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Copyright of Pediatrie pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. Various human viruses have been identified in wild monkeys and in captive primates. Cases of transmission of viruses from wild monkeys to humans and vice versa are known. The aim of this study was to identify markers of anthroponotic viral infections in vervet monkeys (Chlorocebus pygerythrus) arrived from their natural habitat (Tanzania). Materials and methods. Fecal samples (n = 56) and blood serum samples (n = 75) obtained from 75 animals, respectively, on days 10 and 23 after admission to the primate center, were tested for the markers of anthroponotic viral infections (Ebola virus, Marburg virus, lymphocytic choriomeningitis, hepatitis C virus, herpes simplex virus (HSV), cytomegalovirus (CMV), Epstein–Barr virus (EBV), parainfluenza types 1 and 3, intestinal adenoviruses, rotaviruses) by enzyme immunoassay (ELISA) and polymerase chain reaction (PCR). Results and discussion. Among the examined animals, markers of 6 out of 11 tested viral infections were identified. Detection rates of IgG antibodies to HSV-1,2 (15.9%) and CMV (15.9%) were two times as low as IgG antibodies to EBV (31.8%). Among the markers of respiratory viral infections, IgG antibodies to parainfluenza virus type 1 were found (6.8%). 14.3% of the animals had rotavirus antigen, and 94% had simian adenovirus DNA. Markers of hemorrhagic fevers Ebola, Marburg, LCM, hepatitis C, and type 3 parainfluenza were not detected. Conclusion. When importing monkeys from different regions of the world, an expanded screening for viral infections is needed considering the epidemiological situation both in the country of importation and in the country of destination.

Lassa fever (LF) is a zoonotic viral hemorrhagic disease endemic to several West African countries. Approximately 300–500,000 cases occur annually across all ages with 10–20% case fatality rates. A LF vaccine is a recognized public health priority, with several candidates entering clinical trials. However, the perspectives of regional experts regarding critical vaccine properties, ideal delivery methods, and priority target populations remain unclear. Using a mixed methods approach with a standardized questionnaire, we individually interviewed 8 West African stakeholders, each with extensive knowledge and experience of LF. They strongly favored the use of a mass, proactive campaign strategy to immunize a wide age range of people in high-risk areas, including pregnant women and health care workers. We estimated that these and other plausible delivery scenarios could result in an initial demand of anywhere from 1 to 100 million doses, with most demand coming from Nigeria. These findings may help inform LF vaccine development and deployment efforts. [ABSTRACT FROM AUTHOR]

Marburg virus disease (MVD) caused by the Marburg virus has a high mortality rate. Rousettus aegyptiacus fruit bats act as the natural reservoir host of the virus. But it can also potentially be transmitted from person to person through direct contact with body secretions. The recent outbreaks have already killed seven people out of nine confirmed cases in Equatorial Guinea and five patients out of eight confirmed cases in Tanzania. In the recent past, Ghana reported three MVD cases and two associated deaths in 2022. Specific treatments or vaccines are unavailable for MVD, and supportive care is the primary treatment option. The history of MVD outbreaks and the current scenario show its potential to become an emerging threat to global public health. The recent outbreaks in Tanzania and Equatorial Guinea have already caused a high fatality rate. The absence of effective treatment and vaccines raises concerns about the potential to cause widespread harm. Besides, its capacity for human‐to‐human transmission and potential to cross the country's border could result in a multicountry outbreak. Therefore, we recommend intensive surveillance of MVD, preventative measures, and early detection to limit the spread of the disease and prevent another pandemic. [ABSTRACT FROM AUTHOR]

Abstract Marburg virus disease (MVD) caused by the Marburg virus has a high mortality rate. Rousettus aegyptiacus fruit bats act as the natural reservoir host of the virus. But it can also potentially be transmitted from person to person through direct contact with body secretions. The recent outbreaks have already killed seven people out of nine confirmed cases in Equatorial Guinea and five patients out of eight confirmed cases in Tanzania. In the recent past, Ghana reported three MVD cases and two associated deaths in 2022. Specific treatments or vaccines are unavailable for MVD, and supportive care is the primary treatment option. The history of MVD outbreaks and the current scenario show its potential to become an emerging threat to global public health. The recent outbreaks in Tanzania and Equatorial Guinea have already caused a high fatality rate. The absence of effective treatment and vaccines raises concerns about the potential to cause widespread harm. Besides, its capacity for human‐to‐human transmission and potential to cross the country's border could result in a multicountry outbreak. Therefore, we recommend intensive surveillance of MVD, preventative measures, and early detection to limit the spread of the disease and prevent another pandemic.

