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Murray Valley Encephalitis Virus

Introduction Murray Valley encephalitis virus (MVEV) is one of several mosquito-borne flaviviruses of the Japanese encephalitis virus complex that causes severe disease in humans. It is restricted to a small region of Oceania and, with the exception of travel-related cases, has been exclusively reported in Australia and Papua New Guinea. It is endemic in tropical portions of the Northern Territory and Kimberley region of Western Australia,…

Usutu Virus

Introduction and History USUV was first identified in South Africa in Culex naevei mosquitoes in 1959 and subsequently spread to regions thousands of kilometers apart, such as Senegal, Central African Republic, Nigeria, Uganda, Burkina Faso, Cote d’Ivoire, and Morocco. At that time, it was not associated with clinical disease in birds or mammals. Recently, these and other flaviviruses have spread and are now found in Tunisian…

Kunjin Virus

Introduction Australia hosts at least 75 species of arboviruses, several of which are associated with mild to life-threatening human disease. Among these are encephalitic flaviviruses, such as the Kunjin strain of WNV (KUNV), Japanese encephalitis virus (JEV), and Murray Valley encephalitis virus (MVEV). Australia is also home to Ross River and Barmah Forest alphaviruses, which cause severe, and sometimes chronic, polyarthritis. The numbers of locally acquired…

West Nile Virus

Introduction West Nile virus (WNV) was first isolated in 1937 in the West Nile district of Uganda and was subsequently reported in other areas of Africa, the Middle East, Europe, South Asia, and Australia. For decades, infections with WNV were generally mild and infrequent. This changed in the 1990s as severe disease became increasingly common and widespread, due at least in part, to commerce and the…

Zika Virus

Introduction In 2014, a rare and mysterious disease began to be seen in newborns in Brazil. Babies afflicted with this disease had several distinctive features: severe microcephaly accompanied by neurological, developmental, and prominent skull abnormalities; decreased range of motion; and, in some cases, eye damage. The number of miscarriages and stillbirths also increased in the affected areas. The disorder spread rapidly throughout Latin America and to…

Dengue Virus

Introduction Dengue fever (DF) and the more serious forms of DENV infection, dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS), are currently found throughout much of the world. DF causes extreme bone pain. DHF and DSS are life-threatening, primarily in individuals who have been infected with one, and then another, of the four DENV serotypes. Dengue-related diseases are the most common vector-borne infections of humans,…

Introduction to Flaviviruses

Introduction The flaviviruses are the largest group of the Flaviviridae family that infects humans. Hepatitis C virus is also a member of the Flaviviridae family, but is not a flavivirus. Some flaviviruses cause severe pathology in both immunocompromised and immunocompetent people, while infection with other flaviviruses is typically asymptomatic or leads to only a mild, febrile disease. This book presents current and historical information about neglected…

The Impact of Vaccination on the Epidemiology of Infectious Diseases

Abstract Looking back at the past 100 years of medical advances in the prevention and treatment of disease, vaccination is the miracle of modern medicine. In the past 50 years, evidence suggests it has saved more lives worldwide than any other med… 1 You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in…

Evidence Synopsis

Title: Benefits and Harms of Melatonin and Hypnotics in Preventing Jet Lag in Long-Haul Air Travelers Date completed: May 7, 2015 Authors: Steven Lascher, DVM, PhD, MPH and David R. Goldmann, MD Clinical question: Are melatonin and/or hypnotics effective preventive interventions for jet lag in long-haul travelers? Author recommendations: For long-distance air travelers who may benefit from jet lag mitigation, clinicians may prescribe melatonin or a…

Evidence Synopsis

Title: Benefits and Harms of Drugs for Prevention of Chloroquine-Resistant Malaria in Travelers Date completed: April 20, 2015 Authors: Steven Lascher, DVM, PhD, MPH and David R. Goldmann, MD Clinical question: What are the benefits and harms of drugs for prevention of chloroquine-resistant malaria in travelers? Author recommendations: For travelers to areas with known or potential chloroquine-resistent malaria with a predominance of Plasmodium falciparum or Plasmodium…

