West Nile fever in Volgograd Oblast: features of the epidemic process’s manifestations at the present stage

Objective: To study the regional features of the West Nile fever (WNF) epidemic process manifestations using the example of the territory with stable and long-term pathogen circulation (Volgograd Oblast).Materials and Methods: We used the data of the Reference Center for monitoring the WNF pathogen based on the Volgograd Research Anti-Plague Institute of Rospotrebnadzor over 1999–2021. The main method is a comprehensive epidemiological method.Results: The long-term changes in the WNF incidence in Volgograd Oblast is characterized by a cyclical nature with an interval of 1–8 years and a tendency to decrease. The maximum risk of infection occurs in August (58.8%), but there is an increase in the number of cases in September. The average duration of the epidemic season is 8.4 weeks. Case fatality rate is at the level of 4.3%; the prevalence of the number of deaths in the group of 70 years and older (75%), as well as among men (63.6%) has been established. The greatest contribution to the incidence rate is made by the age group of 60 years and older (37.7%). Features of the clinical presentation include the dominance of forms without damage to the central nervous system (91.1%) and moderate clinical course (72.3%). The prevalence of the urban population among the infected was noted (85.5%).Conclusion: A comparative analysis of the clinical and epidemiological WNF manifestations in Volgograd Oblast, territories with a stable circulation of the pathogen (Astrakhan and Rostov Oblasts) and, in overall, the Russian Federation, established differences in the duration of cyclical fluctuations in incidence, seasonality (Rostov Oblast), age structure of incidence (Astrakhan Oblast), distribution of cases by the severity of the clinical course, the site of the alleged infection and social status.

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Morbidity, mortality and long-term sequelae of West Nile virus disease in Québec

Epidemiology and Infection ◽

10.1017/s0950268818000687 ◽

2018 ◽

Vol 146 (7) ◽

pp. 867-874 ◽

Cited By ~ 6

Author(s):

N. Ouhoumanne ◽

A-M. Lowe ◽

A. Fortin ◽

D. Kairy ◽

A. Vibien ◽

...

Keyword(s):

Public Health ◽

West Nile Virus ◽

Symptom Onset ◽

Virus Disease ◽

Short Form ◽

Functional Limitations ◽

Severe Illness ◽

West Nile Fever ◽

West Nile

AbstractWe aimed to describe the clinical characteristics of West Nile patients reported in Québec in 2012 and 2013 and to document physical, mental and functional status 24 months after symptom onset according to illness severity. The cases were recruited by a public health professional. Data were collected from public health files, medical records and two standardised phone questionnaires: the Short Form-36 and the Instrumental Activities of Daily Living. In all, 92 persons participated in the study (25 had West Nile fever (WNF), 18 had meningitis and 49 had encephalitis). Encephalitis participants were older, had more underlying medical conditions, more neurological symptoms, worse hospital course and higher lethality than meningitis or WNF participants. Nearly half of the surviving hospitalised encephalitis patients required extra support upon discharge. At 24-month follow-up, encephalitis and meningitis patients had a lower score in two domains of the mental component: mental health and social functioning (P = 0.0025 and 0.0297, respectively) compared with the norms based on age- and sex-matched Canadians. Physical status was not affected by West Nile virus (WNV) infection. In addition, 5/36 (15%) of encephalitis, 1/17 (6%) of meningitis and 1/23 (5%) of WNF participants had new functional limitations 24 months after symptom onset. In summary, mental and functional sequelae in encephalitis patients are likely to represent a source of long-term morbidity. Preventive measures should target patients at higher risk of severe illness after WNV infection.

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CLINICAL-EPIDEMIOLOGICAL CHARACTERISTIC OF WEST NILE FEVER IN KRASNODAR REGION

Journal of microbiology epidemiology immunobiology ◽

10.36233/0372-9311-2016-2-74-80 ◽

2016 ◽

pp. 74-80 ◽

Cited By ~ 1

Author(s):

L. I. Zhukova ◽

G. K. Rafeenko ◽

V. N. Gorodin ◽

A. A. Vanyukov

Keyword(s):

Clinical Symptoms ◽

Clinical Course ◽

Clinical Signs ◽

West Nile Fever ◽

Epidemiological Characteristic ◽

West Nile ◽

Epidemic Process ◽

The Future ◽

Krasnodar Region

Aim. Clinical-epidemiological characteristic of West Nile fever on the territory of Krasnodar Region in multi-year dynamics. Materials and methods. Manifestations of epidemic process and clinical symptoms of West Nile fever (WNF) on the territory of Krasnodar Region were analyzed retrospectively from 1988 to 2013. Results of epidemiologic observations with inclusion of monitoring of arbovirus circulation, carried out by Prichernomorskaya Station of Plague Control and Centre of Hygiene and Epidemiology in Krasnodar Region were used. Clinical course of verified WNF was studied in 62 patients, treated in the Specialized Clinical Infectious Hospital ofKrasnodar in 1999 - 2012. Results. Clinical-epidemiologic characteristic of cases of West Nile fever morbidity on the territory of Krasnodar Region is presented. The presence of acting foci of arbovirus infections was noted. Clinical signs of the disease are established, patients allocated into groups that require examination for West Nile fever. Conclusion. Complex of entomologic-virologic monitoring, prophylactic and counter-epidemic measures was determined, that allow to prevent emergence of dangerous epidemiologic manifestations of foci of the disease in the future.