* Infectious Diseases and Clinical Xenotransplantation * Looking Beyond the Lens of Crimean-Congo Hemorrhagic Fever in Africa * Strategies to Enhance COVID-19 Vaccine Uptake among Prioritized Groups, Uganda-Lessons Learned and [...]

Lassa fever (LF) is a deadly viral hemorrhagic fever disease that is endemic in several countries in West Africa. It is caused by Lassa virus (LASV), which has been estimated to be responsible for approximately 300,000 infections and 5000 deaths annually. LASV is a highly pathogenic human pathogen without effective therapeutics or FDA-approved vaccines. Here, we aim to provide a literature review of the current understanding of the basic mechanism of immune responses to LASV infection in animal models and patients, as well as to several of its candidate vaccines. [ABSTRACT FROM AUTHOR]

Recent outbreaks of Ebola virus disease and Zika virus disease highlight the need for disseminating accurate predictions of emerging zoonotic viruses to national governments for disease surveillance and response. Although there are published maps for many emerging zoonotic viruses, it is unknown if there is agreement among different models or if they are concordant with national expert opinion. Therefore, we reviewed existing predictions for five high priority emerging zoonotic viruses with national experts in Cameroon to investigate these issues and determine how to make predictions more useful for national policymakers. Predictive maps relied primarily on environmental parameters and species distribution models. Rift Valley fever virus and Crimean-Congo hemorrhagic fever virus predictions differed from national expert opinion, potentially because of local livestock movements. Our findings reveal that involving national experts could elicit additional data to improve predictions of emerging pathogens as well as help repackage predictions for policymakers.

Lassa fever (LF) is a deadly viral hemorrhagic disease that is endemic to West Africa. The causative agent of LF is Lassa virus (LASV), which causes approximately 300,000 infections and 5,000 deaths annually. There are currently no approved therapeutics or FDA-approved vaccines against LASV. The high genetic variability between LASV strains and immune evasion mediated by the virus complicate the development of effective therapeutics and vaccines. Here, we aim to provide a comprehensive review of the basic biology of LASV and its mechanisms of disease pathogenesis and virulence in various animal models, as well as an update on prospective vaccines, therapeutics, and diagnostics for LF. Until effective vaccines and/or therapeutics are available for use to prevent or treat LF, a better level of understanding of the basic biology of LASV, its natural genetic variations and immune evasion mechanisms as potential pathogenicity factors, and of the rodent reservoir-vector populations and their geographical distributions, is necessary for the development of accurate diagnostics and effective therapeutics and vaccines against this deadly human viral pathogen.

Viral hemorrhagic fevers (VHFs) caused by viruses are severe infectious diseases that lead to serious disturbances of the body’s homeostasis, in most cases accompanied by symptoms of hemorrhagic diathesis. They are spread by infection vectors such as insects (mosquitoes, ticks), airborne droplets or direct contact with contaminated material (blood, sweat, excrement, feces). There are four major groups of RNA viruses that cause hemorrhagic fevers – these include pathogens from the families Flaviviridae, Bunyaviridae, Arenaviridae and Filoviridae. Despite their common name, VHFs are distinct disease entities with different etiologies, clinical manifestations and routes of transmission. Although they have been known for several decades and are associated with illnesses in tropical countries, the risk of their occurrence, in times of globalization and widespread international travel, is increasingly high. It is not insignificant that progressive climate change is making vectors of VHFs, which years ago were seen only in tropical countries, increasingly common on the European continent and even in eastern European countries.

