ADE of SARS CoV-2 infection by previous alphacoronavirus immunity.

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Differential Laboratory Diagnosis of Acute Fever in Guinea: Preparedness for the Threat of Hemorrhagic Fevers

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18116022 ◽

2021 ◽

Vol 18 (11) ◽

pp. 6022

Author(s):

Vladimir G. Dedkov ◽

N’Faly Magassouba ◽

Olga A. Stukolova ◽

Victoria A. Savina ◽

Jakob Camara ◽

...

Keyword(s):

Ebola Virus ◽

Febrile Illness ◽

Laboratory Diagnosis ◽

Acute Febrile Illness ◽

Causative Pathogen ◽

Hemorrhagic Fevers ◽

Wide Range ◽

Causative Agents ◽

Pathognomonic Sign

Acute febrile illnesses occur frequently in Guinea. Acute fever itself is not a unique, hallmark indication (pathognomonic sign) of any one illness or disease. In the infectious disease context, fever’s underlying cause can be a wide range of viral or bacterial pathogens, including the Ebola virus. In this study, molecular and serological methods were used to analyze samples from patients hospitalized with acute febrile illness in various regions of Guinea. This analysis was undertaken with the goal of accomplishing differential diagnosis (determination of causative pathogen) in such cases. As a result, a number of pathogens, both viral and bacterial, were identified in Guinea as causative agents behind acute febrile illness. In approximately 60% of the studied samples, however, a definitive determination could not be made.

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Scrub Typhus and Molecular Characterization of Orientia tsutsugamushi from Central Nepal

Pathogens ◽

10.3390/pathogens10040422 ◽

2021 ◽

Vol 10 (4) ◽

pp. 422

Author(s):

Rajendra Gautam ◽

Keshab Parajuli ◽

Mythili Tadepalli ◽

Stephen Graves ◽

John Stenos ◽

...

Keyword(s):

Genetic Diversity ◽

Scrub Typhus ◽

Febrile Illness ◽

Acute Febrile Illness ◽

Limited Information ◽

Orientia Tsutsugamushi ◽

Health Measures ◽

Central Nepal ◽

Vector Borne

Scrub typhus is a vector-borne, acute febrile illness caused by Orientia tsutsugamushi. Scrub typhus continues to be an important but neglected tropical disease in Nepal. Information on this pathogen in Nepal is limited to serological surveys with little information available on molecular methods to detect O. tsutsugamushi. Limited information exists on the genetic diversity of this pathogen. A total of 282 blood samples were obtained from patients with suspected scrub typhus from central Nepal and 84 (30%) were positive for O. tsutsugamushi by 16S rRNA qPCR. Positive samples were further subjected to 56 kDa and 47 kDa molecular typing and molecularly compared to other O. tsutsugamushi strains. Phylogenetic analysis revealed that Nepalese O. tsutsugamushi strains largely cluster together and cluster away from other O. tsutsugamushi strains from Asia and elsewhere. One exception was the sample of Nepal_1, with its partial 56 kDa sequence clustering more closely with non-Nepalese O. tsutsugamushi 56 kDa sequences, potentially indicating that homologous recombination may influence the genetic diversity of strains in this region. Knowledge on the circulating strains in Nepal is important to the development of diagnostic tests and vaccines to support public health measures to control scrub typhus in this country.

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Adjuvanted recombinant hemagglutinin H7 vaccine to highly pathogenic influenza A(H7N9) elicits high and sustained antibody responses in healthy adults

npj Vaccines ◽

10.1038/s41541-021-00287-7 ◽

2021 ◽

Vol 6 (1) ◽

Author(s):

Christine M. Oshansky ◽

◽

James King ◽

Di Lu ◽

James Zhou ◽

...