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Faculty Opinions recommendation of Long-term clinical and neuropsychological outcomes of West Nile virus infection.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1040429.489397 ◽

2006 ◽

Author(s):

Phillip Peterson

Keyword(s):

West Nile Virus ◽

Virus Infection ◽

West Nile Virus Infection ◽

West Nile ◽

Neuropsychological Outcomes

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Severe tricuspid regurgitation 14 years after diagnosis of “transient neonatal tricuspid regurgitation”

Heart ◽

10.1136/hrt.86.1.88 ◽

2001 ◽

Vol 86 (1) ◽

pp. 88-90

Author(s):

D Boshoff ◽

L Mertens ◽

M Gewillig

Keyword(s):

Tricuspid Regurgitation ◽

Neonatal Period ◽

Clinical Course ◽

Subsequent Evolution ◽

Severe Tricuspid Regurgitation ◽

Echocardiographic Examination ◽

Long Term Follow Up ◽

Transient Tricuspid Regurgitation

A 14 year old girl presented with severe tricuspid regurgitation after she was diagnosed with “transient tricuspid regurgitation of the newborn”. In the neonatal period she had presented with severe tricuspid regurgitation without an obvious underlying anatomical cause. This spontaneously regressed during the first months of life. She was dismissed from follow up at the age of 5 years after complete normalisation of the clinical and echocardiographic examination. The subsequent evolution and management of the patient, as well as the possible pathogenesis responsible for the unusual clinical course, is discussed. This case stresses the importance of long term follow up of patients with transient tricuspid regurgitation.

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Mild gray matter atrophy in patients with long-standing multiple sclerosis and favorable clinical course

Multiple Sclerosis Journal ◽

10.1177/13524585211019650 ◽

2021 ◽

pp. 135245852110196

Author(s):

Rosa Cortese ◽

Marco Battaglini ◽

Francesca Parodi ◽

Maria Laura Stromillo ◽

Emilio Portaccio ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Multiple Sclerosis ◽

Gray Matter ◽

Clinical Course ◽

Resonance Imaging ◽

Volume Changes ◽

Magnetic Resonance Imaging Mri ◽

Global Brain ◽

Diffuse Brain

The mechanisms responsible for the favorable clinical course in multiple sclerosis (MS) remain unclear. In this longitudinal study, we assessed whether magnetic resonance imaging (MRI)-based changes in focal and diffuse brain damage are associated with a long-term favorable MS diseases course. We found that global brain and gray matter (GM) atrophy changes were milder in MS patients with long-standing disease (⩾30 years from onset) and favorable (no/minimal disability) clinical course than in sex-age-matched disable MS patients, independently of lesions accumulation. Data showed that different trajectories of volume changes, as reflected by mild GM atrophy, may characterize patients with long-term favorable evolution.

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West Nile fever upsurge in a Greek regional unit, 2020

Acta Tropica ◽

10.1016/j.actatropica.2021.106010 ◽

2021 ◽

pp. 106010

Author(s):

Anna Papa ◽

Katerina Tsioka ◽

Sandra Gewehr ◽

Stella Kalaitzopouou ◽

Danai Pervanidou ◽

...

Keyword(s):

West Nile Fever ◽

West Nile ◽

Regional Unit

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530. COVID-19 in kidney transplant recipients: Single-center experience and case-control study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.724 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S332-S332

Author(s):

Anna Hardesty ◽

Aakriti Pandita ◽

Yiyun Shi ◽

Kendra Vieira ◽

Ralph Rogers ◽

...

Keyword(s):

Kidney Transplant ◽

Case Control Study ◽

Clinical Course ◽

Case Series ◽

Case Fatality ◽

Case Control ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Transplant Patients ◽