Analysis of preconditions for spread of viral hemorrhagic fevers has been made and risks of such infections in Bulgaria and Europe have been assessed. For this purpose, the epidemic situations of the last 10 years caused by the pathogens of hemorrhagic fevers Marburg, Ebola, Lassa and Crimean-Congo hemorrhagic fever have been traced according to literature data. The long-term experience in Bulgaria in diagnosis and prevention of Crimean-Congo hemorrhagic fever, the cause of which is an endemic representative of the hemorrhagic fevers with the fourth level of biological safety, is discussed. Recommendations for monitoring of the latent circulation of the virus in endemic areas among people and rural animals are made. The article provides guidelines for raising awareness among the most at-risk groups. Perspectives for epidemiological control of infections and specifically of the Crimean-Congo hemorrhagic fever are considered. Baseline guidelines for prevention are presented and effectiveness of different measures is assessed. [ABSTRACT FROM AUTHOR]

Hantaviruses (family Hantaviridae, genus Orthohantavirus) are RNA viruses transmitted by aerosolized excreta from infected rodents and shrews. In humans, they cause hemorrhagic fever with renal syndrome (more often observed in [...]

Argentine hemorrhagic fever (AHF) is a severe hemorrhagic fever caused by a New World arenavirus, Junin virus (JUNV), which was discovered in 1958 (1). The virus reservoir consists of rodents [...]

Crimean-Congo hemorrhagic fever (CCHF), the most widespread tickborne viral infection in humans, is a zoonotic disease caused by an orthonairovirus of the Nairoviridae family. Symptoms in humans vary from a [...]

Crimean-Congo hemorrhagic fever (CCHF) is caused by CCHF virus (CCHFV), an emerging zoonotic virus belonging to the order Bunyavirales within the family Nairoviridae. The virus is maintained through a tick-vertebrate [...]

Crimean-Congo hemorrhagic fever (CCHF) is a fatal, zoonotic, tickborne viral infection endemic to Africa, the Middle East, Asia, and Europe. The CCHF virus (CCHFV) is primarily maintained in nature in [...]

Lassa fever (LF) is a deadly viral hemorrhagic disease that is endemic to West Africa. The causative agent of LF is Lassa virus (LASV), which causes approximately 300,000 infections and 5,000 deaths annually. There are currently no approved therapeutics or FDA-approved vaccines against LASV. The high genetic variability between LASV strains and immune evasion mediated by the virus complicate the development of effective therapeutics and vaccines. Here, we aim to provide a comprehensive review of the basic biology of LASV and its mechanisms of disease pathogenesis and virulence in various animal models, as well as an update on prospective vaccines, therapeutics, and diagnostics for LF. Until effective vaccines and/or therapeutics are available for use to prevent or treat LF, a better level of understanding of the basic biology of LASV, its natural genetic variations and immune evasion mechanisms as potential pathogenicity factors, and of the rodent reservoir-vector populations and their geographical distributions, is necessary for the development of accurate diagnostics and effective therapeutics and vaccines against this deadly human viral pathogen. [ABSTRACT FROM AUTHOR]

Copyright of Health Problems of Civilization is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Ebola virus disease (EVD) supportive care strategies are largely guided by retrospective observational research. This study investigated the effect of EVD supportive care algorithms on duration of survival in a controlled nonhuman primate (NHP) model.Methods: Fourteen rhesus macaques were challenged intramuscularly with a target dose of Ebola virus (1000 plaque-forming units; Kikwit). NHPs were allocated to intensive care unit (ICU)-like algorithms (n = 7), intravenous fluids plus levofloxacin (n = 2), or a control group (n = 5). The primary outcome measure was duration of survival, and secondary outcomes included changes in clinical laboratory values.Results: Duration of survival was not significantly different between the pooled ICU-like algorithm and control groups (8.2 vs 6.9 days of survival; hazard ratio; 0.50; P = .25). Norepinephrine was effective in transiently maintaining baseline blood pressure. NHPs treated with ICU-like algorithms had delayed onset of liver and kidney injury.Conclusions: While an obvious survival difference was not observed with ICU-like care, clinical observations from this model may aid in EVD supportive care NHP model refinement. [ABSTRACT FROM AUTHOR]

Hantaviruses belonging to the genus Orthohantavirus, family Hantaviridae, are frequently zoonotic. Rodents are the usual reservoirs of human pathogenic hantaviruses and typically do not show obvious signs of disease (2,2). [...]

