African Swine Fever Virus F317L Protein Inhibits NF-κB Activation To Evade Host Immune Response and Promote Viral Replication

African swine fever (ASF) is one of the most important pig diseases, causing a high case fatality rate and trade restrictions upon reported outbreaks. The limited understanding of the functions of the proteins of the causative agent, African swine fever virus (ASFV), has become a primary barrier to developing available commercial ASFV vaccines.

Risk factors for mortality in patients over 70 years old with COVID-19 in Wuhan at the early break: retrospective case series

Background Elderly patients with COVID-19 were shown to have a high case-fatality rate. We aimed to explore the risk factors associated with death in patients over 70 years old (yr). Methods In this retrospective study, we enrolled consecutively hospitalized patients over 70 yr with COVID-19 between January 20 and February 15, 2020 in Renmin Hospital of Wuhan University. Epidemiological, demographic, and clinical data were collected. Clinical subtypes, including mild, moderate, severe, and critical types, were used to evaluate the severity of disease. Patients were classified into two groups: survivor and non-survivor groups. Clinical data were compared between the two groups. Univariable and multivariable Cox regression methods were used to explore the risk factors. Results A total of 147 patients were enrolled. The case-fatality rate was 28.6%. Multivariable Cox proportional hazard regression showed that clinical subtypes, including the severe type (HR = 2.983, 95% CI: 1.231–7.226, P = 0.016) and the critical type (HR = 3.267, 95%CI: 1.009–10.576, P = 0.048), were associated with increasing risk of death when compared with the general type. Blood urea nitrogen greater than 9.5 mmol/L (HR = 2.805, 95% CI: 1.141–6.892, P = 0.025) on admission was an independent risk factor for death among laboratory findings. Conclusion The patients over 70 yr with COVID-19 had a high case-fatality rate. The risk factors, including clinical subtypes and blood urea nitrogen greater than 9.5 mmol/L, could help physicians to identify elderly patients with poor clinical outcomes at an early stage.

Management of acute aluminum phosphide poisoning: Has anything changed?

: Due to its easy availability, rapid and severe toxicity, and no specific antidote, aluminum phosphide has emerged as a lethal toxin, commonly used for suicidal intent in agricultural communities. Despite various advances in medicine, this compound’s toxicity is poorly understood, and it still has a very high case fatality rate with no definitive treatment options available. This review aims to understand the mechanism of toxicity, clinical toxidrome of acute aluminum phosphide poisoning, and the available therapeutic options, including recent advances. A literature review was performed searching PubMed, EMBASE Ovid, and Cochrane Library, using the following search items: (“aluminum phosphide poisoning” OR “aluminum phosphide poisoning toxicity” OR “aluminum phosphide ingestion”) AND (“management” OR “therapy” OR “treatment”). Selected articles were discussed amongst all the authors to shape this review. High case fatality rate and lack of any specific antidote are persisting challenges. Therapeutic measures need to be implemented from all fronts – reducing easy access to the poison, developing less toxic alternatives for use as a pesticide, and more studies directed at developing an effective reversal agent for phosphine. The advent of promising agents like glucose-insulin-potassium infusion and lipid emulsion is a new ray of hope in the complete recovery in this fatal poisoning. The current need of the hour is to find an agent that rapidly and effectively reverses aluminum phosphide's toxic effects. Large multicenter controlled trials are required to establish the role of glucose-insulin-potassium and lipid emulsion.

Modeling the effectiveness of the PSBB based on COVID-19 case in Greater Surabaya Area

East Java province with high mobility has a high case fatality rate of COVID-19. The core spread of COVID-19 is from the Greater Surabaya area following Surabaya, Sidoarjo, and Gresik districts. The East Java Government through Regulation No.18/2020 imposed a Large-Scale Social Restriction (PSBB) that is intended to support the effectiveness of the physical distancing strategy in addressing the emergency status of the COVID-19. But no official report has been found on the effectiveness of PSBB. Therefore, it is necessary to evaluate the effectiveness of PSBB, especially in Greater Surabaya. This research aims to know the model of PSBB policy to minimize the spread of COVID-19 in the greater Surabaya. The study focused on health facility (ventilator, ICU, non-ICU), population, case over a certain period, and positive case in care. This study analyzes the distribution pattern and models the effectiveness of PSBB against the spread of COVID-19 in Greater Surabaya. The data analysis used the COVID-19 Surge-CDC Model. The result of the research shows that the condition of COVID-19 cases increased significantly in the model without intervention. The sharp increase in cases is related to the anticipation of other policies related to the ability of regions to provide health facilities.