Quick Evidence Synopsis

Title: Efficacy and Safety of Vaccines for Dengue Date completed: April 22, 2015 Authors: Tatyana A. Shamliyan, MD, MS and David R. Goldmann, MD Clinical question: What are the efficacy and safety of dengue vaccine in children and adults? What does the evidence conclude? Intervention Quality of Evidence a Balance between Benefits and Harms b Three injections of recombinant live attenuated tetravalent dengue vaccine (CYD-TDV) Moderate…

Evidence Synopsis

Title: Benefits and Harms of Immunization Against Typhoid Fever in Travelers Who Have Not Been Previously Exposed Date completed: April 23, 2015 Authors: Steven Lascher, DVM, PhD, MPH and David R. Goldmann, MD Clinical question: What are the benefits and harms of immunization against typhoid fever in travelers who have not been previously exposed? Author recommendations: For adult travelers who have never been exposed to typhoid…

Evidence Synopsis

Title: Benefits of Measures to Prevent Venous Thromboembolism in People Undertaking Long-Haul Air Travel Date completed: May 14, 2015 Authors: Steven Lascher, DVM, PhD, MPH and David R. Goldmann, MD Clinical question: What are the benefits and harms of measures to prevent venous thromboembolism (VTE) in people undertaking long-haul air travel? Author recommendations: For healthy travelers who are planning a long-haul flight of more than 4…

Evidence Synopsis

Title: Use of Supplementary Oxygen in Patients with Chronic Respiratory or Cardiac Disease During Air Travel Date completed: March 19, 2015 Authors: Steven Lascher, DVM, PhD, MPH and David R. Goldmann, MD Clinical question: What are the benefits and harms of supplementary oxygen in patients with chronic respirator or cardiac disease during air travel? Author recommendations: For patients with diagnosed chronic cardiac (e.g., New York Heart…

Evidence Synopsis

Title: Automated External Defibrillators for Cardiac Arrest During Air Travel Date completed: March 31, 2015 Authors: Steven Lascher, DVM, PhD, MPH and David R. Goldmann, MD Clinical question: What are the benefits and harms of automated external defibrillators (AEDs) for cardiac arrest during air travel? Author recommendations: For travelers who suffer sudden cardiac arrest (SCA) at the airline terminal or in flight, a combination of cardiopulmonary…

Evidence Synopsis

Title: Benefits and Harms of Sunscreens to Decrease Ultraviolet Exposure from Sunlight Date completed: May 28, 2015 Authors: Steven Lascher, DVM, PhD, MPH and David R. Goldmann, MD Clinical question: What are the benefits and harms of sunscreens to decrease ultraviolet (UV) exposure from sunlight? You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are…

The Eosinophilic Patient with Suspected Parasitic Infection

Elevations of the peripheral blood absolute eosinophil count (>450 eosinophils/mm 3 ) can occur in a wide variety of clinical situations, including parasitic infections, allergic states, collagen vascular diseases, hypereosinophilic syndromes, and other miscellaneous disorders ( Table 49.1 ). The immunobiology of eosinophils is thoroughly described in Weller (1997). The absolute eosinophil count is a more reliable indicator of the presence of eosinophilia than is the…

Trematodes

The flukes, or trematodes, are long-lived parasites that can cause human disease by mechanical obstruction and by inciting local inflammatory responses in affected organs ( Table 48.1 ). Blood flukes ( Schistosoma spp.), hepatobiliary flukes ( Clonorchis sinensis , Opisthorchis spp., and Fasciola hepatica ), and lung flukes ( Paragonimus spp.) can be associated with major systemic pathology, whereas intestinal flukes ( Metagonimus yokogawai , Heterophyes…

Filarial Infections

Filarial worms are nematodes or roundworms that dwell in the subcutaneous tissues and the lymphatics. Although eight filarial species commonly infect humans, four are responsible for most of the pathology associated with these infections. These are (1) Brugia malayi , (2) Wuchereria bancrofti , (3) Onchocerca volvulus , and (4) Loa loa. The distribution and vectors of all the filarial parasites of humans are given in…