Introduction Viral hemorrhagic fevers are a group of infectious diseases with symptoms that are similar among humans (1). The causative viruses affect the vascular system and can cause a hemorrhagic [...], Recent occurrences of filoviruses and the arenavirus Lassa virus (LASV) in overlapping endemic areas of Africa highlight the need for a prophylactic vaccine that would confer protection against all of these viruses that cause lethal hemorrhagic fever (HF). We developed a quadrivalent formulation of VesiculoVax that contains recombinant vesicular stomatitis virus (rVSV) vectors expressing filovirus glycoproteins and that also contains a rVSV vector expressing the glycoprotein of a lineage IV strain of LASV. Cynomolgus macaques were vaccinated twice with the quadrivalent formulation, followed by challenge 28 days after the boost vaccination with each of the 3 corresponding filoviruses (Ebola, Sudan, Marburg) or a heterologous contemporary lineage II strain of LASV. Serum IgG and neutralizing antibody responses specific for all 4 glycoproteins were detected in all vaccinated animals. A modest and balanced cell-mediated immune response specific for the glycoproteins was also detected in most of the vaccinated macaques. Regardless of the level of total glycoprotein-specific immune response detected after vaccination, all immunized animals were protected from disease and death following lethal challenges. These findings indicate that vaccination with attenuated rVSV vectors each expressing a single HF virus glycoprotein may provide protection against those filoviruses and LASV most commonly responsible for outbreaks of severe HF in Africa.

The genus Marburgvirus, like Ebolavirus, belongs to the family Filoviridae and consists of virus species that cause severe hemorrhagic fever in humans and nonhuman primates. Marburgvirus contains 1 species, Marburg [...]

Ebola virus (EBOV; family Filoviridae, genus Ebolavirus) and Lassa virus (LASV; family Arenaviridae, genus Mammarenavirus) are prominent etiologic agents of viral hemorrhagic fever diseases in humans that have variable but [...]

Crimean-Congo hemorrhagic fever virus (CCHFV), an RNA virus of the family Nairoviridae, is the most widespread tickborne virus affecting humans. It causes Crimean-Congo hemorrhagic fever (CCHF), which has a high [...]

The 2014 outbreak of Ebola virus disease in West Africa has changed our understanding of viral hemorrhagic fever epidemiology. What was previously thought to be a sporadic, localized disease is [...]

Lassa virus (LASV) is the etiologic agent of Lassa fever (LF), a viral hemorrhagic fever endemic to West Africa. Incidence of LF in areas to which it is endemic is [...]

Deep sequencing was used to discover a novel rhabdovirus (Bas-Congo virus, or BASV) associated with a 2009 outbreak of 3 human cases of acute hemorrhagic fever in Mangala village, Democratic Republic of Congo (DRC), Africa. The cases, presenting over a 3-week period, were characterized by abrupt disease onset, high fever, mucosal hemorrhage, and, in two patients, death within 3 days. BASV was detected in an acute serum sample from the lone survivor at a concentration of 1.09 × 10(6) RNA copies/mL, and 98.2% of the genome was subsequently de novo assembled from ≈ 140 million sequence reads. Phylogenetic analysis revealed that BASV is highly divergent and shares less than 34% amino acid identity with any other rhabdovirus. High convalescent neutralizing antibody titers of >1:1000 were detected in the survivor and an asymptomatic nurse directly caring for him, both of whom were health care workers, suggesting the potential for human-to-human transmission of BASV. The natural animal reservoir host or arthropod vector and precise mode of transmission for the virus remain unclear. BASV is an emerging human pathogen associated with acute hemorrhagic fever in Africa.

