Effectiveness of two doses of tick-borne encephalitis (TBE) vaccine

Vaccine effectiveness (VE) was consistently high following two doses (94.6–97.4%) and three doses (96.1%) of the tick-borne encephalitis (TBE) vaccine. These data support the public health value of providing two doses of the TBE vaccine to a traveller to an endemic area presenting with insufficient time to complete the full three-dose primary series.

Identification of asymptomatic Leishmania infections: a scoping review

Background Asymptomatic Leishmania infection may play an important role in the transmission of the parasite in endemic areas. At present there is no consensus on the definition of asymptomatic Leishmania infection, nor is there a safe and accessible gold standard test for its identification. Methods This paper presents a scoping review to summarize definitions of asymptomatic Leishmania infection found in the literature, as well as to detail the approach (molecular, serological, cellular, and/or parasitological tests) used by researchers to identify this asymptomatic population. A scoping review of published and gray literature related to asymptomatic Leishmania infection was conducted; retrieved citations were screened based on predefined eligibility criteria, and relevant data items were extracted from eligible articles. The analysis is descriptive and is presented using tables, figures, and thematic narrative synthesis. Results We conducted a screening of 3008 articles, of which 175 were selected for the full review. Of these articles, we selected 106 that met the inclusion criteria. These articles were published between 1991 and 2021, and in the last 5 years, up to 38 articles were reported. Most of the studies were conducted in Brazil (26%), Spain (14%), India (12%), Bangladesh (10%), and Ethiopia (7%). Of the studies, 84.9% were conducted in the immunocompetent population, while 15.1% were conducted in the immunosuppressed population (HIV, immunosuppressive drugs, and organ transplantation population). We report 14 different techniques and 10 strategies employed by researchers to define asymptomatic Leishmania infection in an endemic area. Conclusions The definition of asymptomatic Leishmania infection is not unified across the literature, but often includes the following criteria: residence (or extended stay) in a Leishmania-endemic area, no reported signs/symptoms compatible with leishmaniasis, and positive on a combination of serological, molecular, cellular, and/or parasitological tests. Caution is recommended when comparing results of different studies on the subject of asymptomatic infections, as the reported prevalence cannot be confidently compared between areas due to the wide variety of tests employed by research groups. More research on the importance of asymptomatic immunosuppressed and immunocompetent Leishmania-positive populations in leishmaniasis epidemiology is required. Graphical Abstract

Lessons learned from a fatal case of tuberculous meningitis with a rapid decline in an infant

Tuberculous meningitis is a highly lethal, often underrecognized disease with characteristic clinical and imaging features which can be cured if the diagnosis and subsequent treatment are begun at early stages. Frequently, there is a delayed diagnosis of this condition due to unfamiliarity of clinicians in non-endemic areas about its presentation and diagnostic workup. This article presents a case of rapid decline and fatality due to tuberculous meningitis in an 11-month-old child from a non-TB-endemic area and describes the characteristic clinical presentation, imaging findings, and diagnostic pitfalls associated with this condition.

Description of Extraordinary Events of Dengue Hemorrhagic Fever In Belu Regency, East Nusa Tenggara Province 2020

Belu Regency is located in the province of East Nusa Tenggara (NTT), Indonesia and is an endemic area for dengue fever. Nationally, until June 2020, there were 16,320 cases of dengue fever with a CFR of 0.009%, while in Belu Regency there were 820 cases recorded until June 2020 with a CFR of 0.97%. This study aims to describe the outbreak of DHF by person, place and time as well as the distribution of cases in Belu Regency. this research is descriptive observational with case series design. The source of research data is secondary data on dengue cases obtained from the 2016-2019 Dengue Hemorrhagic Fever (DHF) Report and the DHF outbreak report in January-June 2020, the Belu District Health O ce. DHF cases in Belu Regency until June 2020 were 820 cases with symptoms of fever 2-7 days by 100% and supported by laboratory platelet examinations of 73%. The highest IR rate until June 2020 is 367 per 100. 000 residents with a CFR of 0.97% spread over 12 sub-districts of Belu Regency. The highest IRs (>20 per 10,000 population) are Atambua city, South Atambua, East Tasifeto, West Atambua, Kakuluk Mesak and West Tasifeto subdistricts. The majority of DHF in the age group 5-14 years 521 cases (27.1%) with female sex as many as 495 cases (51.51%). DHF cases were found since the first epidemiological week at the beginning of the year with peak cases at the 13th week. Belu Regency Is a dengue endemic area with an IR of 367/100,000 population with a CFR of 0.97%. The highest cases were in the 5-14 year age group and spread across 12 sub-districts of Belu Regency.

Characteristics Environmental and Anopheles Larva Species In High And Low Clinical Malaria Cases In The Landak District of West Kalimantan Province

Malaria remains a health problem in Indonesia. West Kalimantan is a malaria endemic area with high and lowincidence. Landak District is one of the malaria endemic area. Malaria cases were found in the areas around illegalgold mining and oil palm plantations. The aims of this study were to describe the characteristics of the breeding sitesand species of Anopheles larvae found in high malaria cases area, namely Amboyo Utara Village and low clinicalmalaria cases, area namely Mandor Village. This research is a descriptive research with cross sectional design. Thesamples were Anopheles larvae collected with Accidental sampling technique in the breeding sites. Environmentalcharacterization of breeding sites were physical characteristic including water temperature and sun exposure,chemical characteristic including water pH and salinity, and biological characteristics including water biota. Theresults of this study ware environmental characteristics that have the potential to breed Anopheles mosquitoes inAmboyo Utara Village, including water temperature 26-30C, shandy, water pH 5.0-7.6, salinity 0.2-1.0 ppt, biotaswater hyacinth, grass and tadpole. The Mandor village, water temperature 29-30 ºC, shandy, pH of 6.9-8.0, salinity of0.5 ppt, water biota grass. Anopheles species found in Amboyo Utara village were larvae of An. vagus (94.30%), An.tessellatus (3.42%), An. subpictus (1.62%), An. indefinitus (0.81%) and An. maculatus (0.81%). Characteristics ofbreeding sites in Mandor village were larvae of An. maculatus (11.11%), An. subpictus (3.70%), and An. vagus(85.18%). The conclusion of this study was that di erent species found at breeding sites with di erent environmentalcharacteristics in both high and low malaria areas in Landak District, West Kalimantan Province.

Case Report: Fulminant Myocarditis Successfully Treated With Extracorporeal Membrane Oxygenation in Ikeda Strain Orientia tsutsugamushi Infection

Scrub typhus is an acute zoonotic febrile illness caused by Orientia tsutsugamushi having a specific geographic endemic area. This infection could be complicated with multi-organ involvement including myocarditis with variable severity. Here, we report a rare case of scrub typhus with biopsy-proven acute fulminant myocarditis which progressed very rapidly to cardiac arrest and was treated successfully with extracorporeal cardiopulmonary resuscitation. Clinicians should be alert to possible rapid progression of scrub typhus myocarditis to fulminant form and be prepared for close monitoring and temporary mechanical support if indicated.