Crimean-Congo hemorrhagic fever-induced liver injury: a systematic review and meta-analysis

Background: Crimean-Congo hemorrhagic fever (CCHF) is a fatal acute tick-borne viral infection and a substantial emerging global public health threat. This illness has a high case fatality rate of up to 40%. The liver is one of the important target organs of the CCHF virus. Objective: The aim of this meta-analysis to evaluate the correlation between CCHF and liver injury and draw more generalized inferences about the abnormal serum markers of liver injury such as alanine aminotransferase (ALT), aspartate aminotransferase (AST) in CCHF patients. Methods: A literature search was accomplished for published eligible articles with MEDLINE/PubMed and Embase databases. All eligible observational studies and case series were included from around the world. The inclusion criteria were articles describing liver injury biomarkers AST and ALT amongst patients diagnosed with CCHF. Results: Data from 18 studies, consisting of 1238 patients with CCHF were included in this meta-analysis. The overall pooled prevalence of at least one raised liver injury biomarker was 77.95% (95% CI, I2 = 88.50%, p < 0.0001). Similarly, pooled prevalence of elevated AST and ALT was 85.92% (95% CI, I2 = 85.27%, p < 0.0001) and 64.30% (95% CI, I2 = 88.32%, p < 0.0001) respectively. Both Egger and Begg-Mazumdar’s tests detected no apparent publication bias in all three meta-analyses(p > 0.05). Conclusion: These elevated liver injury biomarkers have been identified as significant prognostic factors. Hence, Physicians must recognize and continuously monitor these biomarkers, since these aid early stratification of prognosis and the prevention of severe outcomes in infection with such a high case fatality rate.

Neonatal Listeria innocua sepsis

Neonatal listeriosis is a potentially life-threatening infection, usually caused by Listeria monocytogenes. It has a high case fatality rate and can cause severe neurological sequelae among survivors. Early-onset listeriosis is caused by vertical transmission through transplacental route, inhalation of infected amniotic fluid or through ascending infection from the vaginal colonization. We report fatal neonatal listeriosis in a 5 day old female infant caused by L. innocua. L. innocua is considered as non-pathogen and only few cases were reported in an immunocompromised individual.

COVID-19 in Sudan

The steadily growing COVID-19 pandemic is challenging health systems worldwide including Sudan. In Sudan, the first COVID-19 case was reported on 13th March 2020, and up to 11 November 2020 there were 14,401 confirmed cases of which 9,535 cases recovered and the rest 3,750 cases were under treatment. Additionally, 1,116 deaths were reported, indicating a relatively high case fatality rate of 7.7%. Several preventive and control measures were implemented by the government of Sudan and health partners, including the partial lockdown of the country, promoting social distancing, and suspending mass gathering such as festivals and performing religious practices in groups. However, new cases still emerging every day and this could be attributed to the noncompliance of the individuals to the advocated preventive measurements.

Hantavirus: Structure, Mechanism of Transmission of Disease, Development of Drugs and Vaccines, and Prevention in Indonesia

<p class="awabstrak2"><em>Hantavirus</em> is a zoonosis transmitted by rodents and have been spread in various countries. <em>Hantavirus</em> causes <em>Hantavirus</em> Pulmonary Syndrome (HPS) and Haemorrhagic Fever with Renal Syndrome (HFRS) in humans is still receiving worldwide attention due to the high case fatality rate. Epidemiological studies have shown that <em>Hantavirus</em> is widespread globally, including in Indonesia. Indonesia is an archipelago and has a tropical climate, and is crossed by the equator so that it has an enormous diversity of animals, including those that become reservoirs of <em>Hantavirus</em> and other vulnerable animals. The high risk of developing <em>Hantavirus</em> in Indonesia does not rule out the possibility of a <em>Hantavirus</em> outbreak if no preventive action is taken. Until now there is no effective and safe vaccine or treatment for <em>Hantavirus</em>. Various development efforts continue to be made to obtain an appropriate and safe vaccine to prevent and stop the spread of <em>Hantavirus</em>. This paper discusses <em>Hantavirus</em>, including its structure and mechanism of transmission, the current situation of <em>Hantavirus</em> in Indonesia and the efforts that can be made to prevent <em>Hantavirus</em>, including the development of vaccines and their drugs.</p>

Estimation of fatality rate in Africa through the behavior of COVID-19 in Italy relevance to age profiles

The emergence and pandemic of COVID-19 has rapidly become a global concern. In Italy, on 27 March 2020, there were 8165 deaths and 80539 confirmed cases of COVID-19. Demographic situations, like age profiles is reported to be the cause of high case fatality rate (CFR) in Italy. In Africa, the COVID-19 pandemic has not yet grasped epic proportion, but the estimation of CFR is still needed. We compared the CFR observed in Italy with the age profiles in 46 Africa countries and 2 territories which are already confirmed COVID-19 case. The estimation of the CFR in Africa ranges between (1.0%-5.4%) while in Italy is 10.1%. The five highest CFR countries and territories in Africa are Reunion (5.4%), Mauritius (5.1%), Tunisia (3.9%), Seychelles (3.8%) and Morocco (3.3%). The last three countries with low CFR are Uganda (1.0%), Zambia (1.1%) and Angola (1.1%). The observed difference is related to the age profiles.