Presently, the Arenavirus genus (Arenaviridae family) includes 26 individual species of viruses. It is divided into two main groups – Old World arenaviruses and New World arenaviruses. The New World arenaviruses comprise four clades: А, B, C, D; pathogenic for humans New World arenaviruses are attributed to clade B. Lassa, Lujo, Machupo, Junin, Guanarito and Sabia viruses are the agents of extremely hazardous hemorrhagic fevers (Lassa hemorrhagic fever, Lujo hemorrhagic fever, Bolivian hemorrhagic fever, Argentinean hemorrhagic fever, Venezuelan hemorrhagic fever, Brazilian hemorrhagic fever, accordingly). These arenaviruses pose a potential threat to national public health due to the possibility of their accidental importation into the territory of the Russian Federation. The vaccination of risk group is the most effective and money-saving means of protection against epidemic spread. Objective of this review is to analyze the specific preparations for arenaviral hemorrhagic fever prevention that are currently under development. Production of live vaccines based on attenuated strains of the agents, the DNA vaccines, vector recombinant vaccines and vaccines on the basis of RNA-replicons is viewed as the main trends in the area. Тhe most important results in the development of effective prophylactic means against arenaviral hemorrhagic fevers are discussed in this paper.

Nosocomial transmission of Lassa virus (LASV) is reported to be low when care for the index patient includes proper barrier nursing methods. We investigated whether asymptomatic LASV infection occurred in healthcare workers who used standard barrier nursing methods during the first 15 days of caring for a patient with Lassa fever in Sweden. Of 76 persons who were defined as having been potentially exposed to LASV, 53 provided blood samples for detection of LASV IgG. These persons also responded to a detailed questionnaire to evaluate exposure to different body fluids from the index patient. LASV-specific IgG was not detected in any of the 53 persons. Five of 53 persons had not been using proper barrier nursing methods. Our results strengthen the argument for a low risk of secondary transmission of LASV in humans when standard barrier nursing methods are used and the patient has only mild symptoms.

Viral infections have become an important public health issue in South America during the past 2 decades. Outbreaks of arboviral disease, such as dengue, chikungunya, Zika, and yellow fever, have [...]

Crimean-Congo hemorrhagic fever (CCHF), caused by an orthonairovirus of the Nairoviridae family, is usually transmitted by bites of Hyalomma sp. ticks. Case-fatality rates vary from 10% to 40%. Most cases [...]

Dengue virus (DENV) is an arthropodborne flavivirus that is endemic in tropical and subtropical regions, causing hundreds of millions of infections annually (1). It is subdivided into 4 serotypes, DENV-1-4. [...]

In the 1970s, the British Royal Air Force (RAF) was tasked with developing a portable isolation facility that could retrieve patients with infectious diseases. The original Vickers Isolator was manufactured [...]

Iraq saw a significant increase in cases of Crimean-Congo haemorrhagic fever (CCHF) in the first five months of 2022. A further increase can be expected in July during the religious [...]

Background: Undifferentiated febrile illness (UFI) is one of the most common reasons for people seeking healthcare in low-income countries. While illness and death due to specific infections such as malaria are often well-quantified, others are frequently uncounted and their impact underappreciated. A number of high consequence infectious diseases, including Ebola virus, are endemic or epidemic in the Federal Republic of Sudan which has experienced at least 12 UFI outbreaks, frequently associated with haemorrhage and high case fatality rates (CFR), since 2012. One of these occurred in Darfur in 2015/2016 with 594 cases and 108 deaths (CFR 18.2%). The aetiology of these outbreaks remains unknown. Methodology/Principal findings: We report a retrospective cohort study of the 2015/2016 Darfur outbreak, using a subset of 65 of 263 outbreak samples received by the National Public Health Laboratory which met selection criteria of sufficient sample volume and epidemiological data. Clinical features included fever (95.8%), bleeding (95.7%), headache (51.6%) and arthralgia (42.2%). No epidemiological patterns indicative of person-to-person transmission or health-worker cases were reported. Samples were tested at the Public Health England Rare and Imported Pathogens Laboratory using a bespoke panel of likely pathogens including haemorrhagic fever viruses, arboviruses and Rickettsia, Leptospira and Borrelia spp. Seven (11%) were positive for Crimean-Congo haemorrhagic fever virus (CCHFV) by real-time reverse transcription PCR. The remaining samples tested negative on all assays. Conclusions/Significance: CCHFV is an important cause of fever and haemorrhage in Darfur, but not the sole major source of UFI outbreaks in Sudan. Prospective studies are needed to explore other aetiologies, including novel pathogens. The presence of CCHFV has critical infection, prevention and control as well as clinical implications for future response. Our study reinforces the need to boost surveillance, lab and investigative capacity to underpin effective response, and for local and international health security. [ABSTRACT FROM AUTHOR]