Keyword(s):

Influenza A ◽

Study Groups ◽

Cross Reactivity ◽

Healthy Adults ◽

Response Strategy ◽

Seroprotection Rate ◽

Highly Pathogenic ◽

Homologous Virus ◽

Human Infections ◽

Epidemic Wave

AbstractAn unprecedented number of human infections with avian influenza A(H7N9) in the fifth epidemic wave during the winter of 2016–2017 in China and their antigenic divergence from the viruses that emerged in 2013 prompted development of updated vaccines for pandemic preparedness. We report on the findings of a clinical study in healthy adults designed to evaluate the safety and immunogenicity of three dose levels of recombinant influenza vaccine derived from highly pathogenic A/Guangdong/17SF003/2016 (H7N9) virus adjuvanted with AS03 or MF59 oil-in water emulsions. Most of the six study groups meet the FDA CBER-specified vaccine licensure criterion of 70% seroprotection rate (SPR) for hemagglutination inhibition antibodies to the homologous virus. A substantial proportion of subjects show high cross-reactivity to antigenically distinct heterologous A(H7N9) viruses from the first epidemic wave of 2013. These results provide critical information to develop a pandemic response strategy and support regulatory requirements for vaccination under Emergency Use Authorization.

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Respiratory Symptoms and Farming Practices in Farmers Associated With an Acute Febrile Illness After Organic Dust Exposure

CHEST Journal ◽

10.1378/chest.116.5.1452 ◽

1999 ◽

Vol 116 (5) ◽

pp. 1452-1458 ◽

Cited By ~ 35

Author(s):

Susanna Von Essen ◽

Jon Fryzek ◽

Bogdan Nowakowski ◽

Mary Wampler

Keyword(s):

Respiratory Symptoms ◽

Febrile Illness ◽

Dust Exposure ◽

Acute Febrile Illness ◽

Organic Dust ◽

Farming Practices

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Food allergy: nuts and tree nuts

British Journal Of Nutrition ◽

10.1017/bjn20061869 ◽

2006 ◽

Vol 96 (S2) ◽

pp. S95-S102 ◽

Cited By ~ 48

Author(s):

Jesus F. Crespo ◽

John M. James ◽

Consuelo Fernandez-Rodriguez ◽

Julia Rodriguez

Keyword(s):

Food Allergy ◽

Dietary Habits ◽

Storage Proteins ◽

Seed Storage ◽

Seed Storage Proteins ◽

Cross Reactivity ◽

Severe Reaction ◽

Immunological Mechanism ◽

Pathogenesis Related Protein ◽

The Usa

Nuts are a well-defined cause of food allergy, which affect approximately 1 % of the general population in the UK and the USA. There do appear to be differences in the frequency of nut allergy between different countries because of different dietary habits and cooking procedures. For example, in the USA and France, peanuts are one of the most frequent causes of food allergy, but in other countries, it seems to be less common. Genetic factors, in particular, appear to play a role in the development of peanut allergy. While the majority of nut allergens are seed storage proteins, other nut allergens are profilins and pathogenesis-related protein homologues, considered as panallergens because of their widespread distribution in plants. The presence of specific IgE antibodies to several nuts is a common clinical finding, but the clinical relevance of this cross-reactivity is usually limited. Allergic reactions to nuts appear to be particularly severe, sometimes even life-threatening, and fatal reactions following their ingestion have been documented. Food allergy is diagnosed by identifying an underlying immunological mechanism (i.e. allergic testing), and establishing a causal relationship between food ingestion and symptoms (i.e. oral challenges). In natural history investigations carried out in peanut-allergic children, approximately 20 % of the cases outgrew their allergy or developed oral tolerance. The treatment of nut allergies should include patient and family education about avoiding all presentations of the food and the potential for a severe reaction caused by accidental ingestion. Patients and families should be instructed how to recognise early symptoms of an allergic reaction and how to treat severe anaphylaxis promptly.

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Polymyositis Complicating Staphylococcal Septicaemia

Scottish Medical Journal ◽

10.1177/003693308703200510 ◽

1987 ◽

Vol 32 (5) ◽

pp. 149-150

Author(s):

J. Hamilton ◽

R.A. Sharp ◽

J. M. Anderson ◽

M. R. Kerr

Keyword(s):

Inflammatory Myopathy ◽

Febrile Illness ◽

Acute Febrile Illness ◽

Viral Origin ◽

Similar Association

Inflammatory polymyositis can be precipitated by acute febrile illness of viral origin1, but similar association with pyogenic bacterial illness is not recognised. We describe two cases in which recovery from staphylococcal septicaemia was complicated by a widespread inflammatory myopathy.

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