Control Study

Abstract Background Organ transplant recipients (OTR) are considered high-risk for morbidity and mortality from COVID-19. Case-fatality rates (CFR) vary significantly in different case series, and some patients were still hospitalized at the time of analyses. To our knowledge, no case-control study of COVID-19 in OTR has been published to-date. Methods We captured kidney transplant recipients (KTR) diagnosed with COVID-19 between 3/1 and 5/18/2020. After exclusion of KTR on hemodialysis and off immunosuppression (IS), we compared the clinical course of COVID-19 between hospitalized KTR and non-transplant patients, matched by sex and age (controls). All patients were discharged from the hospital or died. Results 16 KTR had COVID-19. All 3 KTR off IS, who were excluded from further analyses, survived. Median age was 54 (range: 34–65) years; 5/13 KTR (38.4%) were men. Median time from transplant was 41 (range: 1–203) months. Two KTR, both transplanted >10 years ago, were managed as outpatients. IS was reduced in 12/13 (92.3%), most often by discontinuation of the antimetabolite. IL6 levels were >1,000 (normal: < 5) pg/mL in 3 KTR. Tacrolimus or sirolimus levels were >10 ng/mL in 6/9 KTR (67%) (Table 1). Eleven KTR were hospitalized (84.6%) and matched with 44 controls. One KTR, the only one treated with hydroxychloroquine, died (CFR 5.8%; 7.6% in KTR on IS; 9% in hospitalized KTR on IS). Four controls died (CFR: 9%; state CFR: 5.2%; inpatient CFR: 16.6%). There were no significant differences in length of stay or worst oxygenation status between hospitalized KTR and controls. Four KTR (30.7%), received remdesivir, 4 convalescent plasma, 3 (23%) tocilizumab. KTR received more often broad-spectrum antibiotics, convalescent plasma or tocilizumab, compared to controls (Table 2). Table 1 Table 2 Conclusion Unlike early reports from the pandemic epicenters, the clinical course and outcomes of KTR with COVID-19 in our small case series were comparable to those of non-transplant patients. Calcineurin or mTOR inhibitor levels were high, likely due to diarrhea and COVID-19-related hepatic dysfunction. Extremely high IL6 levels were common. The role of IS and potential benefits from investigational treatments remain to be elucidated. A larger multi-institutional study is underway. Disclosures All Authors: No reported disclosures

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Long-term Outcome of Patients With West Nile Virus Infection

Infectious Diseases in Clinical Practice ◽

10.1097/01.idc.0000166958.44764.39 ◽

2005 ◽

Vol 13 (3) ◽

pp. 101-103 ◽

Cited By ~ 3

Author(s):

Lara E. Jeha ◽

Gregory P. Hanes ◽

Cathy A. Sila ◽

Richard J. Lederman ◽

Carlos M. Isada ◽

...

Keyword(s):

West Nile Virus ◽

Virus Infection ◽

West Nile Virus Infection ◽

West Nile ◽

Term Outcome ◽

Long Term Outcome

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1787. The Effects of a Systemwide Diagnostic Stewardship Change on West Nile Virus Disease Ordering Practices

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1650 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S658-S658

Author(s):

Andrew H Karaba ◽

Paul W Blair ◽

Kevin M Martin ◽

Mustapha O Saheed ◽

Karen C Carroll ◽

...

Keyword(s):

West Nile Virus ◽

Virus Disease ◽

Case Fatality ◽

Cost Savings ◽

Primary Objective ◽

Neurological Deficits ◽

West Nile ◽

Hospital System ◽

Elisa Testing ◽

Before And After

Abstract Background Neuroinvasive West Nile Virus (WNV) often leads to prolonged neurological deficits and carries a high case fatality rate. The CSF IgM (MAC-ELISA) is preferred over the CSF nucleic acid-based test (NAAT) by the CDC due to its higher sensitivity. However, our hospital system was observed to have an over-utilization of NAAT testing compared with MAC-ELISA testing. The primary objective was to compare the number of MAC-ELISA and NAAT WNV tests ordered before and after a diagnostic stewardship intervention. The secondary objectives were to determine whether this change to lead to any cost savings and increased detection of probable cases of WNV-ND. Methods In an effort to increase the use of the MAC-ELISA and to decrease unnecessary NAAT testing, the NAAT test was removed in April 2018 from the test menu in the electronic health record of a health system comprising five hospitals in the Maryland and Washington, D.C. area. NAAT testing remained possible via a paper order form. This study was a retrospective review of WNV testing done on CSF samples from July 2016 through December 2018. The seasonal and yearly number of total tests, positive tests, and total costs were determined from the period of July, 2017 to April, 2018 and were compared with May, 2018 to January, 2019. A paired t-test was performed to evaluate for differences in total testing, total positives, and total costs during non-winter months before and after the intervention. Results A total of 12.59 MAC-ELISA tests/month (95% CI: 10.29, 14.89) increased to 41 tests/month (95% CI: 34.35, 47.65) which was significantly different (P < 0.001). In contrast, there were 46.23 NAAT tests/month (95% CI: 39.55, 52.91) which decreased to 0 NAAT tests/month after the intervention (P < 0.001). This resulted in an average decrease in WNV test spending from $7200 per month to $471 per month (P < 0.001). Preceding the intervention in test ordering, 0.23% of WNV CSF tests were positive (NAAT+MAC-ELISA) while 2.44% WNV CSF tests were positive after the intervention (P = 0.03). Conclusion Elimination of electronic WNV NAAT ordering is an effective way of decreasing inappropriate WNV NAAT testing, decreasing associated costs, and may lead to improved diagnosis of WNV-ND. Disclosures All authors: No reported disclosures.

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