SUMMARY: Background: Spain, due to its geopolitical situation, is not exempt from the threats and challenges associated with viral infectious diseases such as the «viral hemorrhagic fevers». Implementing actions to reduce these risks with the development of an emergency treatment against these viral agents for intravenous is of great interest. Objective: Develop two formulations of Ribavirin 100 mg/ml with different excipients and manufacturing conditions to look for the most stable formulation. Material and methods: Ribavirin, various buffers and water for injections have been used. Physical alterations, richness and pH have been evaluated following specifications of European Pharmacopoeia monograp. Results: Results of pH and richness of both formulations are exposed with and without terminal sterilization. Conclusions: The results obtained meet specifications for both formulations, demonstrating chemical stability after preservation under long-term study conditions for 12 months and accelerated for 6 months. The development of injectable 100 mg/ml ribavirin (10% w/v) satisfies a therapeutic need related to the treatment of first choice in highly contagious viral diseases that lack treatments. [ABSTRACT FROM AUTHOR]

A tick-borne emerging disease In 2009, severe fever with thrombocytopenia syndrome (SFTS) virus (SFTSV) was identified as an etiological agent of severe acute febrile illness designated as SFTS in Central/East [...], Severe fever with thrombocytopenia syndrome (SFTS) is an emerging disease in China, South Korea, and Japan caused by the tick-borne SFTS virus (SFTSV). Severe and fatal SFTS presents as a hemorrhagic fever characterized by high viral load, uncontrolled inflammatory response, dysregulated adaptive immunity, coagulation abnormalities, hemorrhage, and multiorgan failure with up to 33% case fatality rates (CFRs). Despite its public health significance in Asia, vaccines and specific therapeutics against SFTS are still unavailable. A better understanding of the pathogenesis of SFTS is crucial to improving medical countermeasures against this devastating disease. In this issue of the JCI, Suzuki and colleagues analyzed histopathological samples from 22 individuals who succumbed to SFTS, and identified antibody-producing B cell-lineage plasmablasts and macrophages as principal target cells for SFTSV infection in fatal SFTS. Their results suggest that SFTSV-infected post-germinal center B cells, plasmablasts, and macrophages affect systemic immunopathology and dysregulation, which likely leads to fatal outcomes.

Crimean-Congo hemorrhagic fever virus (CCHFV) has the potential to emerge in areas where competent vectors are present and become a major risk to public health. Because of an absence of [...]

In the United States, 20-40 hantavirus cases are reported annually. Human infections result from inhalation of aerosolized secretions of infected rodents. Hantavirus pulmonary syndrome (HPS) is associated with pneumonitis and [...]

The most prevalent hantaviruses in Europe are Tula virus, Puumala virus (PUUV), and Dobrava-Belgrade virus (DOBV), all orthohantaviruses; PUUV and DOBV cause hemorrhagic fever with renal syndrome (1). Four DOBV [...]

Crimean-Congo hemorrhagic fever (CCHF) is a geographically widespread tickborne disease caused by the CCHF virus (genus Orthonairovirus, family Nairoviridae). In humans, CCHF is associated with a case-fatality rate (CFR) of [...]

Crimean-Congo hemorrhagic fever virus (CCHFV) is a vectorborne virus responsible for severe illness in humans, whereas other mammals usually act as asymptomatic reservoirs. The virus is transmitted through tick bites [...]

Severe fever with thrombocytopenia syndrome virus (SFTSV) is a tickborne virus (genus Phlebovirus, family Phenuiviridae) that can cause a mild to severe febrile illness similar to hemorrhagic fever (1). Phleboviruses [...]

Background: One of the main reasons of hemorrhagic fevers is Ebola. The high rate of mortality and lack of definite treatment have been caused this infection to be a serious problem in the world. Ebola, especially in the early stages, when causes symptoms such as fever, anorexia and nausea, can be confused with malaria infection and conversely, severe malaria with Ebola. Plasmodium falciparum is an important cause of severe malaria that more than other types of plasmodium confused with Ebola. Case presentation: The patient is a 54-year-old man who had gone to Sudan about 8 months ago. The patient reported that fever, chills and headache had been started one week before traveling from Sudan to Iran and hematuria was added to his symptoms in third week of illness in Iran. He was referred to the emergency department with probable diagnosis of Ebola. Plasmodium falciparum gametocytes were revealed in his peripheral blood smear. Finally, he was treated with Coartem (artemether/lumefantrine) for malaria and after clinical improvement discharged to home with good condition. Conclusion: Ebola should be suspected in every patient with fever and a history of traveling to endemic areas. Considering the fact that in most areas where Ebola is endemic also malaria is common, lack of clinical suspicion to malaria causes that clinicians mistake malaria with Ebola. Necessary laboratory tests to rule out important differential diagnoses in patients with suspected Ebola virus contains: Peripheral blood smear for malarial parasite and blood culture and blood cell counts to investigate typhoid fever and other bacterial infections. Therefore, malaria should be considered as an important differential diagnosis in every patient suspected with Ebola.

The status of the various recombinant DNA and RNA-derived candidate vaccines, as well as the Venezuelan equine encephalomyelitis virus (VEEV) replicon vaccine system against extremely hazardous viral hemorrhagic fevers, were reviewed. The VEEV-based replication-incompetent vectors offer attractive features in terms of safety, high expression levels of the heterologous viral antigen, tropism to dendritic cells, robust immune responses, protection efficacy, low potential for pre-existing anti-vector immunity and possibility of engineering multivalent vaccines were tested. These features of the VEEV replicon system hold much promise for the development of new generation vaccine candidates against viral hemorrhagic fevers.

Background: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral hemorrhagic fever with a high fatality rate and high frequency of person-to-person transmission and is caused by SFTSV, a tick-borne Phlebovirus. Because SFTS has similar clinical manifestations and epidemic characters (such as spatial and temporal distributions) with hemorrhagic fever with renal syndrome (HFRS) in China, we reason that SFTS patients might be misdiagnosed as HFRS. Methodology/principal findings: Acute-phase sera of 128 clinically diagnosed HFRS patients were retrospectively analyzed for Hantavirus IgM antibodies with ELISA. Hantavirus-negative patients’ sera were further analyzed for SFTSV IgM antibodies with ELISA. ELISA showed that 73 of 128 (57.0%) of clinically diagnosed HFRS patients were IgM antibody positive to Hantaviruses. Among the 55 Hantavirus-IgM negative patients, four (7.3%) were IgM antibody positive to SFTSV. The results indicated that the four SFTS patients were misdiagnosed as HFRS. The misdiagnosed SFTS patients had clinical manifestations common to HFRS and were unable to be differentiated from HFRS clinically. Conclusions: Our study showed that SFTS patients could be clinically misdiagnosed as HFRS. The misdiagnosis of SFTS as HFRS causes particular concern because it may increase the risk of death of SFTS patients and person-to-person transmission of SFTSV without proper care for and isolation of SFTS patients. [ABSTRACT FROM AUTHOR]

Arenaviruses are a significant cause of hemorrhagic fever, an often-fatal disease for which there is no approved antiviral therapy. Lassa fever in particular generates high morbidity and mortality in West Africa, where the disease is endemic, and a recent outbreak in Nigeria was larger and more geographically diverse than usual. We are developing LHF-535, a small-molecule viral entry inhibitor that targets the arenavirus envelope glycoprotein, as a therapeutic candidate for Lassa fever and other hemorrhagic fevers of arenavirus origin. Using a lentiviral pseudotype infectivity assay, we determined that LHF-535 had sub-nanomolar potency against the viral envelope glycoproteins from all Lassa virus lineages, with the exception of the glycoprotein from the LP strain from lineage I, which was 100-fold less sensitive than that of other strains. This reduced sensitivity was mediated by a unique amino acid substitution, V434I, in the transmembrane domain of the envelope glycoprotein GP2 subunit. This position corresponds to the attenuation determinant of Candid#1, a live-attenuated Junín virus vaccine strain used to prevent Argentine hemorrhagic fever. Using a virus-yield reduction assay, we determined that LHF-535 potently inhibited Junín virus, but not Candid#1, and the Candid#1 attenuation determinant, F427I, regulated this difference in sensitivity. We also demonstrated that a daily oral dose of LHF-535 at 10 mg/kg protected mice from a lethal dose of Tacaribe virus. Serial passage of Tacaribe virus in LHF-535-treated Vero cells yielded viruses that were resistant to LHF-535, and the majority of drug-resistant viruses exhibited attenuated pathogenesis. These findings provide a framework for the clinical development of LHF-535 as a broad-spectrum inhibitor of arenavirus entry and provide an important context for monitoring the emergence of drug-resistant viruses. [ABSTRACT FROM AUTHOR]

Background: A cluster of eleven patients, including eight family members and three healthcare workers with fever and thrombocytopenia occurred in Yixing County, Jiangsu Province, China, from October to November 1996. However, the initial investigation failed to identify its etiology. Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by SFTS bunyavirus (SFTSV), which was first discovered in 2009. The discovery of novel SFTSV resulted in our consideration to test SFTSV on the remaining samples of this cluster in September 2010. Methodology/Principal findings: We retrospectively analyzed the epidemiological and clinical data of this cluster. The first case, one 55-year-old man with fulminant hemorrhagic diseases, died on October 14, 1996. His younger brother (the second case) developed similar hemorrhagic diseases after nursing him and then died on November 3. From November 4 to November 15, nine other patients, including six family members and three medical staffs, developed fever and thrombocytopenia after exposure to the second case. The sera of six patients were collected on November 24, 1996. IgM antibodies against SFTSV were detected in all of the six patients’ sera using enzyme-linked immunosorbent assay (ELISA), while IgG antibodies were detected in one patient’s serum using an indirect immunofluorescence assay (IFA). We also found that IgG antibodies against SFTSV were still detected in four surviving patients’ sera 14 years after illness onset. Conclusions and significance: The mysterious pathogen of the cluster in 1996 was proved to be SFTSV on the basis of its epidemiological data, clinical data and serological results. It suggests that SFTSV has been circulating in China for more than 10 years before being identified in 2009, and SFTSV IgG antibodies can persist for up to 14 years. [ABSTRACT FROM AUTHOR]

Background: Rodents are reservoirs and hosts for several zoonotic diseases such as plague, leptospirosis, and leishmaniasis. Rapid development of industry and agriculture, as well as climate change throughout the globe, has led to change or increase in occurrence of rodent-borne diseases. Considering the distribution of rodents throughout Iran, the aim of this review is to assess the risk of rodent-borne diseases in Iran. Methodology/Principal finding: We searched Google Scholar, PubMed, Science Direct, Scientific Information Database (SID), and Magiran databases up to September 2016 to obtain articles reporting occurrence of rodent-borne diseases in Iran and extract information from them. Out of 70 known rodent-borne diseases, 34 were reported in Iran: 17 (50%) parasitic diseases, 13 (38%) bacterial diseases, and 4 (12%) viral diseases. Twenty-one out of 34 diseases were reported from both humans and rodents. Among the diseases reported in the rodents of Iran, plague, leishmaniasis, and hymenolepiasis were the most frequent. The most infected rodents were Rattus norvegicus (16 diseases), Mus musculus (14 diseases), Rattus rattus (13 diseases), Meriones persicus (7 diseases), Apodemus spp. (5 diseases), Tatera indica (4 diseases), Meriones libycus (3 diseases), Rhombomys opimus (3 diseases), Cricetulus migratorius (3 diseases), and Nesokia indica (2 diseases). Conclusions/Significance: The results of this review indicate the importance of rodent-borne diseases in Iran. Considering notable diversity of rodents and their extensive distribution throughout the country, it is crucial to pay more attention to their role in spreading infectious diseases for better control of the diseases. [ABSTRACT FROM AUTHOR]